The technique of volar splinting of the upper extremity can be used to immobilize hard and soft tissue injuries as well as painful non-traumatic conditions. Examples of hard tissue skeletal injuries include distal radius fracture, Colles fractures, and metacarpal and carpal fractures (except the first metacarpal and trapezius). The basic guideline regarding splinting of skeletal lesions is that it must immobilize a joint above and a joint below the lesion. The exceptions to this rule are metaphyseal, such as Colles or Smith fractures which effectively act like injuries within the joint. For more proximal shaft fractures, the principle of volar splinting expands into sugar tong or Muenster-type splinting, extending above the elbow.
Other examples of conditions amenable to volar splinting include acute gouty arthritis, carpal tunnel syndrome, and radial nerve palsy. Splinting is an adjunct to elevation and ice. It improves patient comfort, facilitates recovery, and protects from further injury. Splints may be used for comfort as a temporizing measure for wrist and hand dislocations or fracture subluxations while awaiting definitive care. Splints differ from casts in that the non-circumferential bandage allows for some degree of swelling without undue constriction. Splints can also be easily removed for wound care. Splinting can be the definitive treatment or temporary treatment before casting. Though plaster is the traditional material used, padded fiberglass and preformed plastic splints are common.