When to Use a Splint vs. Cast for Bone and Joint Injuries

"Splint" is a general term used to describe a removable device that temporarily immobilizes a joint after injury. However, splints can also be used to increase motion in a stiff joint. These devices vary in materials from soft to rigid and can be applied to different joints in the arms and legs.

This article discusses the difference between a splint and a cast, injuries that require a splint, types of splints, fitting and maintenance of these devices, and general healing time frames for common injuries treated with a splint.

Injuries That Require a Splint

The most common use of a splint is immobilizing an injured body part while it heals. It can also reduce pain with movement that can occur with chronic conditions.

Injuries that often require a splint include:

• Ligament sprain
• Tendon rupture
• Severe muscle strain
• Nerve compression conditions (such as carpal tunnel syndrome)
• Tendonitis (inflammation or irritation of tendons)
• Arthritis
• Joint dislocation
• Burns

Some types of fractures can be splinted rather than cast—particularly if the bones are still in proper alignment. Finger and toe fractures are also commonly splinted.

Splints can also help reduce the risk of joint or muscle contractures (a shortening and tightening of muscle fibers that reduces flexibility).

Splint vs. Cast Differences

The biggest difference between a splint and a cast is that a splint can be easily removed and reapplied. Casts have to be cut with a cast saw for removal.

Additional benefits of a splint vs. cast include:

• Splints are removable for skin hygiene/showering.
• Splints can sometimes be removed for range of motion exercises, which helps reduce stiffness that commonly occurs after wearing a cast.
• Splints can sometimes be worn during specific activities, such as playing sports, and removed at rest.
• Splints are often made of softer materials, making them more comfortable than a plaster or fiberglass cast.
• Splinting material is lighter than casting material.
• Splints can often be adjusted to accommodate changes in swelling, while a cast has to be removed and replaced if it is too tight or loose.
• Some splints can be purchased from pharmacies or medical supply stores, while casts have to be applied by a healthcare professional.
• If a cast gets wet, it has to be removed. Splints can typically air-dry.

Types and Materials

There are many different types of splints. Common examples include:

• Wrist cock-up splint
• Resting hand splint
• Ulnar/radial gutter splint
• Thumb spica splint
• Finger splints
• Sugar tong splint
• Posterior knee splint
• Posterior ankle splint

Splints can be made out of a variety of materials, including:

• Neoprene
• Metal
• Plastic
• Foam
• Aluminum
• Silicone

Static vs. Dynamic

Splints can be categorized as static, static progressive, or dynamic, as follows:

• Static splints immobilize a body part and usually include a metal or plastic component.
• Static progressive splints gradually stretch a joint to decrease stiffness and pain. As range of motion improves, the splint is adjusted to hold the joint in the newly stretched position.
• Dynamic splints apply tension to a joint for continuous stretching.

Prefabricated vs. Custom

Depending on what body part is affected and the type of splint you need, you'll get a prefabricated or custom splint, as follows:

• Prefabricated splints: These splints are available off-the-shelf. They are available in a few sizes and are often used for common injuries, such as wrist sprains.
• Custom fitted: These are prefabricated splints with a customizable component that can be bent or molded to the body part.
• Custom fabricated: These splints are made from flat pieces of heated thermoplastic that a healthcare provider molds. Custom splints are often used to immobilize injuries in the hand or fingers.
  

Splint Maintenance

While there are many benefits of using a splint, these devices require some maintenance and special care.

Possible Complications

A variety of complications can arise while using a splint, such as:

• Inconsistent wearing schedule
• Not enough support for the injury
• Too much movement of the injured body part
• Decreased circulation if applied too tightly
• Joint stiffness
• Increased pain (this can indicate a poorly fitted splint)
• Muscle atrophy (shrinkage)
• Pressure sores
• Skin breakdown

Call your healthcare provider if you have increased pain, numbness or tingling, or skin color changes in the splinted area.

Bathing and Showering

Depending on the injury, your healthcare provider might allow you to remove your splint for bathing and showering. However, many times, this isn't an option. You'll need to wrap your splint with a waterproof material, such as a plastic bag, to keep it dry.

Healing Timeline and Splint Removal

The healing timeline and the length of time that splint use is required varies by the type and severity of your injury, as well as your age and overall health.

Fractures can heal as quickly as a few weeks or can take several months or more. Tendon ruptures typically heal within six to 12 weeks after surgery. Some chronic conditions, such as carpal tunnel syndrome, can require long-term, intermittent splint use when symptoms flare up.

Summary

Splints are devices temporarily used to immobilize an injured body part while it heals. They can also be used to increase range of motion in stiff joints. Splints can help treat fractures, muscle or tendon injuries, nerve compression conditions, and arthritis.

Healthcare professionals typically fit them, but some are available off-the-shelf. Splints might only be needed for a few weeks or as long as several months, depending on the severity of your condition.