Case 3
A 21 year old male is brought into the ED by the police. It seems that he had been fighting outside a bar. The man is very uncooperative with your history. He doesn't want to talk about what happened. He does tell you that his right hand hurts. He points to his fourth and fifth fingers of this right hand.
Physical exam shows moderate swelling over the dorsal ulnar surface of the hand, especially over the 4th and 5th metacarpals of the R. Hand. Sensation is intact as well as vascular supply to all the digits.
Patient has severely decreased range of motion of the 4th and 5th digits secondary to pain and swelling
Xray shows fracture of the 5th metacarpal neck. Angluation of fracture is less than 20 degrees
You speak with you attending who says that if the angulation of the fracture is low that the patient will be okay with just a splint until he can see the orthopedist tomorrow.
What type of splint can you use?
show answer
- You would use an Ulnar Gutter Splint
- Short Arm Gutter Splint (Ulnar or Radial)
- Ulnar
- Location
- Extends along ulnar surface just proximal to tip of 5th digit extending high to forearm. Should cover 4th and 5th fingers
- Position hand with MCP joint flexed and at the wrist in 15 degrees of dorsiflexion
- Uses
- Fractures of the proximal phalynx of the ring or little finger
- Boxer's fracture - fourth or fifth metacarpal
- Radial Gutter Splint
- Location
- Extends along radial surface with hole for thumb extending high to forearm.
- Uses
- Index or third finger fracture
Picture of Splint
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