Fracture Management: Basic Principles, Immobilization, and Splinting

Abstract

Fracture immobilization in the acute orthopedic trauma patient is necessary for fracture reduction, joint stability, and pain control and to prevent soft tissue injury. However, precise splinting is achieved through much experience and repetition with focus on soft tissue protection and proper final positioning. This instructional chapter will address basic fracture principles, reduction and splinting principles, techniques for common upper and lower extremity splints, and complications related to incorrect splinting.

In acute trauma patient care, fractures can be categorized as displaced or nondisplaced. For this chapter and review of splinting techniques, reduction maneuvers will not be discussed in detail. Assumption that a joint dislocation is reduced will be made. An orthopedic team is available at all trauma centers and responsible for fracture/dislocation management. However, placement of a temporizing splint by another provider may be necessary until the patient stabilizes or the team is available. Principles, purpose, and techniques will be given, as well as clinical pearls for complications of what can be overlooked as a simple and benign intervention.