OTC Orthopaedic Technologist Certified Lower Extremity Splinting 5 — Questions and Answers
Question 1: A patient with an open (compound) lower extremity fracture requires wound care before splinting. The splint should be applied:
- Directly over the wound with extra padding
- After sterile dressing has been placed over the wound (Correct answer)
- Only after operative debridement
- Before dressing to prevent contamination
Correct answer: After sterile dressing has been placed over the wound
A sterile dressing must cover the open wound before splinting to reduce infection risk while providing immobilization.
Question 2: When padding the malleoli during ankle splinting, which type of padding provides the best contouring protection?
- Foam rubber cut-outs
- Extra layers of cotton webril/cast padding (Correct answer)
- Silicone gel pads
- Adhesive felt (moleskin)
Correct answer: Extra layers of cotton webril/cast padding
Extra layers of cotton webril padding over the malleoli distribute pressure and prevent pressure sores under the rigid splint.
Question 3: A patient presents with a suspected Lisfranc injury. The appropriate initial splinting includes:
- Posterior ankle splint with the foot in plantar flexion
- Short leg posterior splint with U-slab in neutral position, non-weight-bearing (Correct answer)
- Buddy taping of the affected toes
- Long leg splint with knee in 30-degree flexion
Correct answer: Short leg posterior splint with U-slab in neutral position, non-weight-bearing
Lisfranc injuries require a short leg posterior splint with stirrup in neutral position and strict non-weight-bearing due to instability at the tarsometatarsal joint.
Question 4: Which elastic bandage technique is used to secure a lower extremity splint, and why?
- Figure-of-eight pattern to maximize compression
- Spiral wrap from distal to proximal without excessive tension (Correct answer)
- Circular wrap with maximum tension to prevent slipping
- Random overlapping pattern for even coverage
Correct answer: Spiral wrap from distal to proximal without excessive tension
A spiral wrap from distal to proximal with moderate tension secures the splint while allowing venous return and minimizing constriction.
Question 5: Peroneal nerve injury is a known complication of a poorly applied long leg splint. Where is this nerve most vulnerable?
- Posterior aspect of the knee
- Lateral aspect of the fibular head (Correct answer)
- Medial malleolus
- Anterior ankle
Correct answer: Lateral aspect of the fibular head
The common peroneal nerve wraps around the fibular neck just distal to the fibular head, where it is superficial and at risk from pressure.
Question 6: What is the recommended overlap percentage when applying cotton padding (webril) during lower extremity splinting?
- 10–15%
- 25–33%
- 50% (Correct answer)
- 75%
Correct answer: 50%
A 50% overlap of each successive layer ensures even padding thickness and prevents gaps that could cause pressure sores.
Question 7: A toddler presents with a suspected toddler's fracture of the tibia. Which splint is most appropriate?
- Long leg posterior splint with knee in full extension
- Short leg posterior splint in neutral dorsiflexion (Correct answer)
- Knee immobilizer only
- Hip spica splint
Correct answer: Short leg posterior splint in neutral dorsiflexion
A short leg posterior splint in neutral is appropriate for a toddler's fracture, which is a nondisplaced spiral tibial fracture not extending to the knee.
OTC Orthopaedic Technologist Certified Lower Extremity Splinting 5
A patient with an open (compound) lower extremity fracture requires wound care before splinting.
The splint should be applied: