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Lower Extremity Splinting: A Head-to-Head Comparison of A Novel One-Step Spray-on Splint Versus Standard Splinting
Journal article   Open access   Peer reviewed

Lower Extremity Splinting: A Head-to-Head Comparison of A Novel One-Step Spray-on Splint Versus Standard Splinting

Tyler Webb, Daniel Lynch, James Lin, Adam Groth, Thuan Ly and Kevin D. Martin
Military medicine, Vol.188(7-8), pp.E1685-E1689
07/01/2023
DOI: 10.1093/milmed/usab505
PMID: 34865117
url
https://doi.org/10.1093/milmed/usab505View
Published (Version of record) Open Access

Abstract

Introduction Splinting is an essential component of treating many lower extremity musculoskeletal injuries; however, little development has been made in splinting technology. The purpose of this study is to evaluate the efficacy of current immobilization equipment for lower extremity fractures by testing a novel one-step spray-on foam splint (Fast Cast) against structural aluminum malleable (SAM) lower extremity musculoskeletal injuries and 6-inch ACE (3M Corp., Minneapolis, MN, USA) bandage splints. Materials and Methods Six orthopedic surgical residents and two medical students participated in a prospective analysis of austere splinting techniques and equipment that utilized a cadaveric model with a distal third tibia-fibula shaft fracture. Each participant was observed and scored by three fellowship trained attending orthopedic surgeons. All scoring was independent using a 5-point Likert scale based on 10 splinting criteria (50 total points possible), including quality of radiographic reduction, time to completion, safety, and sustain longitudinal traction. The Likert scale is a set of questions that reflects the respondent's degree of agreement or disagreement with a statement. Each of the 10 questions has a range of 1-5. A score of 50 means the splint performed perfectly. The lowest possible score is a 10. The participants utilized standard equipment that included SAM splints and 6-inch ACE wraps (3M Corp., Minneapolis, MN, USA) in their first attempt. A second immobilization attempt was done with a one-step spray-on foam splint (Fast Cast). After each splinting attempt, the reduction was verified with radiographic imaging. Data analysis was performed using standard descriptive statistics, Student's t-tests, and inter-rater reliability was calculated using Cronbach's alpha scores. This project is Institutional Review Board (IRB) exempt. Results The one-step spray-on foam splinting technique was superior (P < .05) in all parameters of the Likert scale, yielding a mean overall score of 45.1 points (+/- 3.8), safety 4.7 points, longitudinal traction 4.5 points, and time 136 seconds (+/- 23). The SAM resulted in a mean overall score of 33.8 points (+/- 7.3), safety 2.8 points, longitudinal traction 4.1 points, and time 170 seconds (+/- 52). Radiographic rating was 4.1 points (+/- 0.7) for the SAM splint and 4.5 (+/- 0.6) for Fast Cast. The differences in time to completion and radiograph rating did not reach statistical significance (P = .12 and P = .07, respectively). Conclusion A one-step spray-on foam splinting technique demonstrated consistent superiority in reducing fracture motion, potential soft-tissue damage, and sustained longitudinal traction as compared to the standard technique.
 General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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