How do you properly splint a broken leg in an emergency. What are the key steps for applying a cast or splint for a fracture. When should you seek immediate medical attention for a leg injury.

Understanding Casts and Splints for Fracture Treatment

Casts and splints play a crucial role in the treatment of broken bones and soft tissue injuries. Their primary functions are to:

• Support and protect injured bones and tissues
• Hold bones in the correct position for healing
• Reduce pain, swelling, and muscle spasms
• Provide stability following orthopedic surgeries

While both casts and splints serve similar purposes, they differ in their design and application. Splints, also known as half-casts, offer less support but can be more easily adjusted to accommodate swelling. Full casts, on the other hand, provide maximum support but are less flexible.

When are splints preferred over casts?

Splints are often the initial choice for fresh injuries due to their ability to accommodate swelling. They’re also beneficial in situations where frequent wound checks or physical therapy exercises are necessary. Your doctor will determine whether a splint or cast is most appropriate based on the nature and location of your injury.

Materials Used in Modern Casts and Splints

The evolution of medical technology has introduced various materials for cast and splint construction, each with its own advantages:

Fiberglass

Fiberglass has become increasingly popular in recent years due to its numerous benefits:

• Lighter weight compared to traditional plaster
• Greater strength and durability
• Better X-ray transparency, allowing for easier follow-up imaging
• Available in a variety of colors for patient preference

Plaster

Despite the rise of fiberglass, plaster still has its place in orthopedic care:

• More cost-effective than fiberglass
• Superior moldability for certain applications
• Preferred for some specific fracture types

Regardless of the material chosen, both fiberglass and plaster casts utilize a protective padding layer, typically made of cotton, to safeguard the skin underneath.

The Process of Applying a Cast or Splint

The application of a cast or splint is a precise medical procedure that requires skill and attention to detail. Here’s an overview of the process:

1. Assessment: The doctor evaluates the injury and determines the appropriate type of support.
2. Preparation: The injured area is cleaned and any necessary padding is applied.
3. Molding: Fiberglass or plaster strips are dipped in water and carefully molded to the shape of the injured limb.
4. Covering: The cast or splint material is wrapped around the padding, ensuring proper fit and support.
5. Drying: The material is allowed to dry and harden, forming a rigid protective shell.

In many cases, a splint may be applied initially to allow for swelling, with a full cast being applied later as the swelling subsides.

How long does it take for a cast to dry completely?

The drying time varies depending on the material used. Plaster casts typically take 24-72 hours to dry fully, while fiberglass casts may be dry to the touch within 20-30 minutes but require 24 hours to reach full strength.

Managing Swelling in the First 48-72 Hours

Swelling is a common and expected response to injury, but it can cause discomfort and pressure within a cast or splint. Managing this swelling is crucial for both comfort and proper healing. Here are some key strategies:

Elevation

Elevating the injured limb above heart level is one of the most effective ways to reduce swelling. This position allows gravity to assist in draining excess fluid away from the injury site. Aim to keep the limb elevated as much as possible, especially during the first 24-72 hours after injury or cast application.

Ice Application

Applying ice to the cast or splint can help reduce swelling and alleviate pain. However, it’s important to do this correctly to avoid damaging the cast or causing skin irritation:

• Use a plastic bag or ice pack to contain the ice
• Wrap the ice pack loosely around the cast at the level of the injury
• Avoid rigid containers that only touch the cast at one point
• Limit ice application to 15-20 minutes at a time, several times a day

Gentle Exercise

Moving the uninjured parts of your limb can help promote circulation and reduce swelling. For example, if you have a leg cast, wiggle your toes frequently. If you have an arm cast, gently flex and extend your fingers. Always follow your doctor’s specific instructions regarding movement and exercise.

Recognizing Signs of Complications

While casts and splints are designed to promote healing, they can sometimes lead to complications if not properly managed. It’s crucial to be aware of potential warning signs that may indicate a problem:

What symptoms require immediate medical attention?

• Increased pain and tightness in the cast or splint
• Numbness or tingling in the affected limb
• Burning or stinging sensations
• Excessive swelling below the cast
• Loss of active movement in toes or fingers
• Discoloration of skin visible at the edges of the cast
• Foul odor emanating from the cast

If you experience any of these symptoms, contact your healthcare provider immediately. Prompt attention can prevent serious complications and ensure proper healing.

Proper Care and Maintenance of Casts and Splints

To ensure optimal healing and prevent complications, it’s essential to properly care for your cast or splint. Here are some key guidelines to follow:

Keeping Your Cast Dry

Unless you have a waterproof cast, it’s crucial to keep your cast dry. Water can weaken the cast material and lead to skin irritation or infection. When bathing or showering:

• Use a cast cover or plastic bag to protect the cast
• Seal the edges of the cover with tape or rubber bands
• Avoid submerging the cast in water

If your cast does get wet, use a hair dryer on the cool setting to dry it as much as possible and contact your doctor for further instructions.

Avoiding Cast Irritation

Itching under a cast is common but can be managed:

• Never insert objects into the cast to scratch
• Use a hair dryer on the cool setting to blow air into the cast
• Ask your doctor about safe anti-itching remedies

Preventing Odor

To minimize unpleasant odors:

• Keep the cast clean and dry
• Use an antiperspirant spray around the edges of the cast
• Avoid using powders inside the cast, as they can cake and cause irritation

Follow-up Care and Cast Removal

Proper follow-up care is essential for ensuring optimal healing and preventing complications. Your healthcare provider will schedule regular check-ups to monitor your progress and make any necessary adjustments to your treatment plan.

What happens during follow-up appointments?

During these appointments, your doctor may:

• Take X-rays to check bone alignment and healing progress
• Examine the cast for signs of wear or damage
• Assess your comfort level and address any concerns
• Adjust or replace the cast if necessary

The Cast Removal Process

When it’s time to remove your cast, your doctor will use a special saw designed to cut through the cast material without harming your skin. The process is generally quick and painless, though you may experience some anxiety about the noise and vibration of the saw.

After cast removal, it’s normal for the affected limb to appear smaller, paler, and hairier than usual. The skin may also be dry and flaky. Your doctor will provide instructions for gradually returning to normal activities and may recommend physical therapy to regain strength and flexibility.

Rehabilitation and Recovery After Cast Removal

The journey to full recovery doesn’t end with cast removal. Proper rehabilitation is crucial for regaining strength, flexibility, and function in the affected limb. Here’s what you can expect during the rehabilitation phase:

Physical Therapy

Many patients benefit from a structured physical therapy program following cast removal. A physical therapist can guide you through exercises designed to:

• Improve range of motion
• Strengthen weakened muscles
• Enhance coordination and balance
• Prevent re-injury

Gradual Return to Activities

It’s important to follow your doctor’s guidelines for returning to normal activities. Rushing back into full activity too quickly can lead to re-injury or complications. Your return-to-activity plan may include:

• Progressive weight-bearing exercises
• Specific activity restrictions
• Use of supportive devices (e.g., crutches, canes, or braces)
• Gradual increase in activity intensity and duration

How long does full recovery typically take?

Recovery time varies greatly depending on the type and severity of the injury, as well as individual factors such as age and overall health. While some patients may regain full function within a few weeks of cast removal, others may require several months of rehabilitation. Your healthcare provider will give you a more accurate timeline based on your specific situation.

Remember, patience and consistency are key during the rehabilitation process. Following your doctor’s instructions and committing to your recovery plan will help ensure the best possible outcome and reduce the risk of future complications.

Care of Casts and Splints – OrthoInfo

Casts and splints support and protect injured bones and soft tissue. When you break a bone, your doctor will put the pieces back together in the right position. Casts and splints hold the bones in place while they heal. They also reduce pain, swelling, and muscle spasm.

In some cases, splints and casts are applied following surgery.

Splints or half-casts provide less support than casts. However, splints can be adjusted to accommodate swelling from injuries easier than enclosed casts. Your doctor will decide which type of support is best for you.

Casts are custom-made. They must fit the shape of your injured limb correctly to provide the best support. Casts can be made of plaster or fiberglass — a plastic that can be shaped.

Photos show a long-arm cast made of fiberglass with cotton lining.

Splints or half-casts can also be custom-made, especially if an exact fit is necessary. Other times, a ready-made splint will be used. These off-the-shelf splints are made in a variety of shapes and sizes and are much easier and faster to use. Some have Velcro straps which make the splints easy to put on, take off, and adjust.

To allow room for swelling, the rigid part of a splint or “half cast” (left) does not wrap all the way around the injured area. It is held in place with an elastic bandage or other material (right).

Materials

Fiberglass or plaster materials form the hard, supportive layer in splints and casts.

Fiberglass is lighter in weight and stronger than plaster. In addition, X-rays can see through fiberglass better than through plaster. This is important because your doctor will probably schedule additional X-rays after your splint or cast has been applied. X-rays can show whether the bones are healing well or have moved out of place.

Plaster is less expensive than fiberglass and shapes better than fiberglass for some uses.

Application

Both fiberglass and plaster splints and casts use padding, usually cotton, as a protective layer next to the skin. Both materials come in strips or rolls, which are dipped in water and applied over the padding covering the injured area. In some cases, special waterproof padding and cast material may be used. Your doctor will let you know if your cast is made and padded with these waterproof materials.

The splint or cast must fit the shape of the injured arm or leg correctly to provide the best possible support. Generally, the splint or cast also covers the joint above and below the broken bone.

In many cases, a splint is applied to a fresh injury first. As swelling subsides, a full cast may replace the splint. If a cast is initially applied to your injury, it may be “valved” (cut) to allow for swelling, then repaired at your first follow-up appointment.

Sometimes, it may be necessary to replace a cast as swelling goes down and the cast gets too big. As a fracture heals, the cast may be replaced by a splint to make it easier to perform physical therapy exercises.

Swelling due to your injury may cause pressure in your splint or cast for the first 48 to 72 hours. This may cause your injured arm or leg to feel snug or tight in the splint or cast. If you have a splint, your doctor will show you how to adjust it to accommodate the swelling.

It is very important to keep the swelling down. This will lessen pain and help your injury heal. To help reduce swelling:

• Elevate. It is very important to elevate your injured arm or leg for the first 24 to 72 hours. Prop your injured arm or leg up above your heart by putting it on pillows or some other support. You will have to recline if the splint or cast is on your leg. Elevation allows clear fluid and blood to drain “downhill” to your heart.
• Exercise. Move your uninjured, but swollen fingers or toes gently and often. Moving them often will prevent stiffness.
• Ice. Apply ice to the splint or cast. Place the ice in a dry plastic bag or ice pack and loosely wrap it around the splint or cast at the level of the injury. Ice that is packed in a rigid container and touches the cast at only one point will not be effective.

Apply ice to the splint or cast and elevate your leg to reduce swelling.

Swelling can create a lot of pressure under your cast. This can lead to problems. If you experience any of the following symptoms, contact your doctor’s office immediately for advice.

• Increased pain and the feeling that the splint or cast is too tight. This may be caused by swelling.
• Numbness and tingling in your hand or foot. This may be caused by too much pressure on the nerves.
• Burning and stinging. This may be caused by too much pressure on the skin.
• Excessive swelling below the cast. This may mean the cast is slowing your blood circulation.
• Loss of active movement of toes or fingers. This requires an urgent evaluation by your doctor.

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Your doctor will explain any restrictions on using your injured arm or leg while it is healing. You must follow your doctor’s instructions carefully to make sure your bone heals properly. The following information provides general guidelines only and is not a substitute for your doctor’s advice.

After you have adjusted to your splint or cast for a few days, it is important to keep it in good condition. This will help your recovery.

• Keep your splint or cast dry. Moisture weakens plaster, and damp padding next to the skin can cause irritation. Use two layers of plastic or purchase waterproof shields to keep your splint or cast dry while you shower or bathe. Even if the cast is covered, do not submerge it or hold it under running water. A small pinhole in the cast cover can cause the injury to get soaked.
• Walking casts. Do not walk on a walking cast until it is completely dry and hard. It takes about 1 hour for fiberglass, and 2 to 3 days for plaster to become hard enough to walk on. You will be given a cast shoe to wear over your walking cast. The cast shoe will help protect the bottom of the cast.
• Avoid dirt. Keep dirt, sand, and powder away from the inside of your splint or cast.
• Padding. Do not pull out the padding from your splint or cast.
• Itching. Do not stick objects such as coat hangers inside the splint or cast to scratch itching skin. Do not apply powders or deodorants to itching skin. If itching persists, contact your doctor. If something gets stuck inside your cast, it may irritate your skin, so contact your doctor. 
• Trimming. Do not break off rough edges of the cast or trim the cast before asking your doctor.
• Skin. Inspect the skin around the cast. If your skin becomes red or raw around the cast, contact your doctor.
• Inspect the cast regularly. If it becomes cracked or develops soft spots, contact your doctor’s office.

Use common sense. You have a serious injury and you must protect your cast from damage so it can protect your injury while it heals.

After the initial swelling has subsided, proper splint or cast support will usually allow you to continue your daily activities with a minimum of inconvenience.

Never remove the cast yourself. You may cut your skin or prevent proper healing of your injury.

Your doctor will use a cast saw to remove your cast. The saw vibrates but does not rotate. If the blade of the saw touches the padding inside the hard shell of the cast, the padding will vibrate with the blade and will protect your skin. Cast saws make noise and may feel hot from friction, but they will not harm you — as the saying goes, their bark is worse than their bite.

If you do feel pain while the cast is being removed, let your doctor or an assistant know, and they will be able to make adjustments.

The saw vibrates but does not rotate. Cast saws make noise but will not harm you.

Broken bones take several weeks to several months to heal. Pain usually stops long before the bone is solid enough to handle the stresses of everyday activities. You will need to wear your cast or splint until your bone is fully healed and can support itself.

While you are wearing your cast or splint, you will likely lose muscle strength in the injured area. Exercises during the healing process and after your cast is removed are important. They will help you restore normal muscle strength, joint motion, and flexibility.

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Reviewed by members of
POSNA (Pediatric Orthopaedic Society of North America)

The Pediatric Orthopaedic Society of North America (POSNA) is a group of board eligible/board certified orthopaedic surgeons who have specialized training in the care of children’s musculoskeletal health. 

Learn more about this topic at POSNA’s OrthoKids website:

Casts and Splints

Information on this topic is also available as an OrthoInfo Basics PDF Handout.

For more information:

Basics Handouts

What Are the Types of Splints, and What Are They Used for?

Written by WebMD Editorial Contributors

• What’s the Difference Between a Splint and a Cast?
• What Are Splints Used For?
• How To Take Care of a Splint
• When To Call Your Doctor
• Complications of Splints

A splint is a supportive device that protects a broken bone or injury. A splint keeps the injured part of your body still to help with pain and promote healing. Some splints are flexible and some are rigid. The type of splint you need will depend on the type of injury you have and the part of your body that is injured. 

Casts and splints are both orthopedic devices that support and protect injured ligaments, bones, tendons, and other tissues. They are both hard wraps. If you have a broken bone, a splint or cast may be used to help keep the broken ends of your bone together to help it heal. 

Casts are custom-made to fit your arm or leg. They are made of plaster or fiberglass and must be removed in your doctor’s office. A cast wraps completely around your injury. Casts are not adjustable and may have to be replaced if they get loose because the swelling goes down. Casts provide more support than a splint. 

Splints are also called half-casts. They don’t provide as much support as a cast. The hard part of a splint doesn’t wrap all the way around your injury. It’s held in place with an elastic bandage or other material. A splint may be applied first if you have a lot of swelling. Splints can be custom-made or ready-made.  

Splints are used to treat different types of injuries. Sometimes a splint is used before a cast, and sometimes a splint is used alone. Injuries that are treated with splints include: 

• Broken bones
• Sprains
• Carpal tunnel syndrome
• Dislocated bones
• Strains
• Tendon ruptures

If you have a removable splint, follow your doctor’s instructions about when you can remove it. Your doctor will also tell you if you can walk or put weight on your splint. Other general care tips include: 

• Place your arm or leg on a pillow above the level of your heart as often as you can over the next 3 days to help reduce swelling. 
• Ice the limb for 10 to 20 minutes every 1 to 2 hours for the next 3 days or until the swelling goes down.
• Don’t get your splint wet.  
• Wiggle your fingers or toes if they aren’t injured to help move the blood in your injured limb. 
• Talk to your doctor about how to maintain your muscle strength and tone while you’re in a splint. 
•  Don’t stick anything under your splint to scratch. 
• If you’re itching and can’t remove your splint, try blowing cool air under your splint from a blow dryer or fan.
• Don’t use oils or lotions near your splint.
• If your splint is irritating your skin, pad the edges with moleskin or tape. 
• If you can’t take off your splint, cover it with plastic sheeting while you take a shower. 
• If you can remove your splint to take a shower, dry your skin well before you put it back on. 

You may have to wear your splint for several days to several weeks. If you have any of the following symptoms, call your doctor: 

• Numbness, tingling, stinging, or burning on or near your injury
• Worsening pain
• Damaged, wet, or broken splint
• Drainage, pus, bleeding, or a bad smell coming from your splint
• Trouble moving your fingers or toes
• If the skin around your splint becomes discolored, pale, gray, or cold to the touch 
• Your splint feels too tight
• You develop a fever

Complications from splints can range from minor to severe, and may include: 

Bone movement. If you have a fracture that’s been set, your bones may move out of place. 

Skin irritation. You may develop pressure sores or other types of skin redness or irritation. 

Stiffness in your joint. Your joint may become stiff after being held still in a splint. 

Burns. Fiberglass and plaster splints can cause heat burns. 

Neurovascular injury. Some types of dislocations and fractures can cause damage to your nerves or arteries when they are repaired.

Compartment syndrome. This is a rare but serious complication that occurs more often with casts than splints. It happens when the pressure in your muscles builds up to a dangerous level. This can interfere with the flow of blood to your muscles and nerves. Compartment syndrome can cause serious injury or death. Symptoms include: 

• Numbness
• Muscle pain that’s worse than you’d expect from your injury
• Severe pain when you stretch your muscle
• Swelling of the muscle
• A feeling of fullness of the muscle
• Muscle tightness
• Burning or tingling sensation in your skin

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Application of transport splints for fractures – articles Medex-Inter

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07/10/2020

Fractures and significant soft tissue injuries are conditions that require emergency medical care. The success of their treatment largely depends on the technique of transporting the patient to a medical facility. Normal conditions for the victim are created by transport immobilization.

The application of transport tires helps:

• provide complete rest for the damaged area;
• reduce pain in injuries of various origins;
• prevent further tissue damage from bone fragments;
• to reduce the risk of a life-threatening condition – traumatic shock.

In contrast to therapeutic immobilization, competent application of transport splints for fractures and severe bruises involves only temporary immobility, which is necessary for safe and emergency transportation of the patient.

Types of immobilization

Depending on the method of fixing the damaged part of the body, there are three algorithms for applying transport splints:

• Autoimmobilization involves fixing the injured area to a healthy one. For example, when a hand is broken, it is fixed in a fixed position with a scarf or bandaged to the body. In case of damage to one leg, it is fixed to the other – healthy.
• Application of a transport splint for bone fractures and soft tissue injuries using improvised means. In the field, tree branches, boards, skis, etc. can be used.
• Immobilization with standard splints. These can be fixation and distraction splints. The former provide immobility of the affected part of the body, the latter – immobility and traction.

Plywood, pneumatic, mesh splints and the so-called Cramer’s ladder splint are used to fix the damaged area in a fixed state in terms of shape, materials and methods of application.

How to properly immobilize

The basic rules for applying transport tires ensure the safe delivery of the victim to a medical facility. In order not to harm the patient and not aggravate his condition, it is necessary: ​​

• cut clothing on the injured area, examine it carefully;
• in the presence of bleeding, stop it, treat the wound, apply an aseptic dressing, inject an anesthetic;
• fix the limb in the most convenient anatomical position;
• if the fracture is closed, follow the sequence of applying the transport splint, carefully pulling the limb along the axis;
• in addition to the damaged area, fix two adjacent joints located above and below the injured area;
• in case of a fracture of the hip or shoulder, fix three joints at once;
• when transferring a patient to a stretcher, support the injured part of the body.

All manipulations must be carried out directly at the scene. You should be extremely careful not to try to move a person, take off his clothes or shoes.

Do’s and Don’ts while immobilized

Rules for applying transport splints for fractures, bruises and other injuries exclude:

• the use of rigid fixing elements without cotton and gauze, which are preliminarily wrapped around the injured area;
• the use of overlays that are too short, not capable of completely immobilizing the limb;
• weak winding of the bandage, which will not be able to properly hold the arm or leg of the victim;
• bandage covering a hemostatic tourniquet applied in the presence of open bleeding.

If the accident occurs outdoors in winter, the affected area should be insulated as much as possible to avoid frostbite.

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How to make a splint in Stranded Deep

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Contents

In the survival game Stranded Deep, players must learn to recover from a variety of status effects, including how to deal with sunstroke, how to heal poison, and how to heal broken bones. For broken limbs, players will need to craft a splint that can force them to scour the island in a weakened state.

To survive in Stranded Deep, players will need to collect resources, build shelters, and hunt or fish for food. While traveling through the islands, it is possible that players will fall from a great height and break their leg.

A broken leg can annoy even players who think they know how to survive on Stranded Deep. This status effect prevents the character from fleeing, reduces walking and swimming speed, and causes additional health loss when jumping. In addition, broken bones cause permanent loss of health, hunger and thirst until they are cured. Players will know they have a broken bone because their character will be limping and looking down will reveal a very unhealthy left leg.

Luckily, a broken leg can be repaired by making and fitting a splint. To do this, players will need to find two wooden sticks and two whips. Sticks can be obtained from wooden logs, fin piles, and ficuses. If the player does not have a cutting tool, sticks can also be found on the island. Players must craft lashes, which require eight Fibrous Leaves.

When the player has the necessary tire components, they must press the “C” key to access the crafting menu. On the crafting screen, the player will need to click on “Consumables” located at the top of the menu, which opens a list of consumables that the player can potentially craft. Players may need to scroll down to find “Tire”. Players must hover over the tire, which will display the requirements and the amount of each that the character possesses, and left-click. This will place the tire in the character’s hand; at this point, players must left-click again to use the item.

Before Stranded Deep characters can heal, the game requires players to remove any negative status effects. Now that the player has splinted their broken bone, they should see a gradual increase in their character’s health.

Some players may notice that their character does not heal even after being splinted.