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1Principles

General considerations

Long leg splintage is a useful technique for temporary immobilization of a fracture involving the distal femur. It can be used in the emergency room to immobilize the limb of a patient with an isolated injury.

It can also be used as a temporary aid to fracture stabilization in the multiple injured patient.

Care should always be taken with any splint to protect pressure areas, such as the Achilles tendon, lateral and medial malleoli and the heel, as ulceration in these areas can be extremely difficult to treat.

Fixed splints should not be applied to patients that have other pathological conditions in the lower limb, neurological compromise that causes sensory defects, such as spinal injury, or diabetes with peripheral neuropathy, or in patients who are unconscious.

 

Types of splint

The splint is both inexpensive, and both easy and quick to apply. It is not possible, however, to obtain good three point immobilization of distal femoral fractures with any splint. The conical shape of the thigh will not allow for close apposition of a splint.

For treatment of distal-femur fractures alone the ankle does not need to be immobilized and therefore a cylinder splint can be used. If there is an ipsilateral ankle, or foot, fracture, the long leg cylinder splint can be converted to one that incorporates the ankle and foot. A cylinder long leg splint is described here, as it is the most commonly used.