Immobilisation of fractures: backslab, cast, splint and traction

What it is

Four methods are set side by side on these two pages: the dorsal or volar back slab, the full cast, the splint, and traction, which is either skin or skeletal.

Back slab against full cast

Back slab (dorsal or volar) — it is a non-circumferential shell of plaster which supports only part of the circumference of the limb, used to temporarily immobilize fractures and soft tissue injuries of the forearm and wrist. Indications: soft tissue injuries of the hand and wrist; fractures of the wrist; fractures of the 2nd to 5th metacarpals; carpal tunnel syndrome. Forearm volar slabs prevent forearm rotation and wrist motion. It starts in the palm at the MC heads, down the volar aspect of forearm to distal forearm. And the line that decides between the two: it is safer than cast but less effective.

Applying it: cut hole in stockinette for thumb; forearm in neutral position with thumb up; wrist slightly extended, 10-20 degrees; one side application of fiber-glass; circumferential applying of crepe bandage.

Full cast — a circumferential immobilizer surrounding the whole circumference of the limb. Indication: primary management of simple and stable fracture. It gives more effective immobilization with less probability of displacement than slab. It is applied as a circumferential application of fiber-glass.