Reduction, Relocation and Splinting in Emergency Room (RASER)

PREFACE

Understanding proper splinting technique is a critical skill for all emergency physicians. We have attempted to compile the necessary techniques into one book for the busy emergency physician to review when on call. Always remember to continue practice splinting as a badly applied splint may be worse than no splint at all.

INTRODUCTION

BASIC TERMINOLOGY

(A) DIRECTION OF FRACTURE LINES:

• Transverse: Fracture line runs perpendicular to the bone axis.

• Oblique: Fracture line runs at 45 – 60° to the bone axis.

• Spiral: Fracture line has a corkscrew appearance and highly unstable.

• Comminuted: More than two fractured fragments.

• Impacted: Fracture ends are compressed together.

(B) ANATOMIC LOCATION:

• In long bones, fractures are characterized by proximal, middle and distal portions of the bone.

• If fracture extends into joint space, it is described as intra-articular.

• Other anatomical terms are referred by fracture site (head, neck, shaft and base).

• In pediatric age group, fractures described in relation to growth plate (physis) e.g. epiphyseal between joint and growth plate, diaphyseal referring to the shaft of the bone.

(C) DISPLACEMENT:

• Alignment: Relationship of axis of fragments of the bone e.g. lateral angulation/valgus deformity.

• Apposition: The amount of contact between the fracture surfaces.

• Translation: Used to describe the movement of fracture fragments from their usual position in a direction perpendicular to the long axis of the bone. It is described as percentage of bone width e.g. the fractured segment is 50% displaced in lateral