injuries poisoning
How To Apply a Thumb Spica Splint
Step by Step Description of Procedure
Wear nonsterile gloves. Apply stockinette to cover the thumb. Cut a hole in the second stockinette to allow for protrusion of the thumb. Apply second stockinette to cover the area from the MCP joints to the mid-forearm Wrap the padding from the MCP joint to the mid-forearm slightly beyond the area to be covered by the splint material; overlap each turn by half the width of the padding and periodically tear the wrapping across its width to decrease the risk of tissue compression Wrap the padding around the thumb. Smooth the padding as necessary. Ensure there are no folds in the padding. Tear away any excess padding to prevent areas of localized pressure on the skin. Lay out a length of splint material matching the distance from just past the DIP joint of the thumb to the mid-forearm. Unroll additional splint material, folding it back and forth along the first length until there are 6 to 8 layers (when using single-layer rolls). Alternatively, if using ready-made splint material, cut a single piece to the above length. Immerse the splinting material in lukewarm water. Squeeze excess water from the splinting material (do not wring out plaster). Apply the splint material around the thumb and radial side of the forearm. Fold the extra stockinette and cotton padding to cover all edges of the splinting material. Wrap the elastic wrap over the splinting material distally to proximally and overlap each revolution by half the width of the elastic wrap. Smooth out the splinting material using your palms rather than your fingertips to conform to the contour of the arm to fill in the interstices in the material. Maintain the thumb in a slightly flexed and abducted position and the hand and wrist in a position as if holding a narrow cup or the stem of a wine glass until the splinting material hardens (see figure Thumb spica splint ). Check the distal neurovascular status (eg, capillary refill, distal sensation, finger flexion and extension). 