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Related Experiment Video

Updated: Aug 6, 2025

Lower-Limb Biomechanical Characteristics Associated with Unplanned Gait Termination Under Different Walking Speeds
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Surface Pressures in Lower Extremity Splints: A Biomechanical Study.

Kempland C Walley1, Nicholas Farrar1, Kameron Shams1

  • 1Department of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.

Foot & Ankle Orthopaedics
|March 20, 2023
PubMed
Summary

Applying padding in the final position and removing it after splinting can reduce anterior ankle pressure and the risk of skin breakdown from lower extremity splints.

Keywords:
iatrogenic injuryimmobilizationpatient safetypressure woundssplintstrauma

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Area of Science:

  • Orthopaedic biomechanics
  • Biomedical engineering
  • Clinical research

Background:

  • Lower extremity splints are common in orthopaedic trauma care.
  • Iatrogenic morbidity, including skin pressure ulcers, can arise from splint use.
  • The impact of joint position on skin pressure during splinting is not well understood.

Purpose of the Study:

  • To biomechanically assess the effect of short-leg splint application techniques on anterior ankle surface pressure.
  • To quantify the risk of iatrogenic skin pressure ulcers related to splinting.
  • To identify technical strategies for minimizing anterior ankle pressure.

Main Methods:

  • A biomechanical study involving 3 healthy subjects (6 limbs).
  • Application of various lower extremity short-leg splint constructs.
  • Measurement of anterior ankle surface pressure using a Tekscan I-Scan system with padding in maximum plantar flexion and neutral positions.

Main Results:

  • Applying padding in maximum plantar flexion then moving to neutral increased anterior ankle contact pressure at least 2-fold.
  • Removing anterior ankle padding post-splinting reduced contact forces by 46% (max PF) and 59% (neutral).

Conclusions:

  • Clinically relevant techniques can mitigate the risk of skin breakdown at the anterior ankle.
  • It is crucial to apply padding in the final intended splint position.
  • Removing anterior ankle padding after splint application, when feasible, is recommended.