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A spica splint is a type of orthopedic splint used to immobilize the thumb and/or wrist while allowing the other digits freedom to move. It is used to provide support for thumb injuries (ligament instability, sprain or muscle strain), gamekeeper's thumb, osteoarthritis, de Quervain's syndrome or fractures of the scaphoid, lunate, or first metacarpal. [1]
Most gamekeeper's thumb injuries are treated by simply immobilizing the joint in a thumb spica splint or a modified wrist splint and allowing the ligament to heal. However, near total or total tears of the UCL may require surgery to achieve a satisfactory repair, especially if accompanied by a Stener lesion.
A post-operative photo of repair of a complete rupture of the ulnar collateral ligament. Note the K-wire to brace the joint. The ulnar collateral ligament is an important stabilizer of the thumb. Thumb instability resulting from disruption of the UCL profoundly impairs the overall function of the involved hand.
A hip spica cast, by contrast, is used to immobilize the trunk and one or more legs. Variants include the single hip spica, which covers the trunk and one leg down to the ankle or foot; the double hip spica, which covers the trunk and both legs; and the one-and-a-half hip spica, which encases one leg fully and the other only to above the knee.
Therefore, people with tenderness over the scaphoid (those who exhibit pain to pressure in the anatomic snuff box) are often splinted in a thumb spica for 7–10 days at which point a second set of X-rays is taken. [7] If a minimally displaced fracture was present initially, healing will now be apparent. Even then a fracture may not be apparent.
Nasal splint [4] Posterior lower leg; Posterior full leg; Posterior elbow; Sugar tong – Used for the forearm or wrist. They are named "sugar-tong" due to their long, U-shaped characteristics, similar to a type of utensil used to pick up sugar cubes. [5] Thumb spica – Used for the thumb. [6] Ulnar gutter – Used for the forearm to the palm. [7]
In such cases, closed reduction followed by immobilization in a thumb spica cast and serial radiography may be all that is required for effective treatment. [ 5 ] For Bennett fractures where there is between 1 mm and 3 mm of displacement at the trapeziometacarpal joint, closed reduction and percutaneous pin fixation (CRPP) with Kirschner wires ...
The splint should be worn at all times. [2] The skin under the splint should be carefully observed during the duration of its use. This is done to monitor for possible skin damage or allergy to splinting materials. [21] When removing the splint to assess the skin underneath, it is important that the finger remains in the splinted position. [3]
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