the Patient With Splints and Braces
Contoured splints of plaster or pliable
thermoplastic materials may be used for conditions that do not require rigid
immobiliza-tion, for those in which swelling may be anticipated, and for those
that require special skin care. The splint needs to immobilize and support the
body part in a functional position. The splint must be well padded to prevent
pressure, skin abrasion, and skin break-down. The splint is overwrapped with an
elastic bandage applied in a spiral fashion and with pressure uniformly
distributed so that the circulation is not restricted. The nurse frequently
assesses the neurovascular status and skin integrity of the splinted extremity.
Soft immobilizers may be used to support an injured body
part. Usually, the extremity is wrapped with an elastic bandage and then
secured in a padded, contoured, canvas immobilizer. Rigid immobilization is not
achieved. The nurse provides skin care and makes adjustments for swelling.
For long-term use, braces
(orthoses) are used to provide sup-port, control movement, and prevent
additional injury. They are custom fitted to various parts of the body. Braces
may be con-structed of plastic materials, canvas, leather, or metal. The
or-thotist adjusts the brace for fit, positioning, and motion.
The nurse helps the patient learn to apply the brace and
to protect the skin from irritation and breakdown. The nurse also assesses
neurovascular integrity and comfort when the patient is
wearing the brace, encourages the patient to wear the
brace as pre-scribed, and reassures the patient that minor adjustments of the
brace by the orthotist will increase comfort and minimize prob-lems associated
with its long-term use.