SPLINTING: TYPES, USES, BENEFITS, AND MORE

Splinting is a common technique used in the medical field to support and guard injured or strained body parts. It involves using a rigid or semi-rigid splint device to immobilize and stabilize the injured area.

Practitioners use splints for immobilization, pain relief, support, and even deformity correction. They consist of various materials, each with benefits and uses. Splinting is commonly used in orthopedics, sports medicine, neurology, and rehabilitation to treat various conditions and injuries.

This article reviews the different types of splints, their uses, benefits, and the latest breakthroughs in splinting technology.

Splints vs Casts: Where Splinting Excels

Splints are versatile orthopedic devices that differ from casts. While casts are rigid and encase a limb completely, splints allow for adjustability and limited mobility.^[1]

Medical professionals use splints for injuries that require less support and immobilization. A splint's partial immobilization and shielding prevents further damage and allows the injured area to heal adequately. By stabilizing the wounded area, splinting reduces swelling, pain, and discomfort, promoting a more comfortable healing process.

Unlike casts, they can act as corrective physical devices that help the body to form proper posture or positioning. They can be easily adjusted and removed for cleaning and physical therapy.

It supports muscles during rehabilitation, allowing for controlled movement and facilitating rehabilitation exercises. This controlled movement helps to increase the range of motion and flexibility in the affected body part.

Some of the most common splint materials include^[2]:

• Plaster: Plaster splints are made by soaking plaster strips in water and then molding them to the injured body part. They are solid and stable but can be heavy and less comfortable for the patient.
• Fiberglass: Fiberglass splints are made by wrapping layers of fiberglass around the injured body part and then hardening it with water. These splints are weightless and durable yet can be more costly than plaster splints.
• Thermoplastic^[3]: Thermoplastic splints are made by heating a plastic sheet and then molding it to the injured body part. They are lightweight, durable, and easily adjusted to fit the individual's body.

Compared to casts, splints or half-casts offer less support. However, compared to enclosed casts, splints are easier to modify according to the swelling following injuries. The kind of support you need will be determined by your physician. ^[4]

Buckles, straps, and ties connect more stable parts of a splint. Sometimes, sleeves can be taken on and off as required.

Types of Splints

There are several splints designed for a specific purpose and body part. Some of the most common types of splints include:

• Static splints: These are rigid devices made of materials like plaster, fiberglass, or thermoplastic that immobilize and support injured body parts. They are often customized to treat fractures, sprains, and other musculoskeletal injuries.
• Static progressive splints: Similar to static splints, these allow for gradual adjustments over time. They treat conditions like contractures, where tight muscles and tendons restrict movement.
• Dynamic splints: These provide continuous passive motion to injured body parts. A spring or elastic band applies a subtle force to the affected limb, promoting movement. These splints can assist physical rehabilitation in those with neurological conditions.
• Serial static splints: Combination of static and dynamic splints used to increase the range of motion over time, often for joint stiffness and contractures.

Uses of Splints

Splints have many uses across several medical fields, as explored below.

Dental Applications

Splints are used in dentistry to provide relief for ailments such as temporomandibular joint (TMJ) disorders, bruxism (teeth grinding), and malocclusion (misaligned bite). TMJ splint therapy can help promote proper alignment that lowers TMJ pain.

Dental splints are custom-made to fit the individual's teeth. They are used to:

• Reposition the jaw
• Reduce pain
• Protect the teeth from further damage

Splint Occupational Therapy

Splints in occupational therapy can assist with rehabilitating and treating various musculoskeletal conditions and those with other disorders.

Occupational therapists use splints to support and immobilize injured or weak body parts, promote proper alignment, and facilitate functional movement.

Here are some ways splints can benefit patients in occupational therapy:

1. Hand and Wrist Splints: Occupational therapists use these splints for carpal tunnel syndrome, tendonitis, arthritis, and fractures. They provide support, reduce pain, and promote proper alignment.
2. Thumb Splints: Used for thumb sprains, De Quervain's tenosynovitis, and arthritis. They immobilize the thumb, reduce pain, and promote healing.
3. Elbow Splints: Used for tennis elbow, golfer's elbow, and fractures. They provide support, reduce pain, and align the elbow.
4. Knee and Leg Splints: Used to support and stabilize the leg or knee after injuries or surgeries. They reduce pain and swelling and promote healing.
5. Ankle-Foot Orthosis Splints: Splints that support and control ankle and foot movement. Uses include foot drop, ankle instability, and gait abnormalities.

Splints can help reduce pain, minimize swelling, and prevent further injury while tissues heal.

Neurological Conditions

Splints occasionally treat those requiring rehabilitation or recovery from neurological injury, such as stroke, cerebral palsy, and multiple sclerosis. Patients with these conditions battle to move and position their bodies optimally.

In these situations, splints may promote movement, prevent muscle stiffness, improve comfort, and maintain proper alignment of the affected body parts. More research is required on the extent to which splinting can help patients with these conditions.^[5]

Splinting may shield the sensitive area in patients with neuropathic pain, helping to restore functionality and comfort.

It is essential to consult with a specialist about your or your loved one’s condition before deciding if a splint is the right course of action.

Spinal Splints

Spinal splints can immobilize and support the spine during recovery from injuries or surgeries. They help to stabilize the spine and prevent further damage.^[6]

From stabilizing the neck after whiplash to providing post-surgical support for the spine, splints come in various forms, like cervical collars and back braces. These can also help manage conditions like lumbar sprains and disc herniation and even provide postural correction.

Splinting for Burns

Splinting can aid in treating burns^[7], especially for burns that affect the joints or areas where movement needs to be restricted.

Regarding burns, it is essential to consult a healthcare provider for an accurate inspection and advice on the appropriate treatment plan, including splints.

The Splinting Process

When applying a splint, it is essential to follow these steps to ensure proper fit and comfort^[8]:

1. Assessment: The first step in the splinting process is to have a healthcare professional assess the injury or condition. A skilled physician can determine the most effective splint type and assist with the rest of the process.
2. Preparation: The injured body part is cleaned and prepared for splinting.
3. Application: The splint is applied to the injured body and molded to fit the individual's body.
4. Adjustment: If necessary, the splint is adjusted to ensure a correct fit and provide the desired degree of support.
5. Follow-up: A professional monitors the patient’s condition; if required, the splint gets adjusted or replaced to ensure proper healing.

Benefits of Splinting

Compared to splints, a cast is heavier, less hygienic, and can restrict blood flow to an area. Lack of circulation can lead to neurological complications, promote muscle atrophy, increase physical discomfort, and slow healing.

Splints offer solutions to these problems. The benefits include:

• Gentler immobilization and support of injured body parts
• Quicker healing and recovery
• Lighter and less complicated to carry
• Not susceptible to neurovascular complications
• A high degree of adjustability and versatility
• More freedom of movement
• Allows for daily cleaning
• Improved breathability
• Reduced pain and discomfort
• Cost-effective compared to a cast, surgery, or hospitalization
• Facilitates physiotherapy, physical recovery, and rehabilitation

One of the most significant benefits of splinting is that it can be combined with other treatment modalities like physical therapy and pain management for optimal healing.

Splinting Drawbacks

While splinting offers many benefits, there are also some disadvantages^[9]. Many of these are similar to those of wearing a cast, yet to a lesser extent.

The drawbacks of splinting include:

• Limited mobility and inconvenience for the patient
• Risk of skin irritation or pressure sores
• Potential for incorrect application or fit, leading to further injury
• Need for frequent adjustments and replacements
• It may not be as protective as a cast
• Regular cleaning and proper drying techniques are essential.

Feeling restricted and dependent on a splint can also take a psychological toll on some individuals, especially with long-term use.

Splints may mask underlying complications of fractures, making timely diagnosis crucial. Regular checkups with your doctor are paramount. Additionally, not all injuries are suitable for splint treatment. Severe fractures, unstable joints, and certain conditions might require casts or other interventions.

Complications

Many complications occur due to improper splint use or a lack of awareness. Complications can include:

• Improper Fitting: A poorly fitted splint can worsen the injury by causing pressure sores, misalignment, or even nerve damage. Ensure proper application and adjustments if needed.
• Delayed Diagnosis: A splint can mask symptoms and delay a proper diagnosis of underlying issues. Open communication with your doctor is essential.
• Compartment Syndrome: This rare but serious complication involves tissue swelling within a confined space, leading to severe pain and nerve damage. Request immediate medical attention if you experience sudden, intense pain under the splint.^[10]

Self-treating with splints is not recommended. Always consult a qualified healthcare professional for evaluation and proper application.

When to See a doctor?

The moment you contract an injury or are living with chronic pain, you should consult with a doctor. During the recovery process, regular checkups can guide the process.

Seek immediate medical attention if the splint feels too tight or becomes painful. Any damage or visible deterioration of the splint warrants a professional evaluation.

Living With a Splint

While splints can improve comfort and recovery, they are not without challenges. Living with splints requires patience and continuous care. Some tips to enhance the experience include:

• Use gentle cleansers
• Dry under the edges thoroughly
• Wear comfortable clothing to sidestep friction and irritation
• Try to use the splint as a reminder not to move the wounded area too much outside of physical therapy
• Rest the area when possible unless your doctor specifies otherwise

Above all, follow your doctor's instructions and attend all follow-up appointments to ensure safe and effective healing. Do not hesitate to talk to your doctor about discomfort, itching, or skin concerns.

Latest Breakthroughs in Splinting

Advancements in splinting have enabled better-fitting splints that precisely contour the body. This precision alleviates pressure, improves comfort, and enhances safety and support.

One of the most notable breakthroughs is the use of 3D printing to create custom splints for patients rapidly. 3D printing permits more accurate splint personalization, reducing the risk of incorrect fit and improving patient comfort.

Another breakthrough is the implementation of smart materials in splinting. These materials can change shape in response to temperature, allowing for more comfortable and effective splints.

The future of splint technology is looking at biodegradable splints with improved durability, strength, and support.^[11]

Conclusion

The next time you encounter a splint, remember that its role extends beyond a simple cast. Splinting is a versatile and effective technique used in the treatment of a variety of conditions and injuries. With reputable materials and methods, splinting can provide support, promote healing, and improve the quality of life for patients. As technology refines, we can anticipate more breakthroughs in the splinting world, making it an even more valuable tool in the medical field.

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