Abstract
Objective: To describe the evidence in the scientific literature regarding the construction and care of plaster splints after traumatic injury. Methods: This is an integrative review, with the inclusion criteria being the selection of articles published in the last ten years. The following guiding question was used for the review: What is the scientific evidence regarding the care and construction of plaster splints for patients with orthopedic trauma? Results: Twenty-nine scientific productions between 2015 and 2024 on orthopedic immobilization were included. Of these studies, 17.2% used plaster splints; 44.8% used fiberglass plaster splints; 17.2% addressed the fiberglass plaster device; and 6.9% did not specify the type of immobilization. 13.8% compared the splint with another orthopedic immobilization. Immobilization is an essential technique in the treatment of musculoskeletal injuries and its effectiveness depends on two main aspects: the use of low-volume materials to protect/cushion the injured area and the correct immobilization technique. Errors in the production of the immobilization may compromise the treatment and cause discomfort. Final considerations: There is no consensus on the choice of immobilization. Furthermore, they demonstrate the importance of the correct technique and adequate guidance to patients, since errors in the procedure may lead to complications, such as skin manifestations and pain.
References
ABZUG JM, et al. Assessment of splints applied for pediatric fractures in an emergency department/urgent care environment. United States. Journal of Pediatric Orthopaedics, 2019; 39(2): 76-84.
ALAM J, et al. Thumb Spica Splinting. In: Stat Pearls, Treasure Island (FL): Stat Pearls Publishing, 2023. Disponível em: https ://www.ncbi.nlm.nih.gov/books/NBK538525/. Acesso em: 15 de setembro de 2024.
ALTHOFF AD e REEVES RA. Splinting.In: StatPearls, Treasure Island (FL): Stat Pearls Publishing. Disponível em: https ://www.ncbi.nlm.nih.gov/books/NBK557673/. 2020.
AX M, et al. A comparison of the functional results and costs of functional cast and volar-flexion ulnar deviation cast at 2-year follow-up in 105 patients aged 65 and older with dorsally displaced distal radius fracture: A randomized controlled trial. United States. Plos one, 2023; 18(4): 283946.
AZEVEDO D e SOLER VM. Fraturas e imobilizações em ortotraumatologia. Brasil. Cuid Arte, Enferm, 2017; 11(2): 239-247.
AZZOLIN L, et al. Optimal postoperative immobilisation for supracondylar humeral fractures. United States. Orthopaedics & Traumatology: Surgery & Research, 2018; 104(5): 645-649.
BOTELHO V, et al. Fraturas de membro superior em hospitais de nível terciário e suas implicações para a saúde pública. Brasil.Revista Eletrônica Acervo Saúde. 2020; 12(9) 4196- 4196.
BRASIL. MINISTÉRIO DA ECONOMIA. Dados abertos da previdência social– Tabelas do Anuário Estatístico da Previdência Social. Brasília: Instituto Nacional do Seguro Social, 2018.
CHAMBERS LR, et al. Initial management of humeral shaft fractures with functional splints versus coaptation splints. Alemanha. European Journal of Orthopaedic Surgery & Traumatology, 2021; 31(6); 1129-1134.
COHEN M. Sociedade Brasileira de ortopedia e traumatologia comissão de educação continuada. Tratado de ortopedia. São Paulo, Editora Roca, 2007; 904.
CONRY KT, et al. Assessment of Splinting Quality: A Prospective Study Comparing Different Practitioners. United States. The Iowa Orthopaedic Journal, 2021; 41(10): 155.
CRE. CONSELHO REGIONAL DE ENFERMAGEM. 2015. Parecer n. 011/2015 - BA. Solicitado parecer que tange às atribuições do técnico de enfermagem na preparação, colocação, retirada de gesso ou tala gessada. Disponível em: http ://www.coren-ba.gov.br/parecer-coren-ba-n%E2%81%B0-0112015_1739 2.html. Acessado em: 20 de setembro de 2024.
CONSELHO REGIONAL DE ENFERMAGEM. 2022. Resposta técnica COREN/SC No 002/CT/2022. Parecer n. 011/2015. Disponível em: https ://transparencia.corensc.gov.br/wp-content/uploa ds/2016/0 5/RT-002-2022-protocolo-111780-aprovado-ROP-618%C2%AA-15-12-2022-Jerry-Schmitz-assinado.p df. Acessado em: 15 de setembro de 2024.
COURTNEY AB e MENACHEM MM. Volar Splinting.In: StatPearls, Treasure Island (FL): Stat Pearls Publishing, 2023. Disponível em: https ://www.ncbi.nlm.nih.gov/books/NBK482429/. Acesso em: 15 de setembro de 2024.
DAINES SB, et al. What is the best material for molding casts in children? United States. Journal of Pediatric Orthopaedics, 2014; 34(7): 743-748.
DAVISON PG, et al. Forearm-based ulnar gutter versus hand-based thermoplastic splint for pediatric metacarpal neck fractures: a blinded, randomized trial. United States. Plastic and Reconstructive Surgery, 2016;137 (3): 908-916.
DEVIN MH, et al. Wrist Splint.In: StatPearls, Treasure Island (FL): StatPearls Publishing, 2023.Disponível em: https ://www.ncbi.nlm.nih.gov/books/NBK557630/. Acesso em: 15 de setembro de 2024.
DIFAZIO RL, et al. Reducing the incidence of cast-related skin complications in children treated with cast immobilization. United States. Journal of Pediatric Orthopaedics, 2017; 37 (8): 526-531.
DOMINGOS JEP, et al. Indicadores diagnósticos para risco de lesão por pressão em pacientes com trauma ortopédico. Brasil. Revista Enfermagem Atual In Derme, 2022; 96(40).
ELLSWORTH BK, et al. Back to Basics: Pediatric Casting Techniques, Pearls, and Pitfalls.United States. The Iowa Orthopaedic Journal, 2023; 43(2): 79.
ESMANHOTTO A. Perfuração de imobilizações ortopédicas em gesso tradicional e sintético e consequências sobre a resistência mecânica, PR. Dissertação (Mestrado em Ciências da Saúde) - Universidade Estadual de Ponta Grossa, 2022.
FOSTER BD, et al. Distal radius fractures do not displace following splint or cast removal in the acute, postreduction period: a prospective, observational study. United States. Journal of Wrist Surgery, 2017; 6(1): 54-059.
GLUCK MJ, et al. Comparative strength of elbow splint designs: a new splint design as a stronger alternative to posterior splints. United States. Journal of Shoulder and Elbow Surgery, 2019; 28(4): 125-130.
GWILYM S, et al. Woodcast versus standard casting material for the immobilization of nonoperatively treated distal radial fractures: a randomized parallel-group feasibility trial. Inglaterra. The Bone & Joint Journal. 2020; 102(1): 48-54.
HOMEM P. A imobilização gessada convencional/clássica em ortotraumatologia. 2ª ed. Coimbra: FORMASAU, 2013; 19-63.
HUNTER H e NALLAMOTHU SV. Ankle Splinting. In: StatPearls, Treasure Island (FL): StatPearls Publishing, 2023. Disponível em: https ://www.ncbi.nlm.nih.gov/books/NBK507726/. Acesso em: 15 de setembro de 2024.
HUNTER H e SIWIECRM. Forearm Splinting. In: StatPearls, Treasure Island (FL): StatPearls Publishing, 2023. Disponível em: https ://www.ncbi.nlm.nih.gov/books/NBK499980/. Acesso em: 15 de setembro de 2024.
JACKSON T, et al. A comparison of sugar-tong and volar–dorsal splints for provisional immobilization of distal radius fractures in the adult population. França. European Journal of Orthopaedic Surgery & Traumatology, 2021; 31: 229-234.
MA H, et al. Topology-optimized splints vs casts for distal radius fractures: a randomized clinical trial. United States. JAMA Network Open, 2024; 7(2): 2354359.
NALIN e VANESA et al. Atuação de enfermagem em serviço ambulatorial de traumato-ortopedia. Revista de Teorias e Práticas Educacionais. Brasil, 2014; 3(1): 5-11.
PESENTI S, et al. Feasibility of a reduction protocol in the emergency department for diaphyseal forearm fractures in children. France. Orthopaedics & Traumatology: Surgery & Research, 2015; 101(5): 597-600.
RODRIGUEZ JAG, et al. Forearm volar slab splint: Casting immobilization series for primary care. Canada. Canadian Family Physician, 2018; 64(8): 581-583.
RODRIGUEZ JAG, et al. Short arm cast: casting immobilization series for primary care. Canada. Canadian Family Physician. 2018; 64(10): 746-749.
RODRIGUEZ JAG, et al. Below-knee cast: Casting immobilization series for primary care. Canada. Canadian Family Physician, 2018; 64(9): 670-673.
SILVA FBA, et al. Influence of postoperative immobilization on pain control of patients with distal radius fracture treated with volar locked plating: A prospective, randomized clinical trial. Netherlands. Injury, 2019; 50(2): 386-391.
SIU C, et al. Long-arm splinting versus above-elbow casting for type 1 supracondylar fractures of the humerus in children: a randomized controlled trial. Switzerland. SN Comprehensive Clinical Medicine. 2023; 5(1): 72.
SOARES CB, et al. Revisão integrativa: conceitos e métodos utilizados na enfermagem. Brasil. Revista da Escola de Enfermagem da USP. 2014; 48: 335-345.
SOUSA LRB, et al. Notificação do acidente traumático em um hospital público da Amazônia brasileira. Brasil.Revista Brasileira em Promoção da Saúde, 2017; 30(1):64.
WALLEY KC, et al. Surface Pressures in Lower Extremity Splints: A Biomechanical Study. United States. Foot & Ankle Orthopaedics, 2023; 8(1): 24730114231160115.
WALTHALl J, et al. Long Arm Splinting. In: StatPearls, Treasure Island (FL): Stat Pearls Publishing, 2023. Disponível em: https ://www.ncbi.nlm.nih.gov/books/NBK513283/. Acesso em: 15 de setembro de 2024.
WHITTEMORE R e KNAFL K. The integrative review: updated methodology. England.O Journal of advanced nursing, 2005; 52(5): 546-553.
WOO CY, et al. Effects of Cast Immobilisation on Skin Barrier Function. Singapore. Ann Acad Med Singapore, 2020; 49: 285-93.
YASINZADEH M, et al. Efficacy of Half-length vs. Standard-sized Short Arm splint in Soft Tissue Injuries of the Hand and Wrist: a Randomized Controlled Trial. Iran. Advanced Journal of Emergency Medicine, 2019; 3(2): 16.
