Forms of External Coaptation

In the time that I have spent at the clinic, I have seen plenty of broken bones.  Splints are the "go-to" form of external coaptation that the clinic uses to fixate and immobilize limb injuries.  The two most common forms of splints I see used are the Robert Jones Bandage and the Schroeder-Thomas Splint.

The Robert Jones bandage is a common external splint used to immobilize lower-limb injuries.  This bandage should not be used on upper-limb fractures/injuries because it cannot properly stabilize such injuries.  The Robert Jones bandage offers limb stability, tissue fluid absorption, and protects from trauma.  It promotes healing by immobilizing the injured area, thus reducing swelling and providing protection from secondary trauma.  The bandage consist of multiple layers of soft, compressible, and absorbent materials such as cotton wrap and conforming bandages.  These layers are supported by bandage tape stirrups, plastic splints, or a combination of both on either side of the leg.  The entire leg is then wrapped with vet wrap and once finished should keep the leg rigid and immobile.

The Schroeder-Thomas splint is another common external splint used to immobilize any fracture below the midfemur of midhumerus.  The splint is a traction device or traction splint.  This most commonly refers to a splinting device that uses straps attaching over the pelvis, hip, or shoulder as an anchor, metal rods to mimic normal bone stability and limb length, and a sling-like device to apply traction in order to reduce pain and realign the limb.  The splint is designed so that bandages and tape are used as slings on the metal frame to position and counteract muscle movement to help align and immobilize parts of the limb.

Although splints are a quick and easy way to set and immobilize fractures, casting is another common form of external coaptation.  Casts lie in contact with the skin and are made to conform to the injured area.  Plaster and fiberglass can be used for casting, but fiberglass is more commonly used because it is lighter, stronger, and dries quickly.  I had the pleasure of seeing a cast applied to a front limb fracture on a dog for the first time the other day.  The patient was anesthetized and the fracture was set.  Cotton cast padding and a stockingnette were applied to decrease pressure points that could cause skin ulceration.  Rolls of casting tape were dunked in warm water and applied up and down the leg.  Within minutes the cast was dry and hard as a rock.  The cast would be left on for 6-8 weeks in order to allow the fracture to form a callous and heal before being removed.