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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]
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.
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.
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.
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]
The splint acts to immobilize flexing of the joint. Surgery generally does not improve outcomes. [2] It may be required if the finger cannot be straightened by pushing on it or the break has pulled off more than 30% of the joint surface. [2] Surgery may be preferred over the use of a splint if a child is non-compliant. [5]
Surgical treatment should also be considered when observation and/or splint therapy has not achieved sufficient results after 49 months. [9] Unlike the surgical treatment given for adults, which is unambiguously a surgical release of the A1 pulley of the thumb, the optimum surgical treatment for infants has not yet been discerned.
Radial length - It is the vertical distance in millimetres between a line tangential to the articular surface of the ulna and a tangential line drawn at the most distal point of radius (radial styloid). Shortening of radial length more than 4mm is associated with wrist pain.
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