What Is Posterior Long Arm Splinting?

Posterior arm splinting is often the treatment of choice in the emergency department (ED) because they reduce swelling that may be present at the site of injury and thereby reduce the further risks.

Posterior long arm splint is used in the management of multiple upper long arm injuries. A splint is a type of medical equipment made of wood or other rigid material. It is used to immobilize a fractured or dislocated bone. A splint usually helps to maintain any part of the body in a fixed position. The most common use of splints is in emergency settings to keep a detached bone in position until it heals. Posterior arm splinting is often the treatment of choice in the emergency department (ED) because they reduce swelling that may be present at the site of injury and thereby reduce the further risks. After a splint is placed, follow-up for definitive care with an orthopedist should occur within one to five days.

A posterior long arm splint is usually recommended for upper arm injuries such as

• The lower end of the upper bone fracture 
• Forearm fracture
• Radial bone fractures
• Olecranon fracture (body part of elbow fractures) 
• Severe ligament injuries of the elbow

Certain injuries require immediate evaluation or intervention by a consultant (e.g., an orthopedic surgeon, a hand surgeon, a plastic surgeon, etc.), and splinting alone cannot be the treatment. Such injuries include the following:

• Complicated or multiple fractures
• Open fractures
• Injuries associated with nerves and blood vessels

Splinting is usually tolerated without the use of anesthesia. However, if a significant manipulation of the injury is required during the splinting process, anesthetic techniques may be used.

• These splints are made of plaster, fiberglass, or a low-temperature thermoplastic material with sufficient padding or cotton.
• The elbow is positioned at a 90° bend, and the splint is applied to the back of the arm, covering half the length of the upper arm bone, ending above or below the wrist.
• Elbow bending and straightening are prevented by a posterior long arm splint, and rotation of the forearm is limited but not completely restricted.
• With the patient adequately positioned, a web roll is started at the wrist and extending past the elbow to the upper arm. The number of layers is determined by the amount of expected swelling, but many splints will use two to four layers.
• At the elbow, a web role must be carefully applied to ensure adequate padding of the body part of the elbow. A web roll may be extended till the upper arm bone: humerus.
• A splint may be applied around the elbow and major aspects of the wrist. Care should be taken to allow moments in fingers. A mold is applied with a splint to keep the fractured bone in position.
• An elastic bandage is wrapped over the splint materials to keep the splint in position.

As with any splinting technique, a posterior long arm splint can have few possible complications that include

• Skin burns if excess heat is used during splinting
• Pressure sores
• Skin infection
• Swelling and pain
• Joint stiffness
• Skin breakdown in case of improperly padded splints 

The Patient can experience discomfort if the splints are wrapped too tight. Over padded splints can become too loose and inadequately immobilize an injury.

Long arm splints are a valuable tool in the treatment of various upper arm injuries. This form of splinting can provide excellent immobilization while allowing a decrease in swelling. Typically, a long arm splint is the initial form of immobilization. It is removed, and patients are transitioned into more definitive immobilization such as a cast.