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American Academy of Pediatrics National Conference and Exhibition
October 11, 2014
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Improperly placed splints caused skin injuries, poor healing

SAN DIEGO — Splints placed incorrectly after a visit to the ED can lead to swelling, skin irritation and poor healing, according to findings presented at the 2014 AAP National Conference and Exhibition.

“Splints are effective for immobilization of fractured extremities in children and adolescents when placed appropriately,” researcher Joshua M. Abzug, MD, FAAP, director of pediatrics orthopedics at the University of Maryland Medical Center and assistant professor of orthopedics at the University of Maryland School of Medicine, said in a press release. “Unfortunately, many practitioners in pediatric emergency departments and urgent care centers incorrectly apply splints, potentially causing injury.”

Joshua M. Azbug

Joshua M. Abzug

Abzug and colleagues evaluated 225 children (mean age, 8 years) who visited an orthopedic clinic for evaluation and to determine complications created by an improperly placed splint on presentation.

Ninety-three percent of splints were placed improperly, and 56% of those had improper joint immobilization. Half of the splints were an inappropriate length, and 78% had the elastic bandage applied directly to the skin.

Forty-one percent of patients had splint-related soft-tissue complications after splint removal. Thirty percent of patients had excessive edema, 19% had pressure points observed on the skin and 2% had pressure points overlying bony prominences. In 6% of cases, patients had direct injury to the skin or soft tissue caused by the splint.

“Increased education regarding the specific techniques involved in the placement of splints as well as awareness of the possible injuries associated with improper application may be beneficial to members of the primary treatment team,” Abzug said. “Furthermore, special care must be given to infants and noncommunicative patients in splints who cannot effectively convey pain or discomfort.”

 

For more information:

Abzug JM. Abstract #27212. Presented at: AAP National Conference and Exhibition; Oct. 11-14, 2014; San Diego.

 

Disclosure: Infectious Diseases in Children was unable to confirm financial disclosures at this time.