OTC Orthopaedic Technologist Certified Lower Extremity Splinting 3 — Questions and Answers
Question 1: What is the primary purpose of bivalving a lower extremity splint or cast?
- To improve radiographic visualization
- To relieve pressure from swelling and prevent compartment syndrome (Correct answer)
- To allow the patient to shower
- To convert it to a functional brace
Correct answer: To relieve pressure from swelling and prevent compartment syndrome
Bivalving cuts the cast or splint on two sides to relieve constriction caused by swelling, reducing the risk of compartment syndrome.
Question 2: When applying a fiberglass splint to the lower extremity, gloves should be worn primarily to:
- Maintain sterility of the wound
- Prevent skin irritation and allergic contact dermatitis from uncured fiberglass resin (Correct answer)
- Improve grip on the splinting material
- Reduce heat generated during curing
Correct answer: Prevent skin irritation and allergic contact dermatitis from uncured fiberglass resin
Uncured fiberglass resin can cause contact dermatitis in both the patient and the technologist, making glove use essential.
Question 3: A 'stirrup' or 'sugar tong' ankle splint applies padding and plaster in what configuration?
- Posterior slab only from calf to heel
- Medial-plantar-lateral U-shaped configuration around the ankle (Correct answer)
- Circumferential wrap from mid-calf to toes
- Anterior and posterior slabs secured with elastic bandage
Correct answer: Medial-plantar-lateral U-shaped configuration around the ankle
The stirrup splint forms a U-shape going from the medial lower leg, under the heel, and up the lateral lower leg, limiting inversion and eversion.
Question 4: What water temperature is recommended when dipping plaster of Paris splint material?
- Ice cold water (0–5°C)
- Room temperature to lukewarm water (21–27°C) (Correct answer)
- Hot water (49–60°C)
- Boiling water (100°C)
Correct answer: Room temperature to lukewarm water (21–27°C)
Room temperature to lukewarm water allows adequate working time; hot water accelerates setting too quickly and can cause thermal burns.
Question 5: A calcaneal fracture splint should position the foot in which configuration?
- Plantar flexion and inversion
- Neutral dorsiflexion with slight eversion (Correct answer)
- Full eversion and dorsiflexion
- Inversion with neutral dorsiflexion
Correct answer: Neutral dorsiflexion with slight eversion
Neutral dorsiflexion with slight eversion maintains optimal alignment and reduces tension on the calcaneal fracture site.
Question 6: After applying a plaster splint to a lower extremity, you instruct the patient to keep the limb elevated for the first 24–48 hours primarily to:
- Speed up the drying of the plaster
- Reduce swelling and lower risk of neurovascular compromise (Correct answer)
- Prevent the patient from bearing weight
- Allow the skin to breathe under the splint
Correct answer: Reduce swelling and lower risk of neurovascular compromise
Elevation reduces dependent edema, decreasing pressure within the splint and lowering risk of circulatory compromise.
Question 7: Which of the following is a contraindication to applying a circumferential cast (not splint) immediately after an acute lower extremity fracture?
- Stable fracture pattern
- Expected significant post-injury swelling (Correct answer)
- Patient cooperation
- Closed fracture with intact skin
Correct answer: Expected significant post-injury swelling
Expected swelling after acute injury makes circumferential casts dangerous because they cannot expand, risking compartment syndrome; a splint is preferred initially.
OTC Orthopaedic Technologist Certified Lower Extremity Splinting 3
What is the primary purpose of bivalving a lower extremity splint or cast?