Orthopaedic Technologist Certified Lower Extremity Splinting Questions and Answers — Questions and Answers
Question 1: A patient presents to the emergency department with an acute, severe ankle sprain with significant swelling. Which of the following is the most appropriate initial method of immobilization?
- Application of a circumferential fiberglass cast.
- A posterior ankle splint combined with a stirrup splint. (Correct answer)
- A short leg walking boot.
- Immediate surgical fixation.
Correct answer: A posterior ankle splint combined with a stirrup splint.
In acute injuries with significant swelling, a circumferential cast is contraindicated due to the risk of compartment syndrome. A combination of a posterior ankle splint and a stirrup splint provides excellent immobilization while allowing for swelling to subside. A walking boot may not provide sufficient stability for a severe sprain, and surgery is not the initial treatment.
Question 2: When applying a posterior short leg splint, the technologist should ensure the splint extends from the metatarsal heads to where?
- Just above the malleoli.
- The mid-calf level.
- Approximately 2 inches distal to the fibular head. (Correct answer)
- The level of the tibial tuberosity.
Correct answer: Approximately 2 inches distal to the fibular head.
To avoid compression of the common peroneal nerve, a posterior short leg splint should terminate approximately 2 inches (or 2-3 fingerbreadths) distal to the fibular head. Extending it too proximally can lead to nerve palsy and foot drop.
Question 3: An Orthopaedic Technologist is preparing materials for a lower extremity splint on an average-sized adult. Which of the following represents the recommended number of plaster layers for adequate strength?
- 4 to 6 layers
- 6 to 10 layers
- 12 to 15 layers (Correct answer)
- 18 to 20 layers
Correct answer: 12 to 15 layers
For a lower extremity splint on an average-sized adult, 12 to 15 layers of plaster are typically required to provide sufficient strength and support. Upper extremities generally require fewer layers (6-10), while using too few on a lower extremity would compromise stability.
Question 4: A patient with a newly applied short leg splint for a non-displaced fibular fracture calls the clinic complaining of increased pain, numbness, and a tingling sensation in their toes. What is the most appropriate immediate action for the Orthopaedic Technologist to advise?
- Take over-the-counter pain medication and see if it improves.
- Elevate the leg higher and apply more ice.
- Loosen the elastic bandage and come to the clinic for immediate evaluation. (Correct answer)
- Schedule a follow-up appointment for the next day.
Correct answer: Loosen the elastic bandage and come to the clinic for immediate evaluation.
The patient's symptoms of increased pain, numbness, and tingling are classic warning signs of neurovascular compromise or compartment syndrome. The immediate priority is to reduce constriction. The patient should loosen the wrap and be evaluated immediately to prevent permanent damage.
Question 5: Which of the following is a primary advantage of using a splint over a circumferential cast for an acute lower extremity fracture?
- It provides more definitive immobilization.
- It is more durable for weight-bearing.
- It accommodates for soft tissue swelling. (Correct answer)
- It requires less padding.
Correct answer: It accommodates for soft tissue swelling.
The main advantage of a splint in the acute setting is that it is non-circumferential, which allows for swelling that naturally occurs after an injury. This significantly reduces the risk of pressure-related complications like skin breakdown and compartment syndrome compared to a rigid, circumferential cast.
Question 6: When molding a plaster splint to the lower extremity, what part of the hand should the technologist primarily use to avoid creating pressure points?
- The fingertips.
- The knuckles.
- The palm of the hand.
- The side of the index finger. (Correct answer)
Correct answer: The side of the index finger.
To ensure even pressure distribution and prevent indentations that can lead to pressure sores, the Orthopaedic Technologist should use the broad, flat surface of the palm and thenar eminence to mold the splint to the contours of the limb. Using fingertips or knuckles creates focal pressure points.
Orthopaedic Technologist Certified Lower Extremity Splinting Questions and Answers
A patient presents to the emergency department with an acute, severe ankle sprain with significant swelling.
Which of the following is the most appropriate initial method of immobilization?