USE OF SPLINTS AND BRACES
The splints and braces support and protect the bones and soft tissues after injury. When a bone is fractured the Orthopedist tries to realign the fractured bones – and maintain them in the correct anatomical position, so as to heal properly. The splints and braces hold the bones in place during this period, while at the same time, due to immobility, they reduce pain, edema and muscle spasms.
In many cases, the splint is applied after surgery.
Simple splints provide less support than circular plaster or plaster splints. However, simple splints are made of easily yielding materials that allow the limb to “swell” without causing problems to the patient (finger swelling, hyposensitivity to the limb). In any case, the orthopedist will decide what kind of support is best for the patient.
SPLINTS AND BRACES
The circular plaster-splint is custom-made. It should fit the shape of the patient’s limb in order to provide better support. It is made of plaster (Plaster of Paris) or special resin (fiberglass) that is properly formed.
Braces can be manufactured on a case-by-case basis, especially when absolute adjustment is required, while other times commercial ready-made braces can be used. They are available in a variety of sizes and shapes, while Velcro adhesive straps are used for easier mounting and removal.
The hard supporting part of the splint is made of fiberglass resin or plaster.
Fiberglass is lighter and stronger than plaster. In addition, X-rays better penetrate the resin in case of radiological examination. On the other hand, the plaster reduces costs and is sometimes more flexible for specific uses.
In both cases, resin or plaster is used as a protective layer for the skin. Both materials come in films of various sizes that are wetted before use (submerged in water) and are applied over the lining on the injured area.
The splint or circular plaster should fit properly on the upper or lower extremities to provide the best possible support for the broken bone.
In many cases, a splint is initially applied to prevent compression of the injured area due to edema and after a few days it is replaced by a splint-plaster. Also, because of the initial edema recession, it is sometimes necessary to change the plaster and place a new one that is better applied.
ADAPTATION TO THE SPLINT OR PLASTER
Edema due to injury can cause pressure on the splint or plaster for the first 48 to 72 hours and thus on the patient’s extremity. In the case of a removable or functional splint, the doctor shall teach the patient how to adjust it better.
It is very important for the patient to control the edema, which will reduce the pain and promote the healing of the fracture. To reduce the patient’s chance of edema (swelling):
- Lifting the leg. It is very important for the patient to raise the injured limb (arm or leg) for the first 48 to 72 hours above the level of the heart using pillows or other support. This requires bedding if it is a foot. In this way the patient takes advantage of the hydrostatic pressure, allowing the fluid (extravascular and extracellular) to return from the periphery to the center.
- Gentle and frequent toe movements prevent post-traumatic stiffness due to immobilization.
- Ice therapy. Applying ice to the splint or plaster helps to relieve the patient and prevents swelling.
Edema can create a lot of pressure under the splint and can lead to serious problems. If the patient feels any of the following symptoms, they should contact the treating physician immediately for advice.
- Increased pain and feeling that the splint is too tight due to edema.
- Numbness and tingling (hyposensitivity and paraesthesia) of the limb due to excessive pressure on the nerves.
- Burning and stinging sensation due to excessive pressure of the material on the skin.
- Excessive edema peripherally to the splint, which may mean that normal blood flow is obstructed.
- Inability to move fingers or toes, which requires immediate medical evaluation.
TAKING CARE OF THE SPLINT OR PLASTER
The doctor will explain to the patient all the limitations caused by the use of the splint or plaster. He should at the same time give all instructions needed to avoid any complications during fracture healing.
The following information provides general guidance and is in no way a substitute for the physician’s instructions to the patient.
After the first few days and after the patient adjusts to the new condition, they should keep the splint or plaster in good condition. This will help in the healing process:
- The splint should be kept dry. Moisture weakens the plaster and can at the same time cause skin irritation. Using two layers of plastic or waterproof material can keep the splint or plaster dry during showering or baths.
- Walking splints (splints that we are allowed to be charged with weight). It is advisable for the patient not to charge the splint until it is completely dry and hard. It takes about an hour for fiberglass, and two to three days for plaster.
- The splint should be kept clean. Sand, dust and dirt in general should stay away from the interior of the splint.
- It is advisable that the patient does not pull the lining
- Items such as hangers and keys inside the splint do not help. In addition, it is advisable to avoid deodorants and powders. If the itching persists, the doctor should be informed.
- The patient should not cut or trim the edges of the splint or plaster that may protrude before asking the doctor.
- Regular inspection of the skin around the splint. In the case of redness, it is advisable for the patient to contact the physician.
- Regular inspection of the splint itself for soft spots or cracks. In this case the doctor should be informed.
In conclusion, the patient should use common sense. The splint, despite its difficulties in daily activities, protects and promotes soft tissue healing and fracture healing. The splint is removed as early as possible, and if possible, a functional splint is used, which is more easily tolerated by the patient.
REMOVING THE SPLINT OR PLASTER
The patient should never remove the splint or plaster alone. He can injure itself and prevent the fracture from healing.
The doctor uses a special pulse saw to remove the plaster. The saw vibrates, but does not rotate. If the blade touches the lining, it does not go further and thus protects the skin. These saws can make noise and raise the temperature, but are absolutely harmless to the patient. However, if the patient feels pain during the removal process, he or she must inform the physician.
TREATMENT – REHABILITATION
The bones may require several weeks to months to “heal” after a fracture. The pain usually subsides early, long before the fracture is healed. The splint or plaster should be used until the fracture is fully healed and the patient can support himself/herself.
During the use of the splint, the patient loses the muscle strength of the limb. For this reason it is important for the patient to follow a muscle-strengthening program after removing the splint to help restore muscle strength and range of motion.