Background

Posterior long arm splinting is used in the management of multiple upper-extremity injuries. Splints stabilize injuries by decreasing movement and providing support, thus preventing further damage. Splinting also alleviates extremity pain and edema and promotes soft-tissue and bone healing. Splints can be used either for immobilizing an extremity before surgical treatment or as a temporizing measure before orthopedic consultation.

Unlike casts, which are circumferential, splints are often the treatment of choice in the emergency department (ED) because they allow for swelling that may be present at the site of injury and thereby decrease the risk of compartment syndrome. After a splint is placed, follow-up for definitive care with an orthopedist should occur within 1-5 days.^[1]

Indications

Upper-extremity injuries for which posterior long arm splinting is indicated include the following^[1] :

• Distal humerus fractures^{[2, 3]}
• Proximal forearm fractures
• Radial head and neck fractures
• Olecranon fractures
• Severe ligamentous injuries of the elbow

Contraindications

There are no absolute contraindications for posterior long arm splinting. However, there are certain injuries that, though not constituting actual contraindications, call for immediate evaluation or intervention by a consultant. Patients with the following injuries should not undergo splinting and should be discharged home for follow-up:

• Multiple or complicated fractures
• Open fractures
• Injuries associated with neurovascular compromise