ABSTRACT
Consideration for splinting and castings requires an evaluation of the injury’s stage and severity, the potential for instability, risk of complication, and patient’s functional requirements. In the primary care setting, splinting is usually more practical and common, and splinting is the preferred method of fracture immobilization in the acute setting.5 Splints are not
circumferential and allow for swelling of the extremity, which will minimize the risk of compartment syndrome. Proper immobilization of a fracture cannot be obtained unless the joints above and below the fracture are immobilized.7 Casts are circumferential and swelling within the cast increases pressure, potentially increasing risks of compartment syndrome and pressure sores; however, casts immobilize an extremity more completely than splints, which make them the better long-term treatment for fractures (level of evidence C, usual practice).5,6
Splinting offers many advantages, including easier application and removal and decreased pressure-related complications due to their noncircumferential property, which allows for the natural swelling that occurs with the initial inammatory phase. Splints may be static (prevent motion) or dynamic (functional; assist with controlled motion). Several types of splints are available including custom-made and “off-theshelf” splints.7 Splints are also more easily removed compared to a cast, which may be an advantage or disadvantage based on the situation. In the initial treatment of fractures, splints are used initially and then replaced by a cast for denitive treatment of unstable fractures.7
