Coaptation Splint (Emergency Medicine)

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Temporary immobilization for:
    • Acute fractures of the humeral diaphysis, proximal or midshaft
    • Postoperative splinting following operative reduction and internal fixation
CONTRAINDICATIONS
  • Infection
  • Impending compartment syndrome
  • Diabetic or other neuropathy
EQUIPMENT
  • Slightly warm (not over 24°C) water and bucket
  • Stockinette (optional)
  • Soft cotton bandage/undersplint material (e.g., Webril padding), 4- to 6-inch
  • Plaster bandages, available in 4- to 6-inch
  • Elastic bandages (Ace)
  • Adhesive tape
ANATOMY
  • The axillary artery and brachial plexus are located in the axilla.
  • The anterior circumflex humeral artery lies just distal to the surgical neck.
  • At the elbow, the ulnar nerve is posterior to the lateral epicondyle, the median nerve is anterior to the joint along with the brachial artery, and the radial nerve lies anterior to the medial epicondyle.
  • The radial nerve supplies sensation to the dorsolateral hand (dorsal and thenar areas) and proximal thumb, the median nerve supplies sensation to the lateral palm and the palmar/distal first and second digits, and the ulnar nerve supplies sensation to the medial hand (dorsal and palmar) and the fifth digit.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Use radiography to confirm that reduction was achieved and maintained.
  • Conduct a neurovascular examination.
  • Instruct the patient to keep the splint clean and dry.
  • The extremity should be kept elevated for the first 2-3 days.
  • Loosen the elastic bandage if neurovascular symptoms arise.
  • Reevaluate if increased pain or burning develops.
COMPLICATIONS
  • Plaster burn
  • Pressure sores
    • The epicondyles and olecranon process are particularly vulnerable.
  • Nerve palsy
    • Use extra padding to protect the subaxillary area.
    • The ulnar nerve is particularly vulnerable to compression at the posterior lateral epicondyle and the radial nerve is particularly vulnerable at the anterior medial epicondyle.
  • Vascular compromise
    • The axillary/brachial artery is vulnerable to compression from bone fragments, swelling, or splinting.
  • Splint dermatitis
  • Permanent joint stiffness
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