A–1 DISTAL PHALANX SPLINTS
Dorsal Distal Phalanx Splints
Dorsal and volar splints are very useful in treating avulsion fractures of the distal phalanx as discussed in the text. Our preference is the dorsal splint, which provides more support because there is less "padding" on the dorsal aspect of the finger. The splint is in closer contact with the bone. When using these splints, do not hyperextend the distal interphalangeal joint as was previously recommended in older texts. Full extension is the position of choice when applying the splint.
This splint is made from a thin metal strip. It provides protection for distal phalangeal fractures resulting from external injury. This splint provides no structural support.
Dorsal and Volar Finger Splints
These splints are fashioned from commercially available metallic splints that have sponge rubber padding on one side. The splint is cut to the proper size and shaped as desired.
The splints should be applied with the metacarpophalangeal joint at 50 degrees of flexion and the interphalangeal joints flexed approximately 15 to 20 degrees.
The injured finger is splinted to the adjacent normal finger. This provides support of the injured digit while permitting motion of the metacarpophalangeal joint and some motion at the interphalangeal joint. This type of splinting is used commonly in sprains of the collateral ligaments of the interphalangeal joints and other injuries discussed in the text. A piece of cast padding cut to proper size is inserted between the fingers and the two digits are taped together.
Gutter splints are used for the treatment of phalanx and metacarpal fractures. Fractures of the ring and little finger are immobilized in an ulnar gutter splint. The MCP joint should be flexed 50 to 90 degrees, and the PIP and DIP joints are extended. Remember to place a piece of padding between the fourth and fifth digits.
Radial gutter splints are used to treat fractures of the index and long fingers. A hole is cut out so that the thumb is free to move normally. Padding is placed between the second and third digits. The position of immobilization of the digits is the same as the ulnar gutter splint (Video A–3A).
A–3 GUTTER SPLINTS (PLASTER APPLICATION)