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Thumb spica splint

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

Indications/Contraindications

Indications:

Thumb fractures

Materials/positioning

Materials:

  • 4” plaster, 3 rolls
  • 4” ACE wraps, 4 rolls
  • 4” Webril, 2 rolls; 2” Webril, 2 rolls (optional)
  • Tape

splint-thumbspica_materials

Positioning:

Usually in a stretcher with the patient sitting upright

Technique

Measure out splint:

On the uninjured side, measure the length of the splint using plaster from just distal to the tip of the thumb proximally to the mid forearm

Splint preparation:

  • 10-12 layers of plaster and 5 layers of webril
  • Cut the splint longitudinally along the midline to the approximate length of the fingers

splint-thumbspica_webril

Splint application

  • Support the forearm and hand
  • Place the distal extent of the splint first such that it extends slightly past the tip of the thumb and position the remainder of the splint along the radial aspect of the hand and forearm

splint-thumbspica_webril2

Apply ACE wrap circumferentially around the thumb and encircling the hand and forearm to secure the radial sided splint

splint-thumbspica_complete+ACE

Pearls & Pitfalls

Potential complications:

Avoid extremes of thumb CMC range of motion, try to splint in neutral with a thumb in the plane of the hand

Tips for efficiency:

Using a smaller ACE wrap for encircling the thumb may be helpful