Assessment of Splinting Quality: A Prospective Study Comparing Different Practitioners

Area of Science:

• Orthopaedic Surgery
• Emergency Medicine
• Medical Device Application

Background:

• Splinting is a common emergency department procedure with frequent follow-up issues due to improper application.
• Decreased emphasis on splinting techniques for orthopaedic surgeons and emergency physicians due to the rise of surgical fixation.
• Limited data exists on splinting error and complication rates.

Purpose of the Study:

• To compare splinting complication rates between orthopaedic and non-orthopaedic services.
• To evaluate differences in complication rates based on emergency room and urgent care center volume.
• To identify common technical errors and complications associated with splint application.

Main Methods:

• Prospective study enrolling 203 patients with extremity splints in an orthopaedic clinic.
• Data collected included provider type, duration of wear, splint type, and material (plaster/fiberglass).
• Errors defined as inappropriate length, circumferential placement, or ACE bandage-skin contact; complications included swelling, blistering, and heat injury.

Main Results:

• Overall, 61% of patients experienced splint-related errors or complications.
• Complication rates varied significantly: Orthopaedics (46%), trauma ED (65%), and outside hospitals (92%).
• Most frequent errors were inappropriate length (29%) and ACE bandage-skin contact (25%).

Conclusions:

• Splint application appropriateness and complication rates differ by provider and institution.
• Outside hospitals exhibit the highest complication rates, while orthopaedic services have the lowest.
• Findings underscore the necessity of enhanced education on proper splinting techniques, particularly in non-trauma settings.