Short Leg Splint (Internal Medicine)

• Temporary immobilization for:
  • Fractures of the distal tibia and fibula
  • Fractures of the talus, calcaneus, cuboid, navicular, cuneiform, and metatarsal bones of the foot
  • Ankle dislocations

• Infection
• Impending compartment syndrome
• Diabetic or other neuropathy

• Slightly warm (not over 24°C) water and bucket
• Stockinette (optional)
• Soft cotton bandage/undersplint material (e.g. Webril padding), 4- or 6-inch
• Plaster bandages, 4- or 6-inch
• Elastic bandages (Ace)
• Adhesive tape

Skeletal anatomy

• Distally, the tibia rests primarily on the talus and is stabilized by the medial malleolus.
• The distal fibula rests primarily against the calcaneous and forms the lateral malleolus.
• The metatarsal bones articulate with the cuneiform bones medially, the cuboid laterally, and the phalanges distally.

Vascular anatomy

• The deep femoral artery supplies the upper leg, and the femoral artery continues distally to become the popliteal artery at the knee and then divides into the anterior and posterior tibial arteries.
• The posterior tibial and anterior tibial arteries supply the foot.

Nerve supply

• The nerve supply to the leg is through the femoral nerve anteriorly and the sciatic nerve posteriorly, which is the combined common peroneal and tibial nerves.
• The superficial and deep peroneal nerves supply the anterior leg and dorsal foot.
• The tibial nerve supplies sensation to the sole of the foot.
• The webspace between the great and second toes is supplied by the deep peroneal nerve.

• Obtain repeat radiographs to confirm that reduction was achieved and maintained.
• Repeat 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.

• Plaster burn
• Pressure sores
• Nerve palsy
• Vascular compromise
• Splint dermatitis
• Permanent joint stiffness