GULU UNIVERSITY MEDICAL JOURNAL

Gulu University Medical Journal (GUMJ) 2009/2010 Vol 5.
splint using cotton wool, cloths or any cushioning
material available to avoid pressure to the skin that can
result into skin forming blisters and subsequently open
sores. Some people have used the normal limb to splint
the injured one especially for lower limb fractures.
Blood flow to the fractured limb should be keenly
observed to ensure blood flow to its distal region which
could be the hand or foot. Ideally preventing mobility
at the site of fracture entails splinting the joint above
and below the injured site, such that no movement is
possible at the joints adjacent to fracture site.
After immobilization of a fractured limb, it is possible to
transport the injured patient from the scene of accident
to home, hospital, bonesetter or from bonesetter to
hospital with minimal pain.
The traditional splints are easy to make using available
local materials in community, and at no cost.
They are a substitute to hospital fracture splints which
are not there in the community or nearby health units
and are acceptable by the communities. They are also
used by traditional bonesetters to immobilize and
maintain the broken bones together during treatment.
Though they have helped society so much, if there is
no adequate padding at all between skin and the sticks
used, the patient usually develops pressure blisters and
later sores.
In most cases splints cannot stop mobility at the two
nearby joints, this permits movements at the fracture
ends causing further injury to soft tissues, and inciting
much pain. The bone ends may pierce through the skin
and protrude to the outside can pierce a nearby big
blood vessel causing severe bleeding and even loss of
the limb. If the sharp bone ends pierce through the skin
and are exposed to the outside, they get contaminated
with soil, grass, dung, that predisposes the patient to
bacterial infections and worst is tetanus. In such a case,
the bone ends should be covered with a piece of cloth
or gauze and the patient should be taken to a health
unit as soon as possible to get professional attention.
When the splint is wrapped so tightly to the skin in
order to achieve a firm immobilization of the fracture
site; blood flow to the foot or hand can be interrupted
or completely cut off. This result into swelling of the
affected limb grossly, severe pain, and the patient may
end up with dead hand or foot, and subsequently
amputation of the leg or forearm. When the splint
is too tight and causing severe pain, normally people
tend to think that the pain is arising from the broken
bone, and when the leg or arm increases to swell, still
the community believes that the swelling is a normal
feature following the trauma.
If the splint has become too tight, or has stayed on the
limb up to 2hours, relax the inelastic straps, and take
patient quickly to a health unit to be assessed by a
medical personnel. The Wooden splints may have spikes
or thorns which can pierce the skin causing puncher
wounds or sores. While making a wooden splint, it’s
advisable to pad the skin with cotton, sponge, piece
of cotton cloth, and use smooth round or rectangular
pieces of wood.
Gulu University Medical Students’ Association (GUMSA) Passion for life 49