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Splinting technique can prevent heel ulcers
Wednesday February 13, 2013

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An article in the January issue of Orthopedics describes a technique using a short leg posterior splint that suspends the heel away from the splint with lower-extremity immobilization. The modification prevents decubitus ulcer formation, the authors state.

The patient is positioned supine with the ankle neutral and the knee in 90 degrees of flexion. Four layers of Webril are wrapped circumferentially from the toes to just distal to the popliteal fossa, taking care to avoid pressure over the common peroneal nerve at the fibular neck. Extra layers of Webril padding are placed on the plantar aspect of the foot and posterior to the proximal Achilles tendon. Four- or 5-inch Ortho-Glass or plaster is applied posteriorly along the length of the Webril, ensuring adequate padding between the splint material and skin at the proximal and distal ends.

To create a space to unload the heel, two small rolls of Webril are inserted deep into the splint material and superficial to the Webril posterior to the heel and the attachment of the Achilles tendon. After an elastic bandage is applied and the splint hardens, the small rolls of Webril are removed and the wrap is readjusted to its original position.

Patients with signs of heel soreness at splinting have been shown to be at significantly increased risk of heel ulcers when immobilized and would benefit from this modification, the authors said.


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Wednesday February 13, 2013
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