Can Simple Changes in Splinting Technique Reduce Posterior Heel Contact Pressure?

Area of Science:

• Biomechanics
• Orthopedics
• Materials Science

Background:

• Lower extremity splints are essential for treating foot and ankle injuries.
• Posterior heel pressure injuries are a common complication of splinting.
• Optimizing splint design can mitigate heel pressure risks.

Purpose of the Study:

• To identify splint characteristics that minimize posterior heel contact pressure.
• To determine if heel position, padding thickness, and padding type affect heel pressure.
• To investigate factors contributing to increased heel pressure during splinting.

Main Methods:

• A biomechanical study involving 10 participants and 20 legs.
• Utilized a pressure transducer to measure posterior heel contact pressure in short leg splints.
• Varied padding layers (0-10), padding brands, and heel position (down vs. floating).

Main Results:

• Resting the heel down consistently resulted in pressures above the 32 mm Hg threshold.
• Floating the heel with 6-10 layers of thicker padding or 8-10 layers of thinner padding reduced pressure below 32 mm Hg.
• Improperly bunched padding increased mean contact pressure threefold.

Conclusions:

• Optimal splinting involves floating the heel with 8-10 evenly applied layers of thicker padding.
• Floating the heel is a key modifiable factor for reducing dermal pressure.
• Attention to splinting details may decrease the incidence of posterior heel pressure ulcers.