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be flexed to 90 degrees at the elbow with no rotation of the forearm. The hand is
dorsiflexed minimally (have the patient hold a small roll of tape or Webril).
With the arm positioned as described, measure from the midpalm around the
elbow to the knuckles dorsally (add 1 to 2 in to allow for shrinkage). The
splinting material should be wide enough to support the arm along the volar and
dorsal surfaces but not so wide as to overlap. Prepare and apply the materials as
described in the “General Splinting” section. Ensure sufficient padding is placed
over the elbow to prevent pressure ulcers. A properly measured splint allows 90
degrees of flexion of the fingers and approaches, but does not cover, the knuckles
dorsally. An assistant is helpful when applying this splint. Ensure the thumb is
free to move in all directions.
Discharge the patient with a sling with the hand slightly above the level of the
elbow.

Thumb Spica Splint
Indications
1. Nonrotated, nonangulated, nonarticular fractures of the thumb metacarpal or
phalanx
2. Ulnar collateral ligament injuries (gamekeeper’s thumb)
3. Suspected or documented scaphoid fracture
Procedure
The splint extends in a U-shaped manner along the radial side of the thumb and
forearm from the thumbnail to the midforearm ( Fig. 130.49H ). The proper
splinting position maintains the wrist in slight dorsiflexion, the thumb in some
flexion and abduction, and the interphalangeal joint in slight flexion. The final
position is as though the patient were holding a glass or catching a ball, and will
allow apposition of the index finger and thumb.
Determine the appropriate length of splint material by measuring from the
patient’s thumbnail to the midforearm. The splint should be wide enough to
completely encircle the thumb. Prepare and apply the splint materials as described
in the “General Splinting” section. The Webril should cover the thumb, hand, and

forearm. Mold the splint so the thumb is maintained in the position previously
described.
A sling is usually unnecessary but may assist in reminding the patient to keep
the site elevated.

Dorsal Extension Finger Splint