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The main goal of forearm splinting is to prevent pronation and supination of the forearm. There are a variety of indications for forearm splinting, including soft tissue strains or sprains, fractures, joint dislocations, tendon lacerations, and compression neuropathy. Forearm splints aim to decrease pain and debility, prevent further injury and facilitate the healing process. In the acute setting, forearm splints are often used for distal radius and/or ulna fractures, radial and/or ulnar shaft fractures, flexor tendon lacerations within the forearm and radial nerve palsies that manifest with wrist drop. In the chronic setting, forearm splinting is commonly used for De Quervain’s tenosynovitis, medial and lateral epicondylitis and any compressive neuropathies affecting the nerves in the forearm. This activity describes the indications, contraindications, and complications of forearm splinting and highlights the role of the interprofessional team in caring for patients requiring forearm splints. Objectives: Identify the technique involved in forearm splinting. Describe the indications for forearm splinting. Review the contraindications to forearm splinting. Explain interprofessional team strategies for enhancing care coordination and communication to improve the utilization of proper technique for forearm splinting. Access free multiple choice questions on this topic.

The technique of splinting can be found throughout multiple fields of medicine including emergency medicine, orthopedics, primary care, and podiatry. It is primarily used to immobilize a joint or limb to allow for pain control, injury stabilization, and ultimately tissue healing. In the acute setting, splinting is useful as a temporizing treatment for sprains, strains, joint dislocations, fractures, and soft tissue lacerations. In the chronic setting, splinting is useful mainly for inflammatory conditions. The main goal of forearm splinting is to prevent rotation about the entire forearm. Specific conditions in which forearm splinting would be useful include injuries to any part of the radius and/or ulna or soft tissue structures located within the forearm.

Complications of forearm splinting include pressure necrosis, which can begin as soon as 2 hours after application, compartment syndrome if wrapped too tightly, thermal injury from plaster if too thick, and joint stiffness, specifically the metacarpophalangeal joints if the splint extends past the distal palmar crease.[6][7][8]

Forearm splinting is done by many healthcare professionals that includes the emergency department physician, orthopedic surgeon, therapist, primary care provider, orthopedic nurse and the urgent care physician. Forearm splinting is an excellent way to immobilize the forearm to help alleviate pain, stabilize injuries, prevent further damage to bones, muscles, nerves and/or arteries, and prevents a closed fracture from becoming an open one. Furthermore, due to the non-circumferential nature of the splint, as opposed to a cast, it can allow for soft tissue swelling and can be easily removed by the clinician to evaluate any wounds beneath.[9][10] In the acute setting, it is an excellent way to temporize forearm injuries.