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Long Leg Splint

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Edited by Grace Xiong, Harry Lightsey, Brendan Striano - 7/1/2021

Indications/Contraindications

Indications:

Tibia fractures of any kind (shaft, plateau), distal femur fractures if patient not tolerating knee immobilizers, post-knee reductions

Materials/positioning

Materials:

  • 4” plaster, 8 rolls
  • 4” ACE wraps, 6 rolls
  • 4” Webril, 10 rolls
  • Tape
  • 4 Kerlix rolls if doing hammock (see below)

splint-longleg_supplies

Positioning:

Supine in stretcher, with either an assistant holding the knee OR have the patient grip their thigh.

Alternatively, may splint the patient with use of a "hammock" sling which allows splinting alone. Technique adapted from Watkins C, Todd D, Jamieson S, Mansour A. Leg hammock for closed reduction of tibial shaft fractures. Orthopedics. 2015 Feb;38(2):113-6. doi: 10.3928/01477447-20150204-03. PMID: 25665109.

splint-longleg_initial

splint-longleg_elevated1

Technique

Measure out splint:

On the uninjured side, measure the length of the splint using plaster.

Two components:

Posterior slab: Measure from upper thigh to just past the toes.
U slab, better done as two "J" slabs: Measure around the lower leg to the upper thigh

splint-longleg_rolledout

Splint preparation:

10-12 layers of plaster and 5 layers of webril

Splint application

Place posterior slab first and tack down with webril. Leave a small "window" anteriorly if skin checks and compartment checks are needed.

Hammock technique illustration:

splint-longleg_wrapping

Wrap with ace wraps:

splint-longleg_plaster1

Molding

Usually no molding as these are often operative injuries.

Remove hammock

Cut down Kerlix hammock and gently pull out from under splint.

splint-longleg_cutkerlix

Pearls & Pitfalls

Potential complications: None usually

Tips for efficiency: Have all supplies ready at the start.

References

Hammock technique adapted from: Watkins C, Todd D, Jamieson S, Mansour A. Leg hammock for closed reduction of tibial shaft fractures. Orthopedics. 2015 Feb;38(2):113-6. doi: 10.3928/01477447-20150204-03. PMID: 25665109.