Patient Information Resources

Orthopedic Services
Glendale Adventist Medical Center
1509 Wilson Terrace
Glendale, CA 91206
Ph: (818) 409-8000

Pain Management

View Web RX

« Back

I fell over the weekend (tripped over a garden hose) and really dinged up my wrist. Trying to decide if the splint I bought at the grocery store is all I need or if I should have a cast put on the arm. How do I know which one works better?

You may need a physician to advise you. Immobilizing the forearm/wrist may not be advised at all. Some injuries heal better and faster with movement rather than restriction. Other injuries (fractures, of course and ligamentous damage) do require a period of immobilization to reduce load and stress on the bone or soft tissue) and to allow for healing. An examination and/or X-ray may be the best way to get an accurate diagnosis and to guide treatment more specificially. When immobilization is recommended, the question you asked invariably comes up: should I use a splint or is a cast better? If the cast is used, should it be a long arm cast (above the elbow including wrist) or short arm cast (below the elbow)? If a splint is used, which one is advised: short arm splint, sugar tong splint, or long arm splint? For those who have never heard of a sugar tong splint, it is much like the long arm splint in that it includes (covers) both the elbow and the wrist. The sugar tong splint does allow elbow motion (flexion and extension), which the long arm splints and casts do not allow. That brings us back to the first question -- which immobilizer to use. Some of this may depend on where the injury is located (in your case, you said it is the wrist), the severity of the injury, and the damage done (e.g., torn ligaments, broken bone, strained muscles or tendons). A second major consideration is whether or not forearm rotation (palm up called supination/palm down called pronation) should be restricted or allowed. The results of a recent study from South Korea may help provide some help in answering the question of which way to go: cast or splint. Healthy adult volunteers (ages 23 to 66) participated. Forearm rotation was measured using a specially designed goniometer (device used to measure joint motion). Measurements of pronation and supination were recorded without a cast or splint. The same measurements were then taken with the arm in each one of the different immobilizers. Four observations were made:
  • The long arm cast was able to hold the forearm and prevent rotations better than any other method.
  • The rest of the immobilizers reduced the amount of forearm rotation by about 60 per cent.
  • Differences were observed in the amount of rotation between men and women with these different methods of immobilization. Women tended to have more forearm rotation than men when in the short arm cast.
  • The short arm splint allowed the most amount of forearm rotation (more than half the normal range-of-motion). The authors advise the use of a long arm cast when forearm rotation must be stopped as much as possible. The long arm cast restrained forearm rotation to less than 10 per cent of normal supination and pronation. The short arm splint should only be used when unrestricted forearm motion is allowed. Our best advice is to seek medical attention and an accurate diagnosis before immobilizing the wrist, forearm, or arm. With this information in mind, you'll be able to understand the reason behind treatment recommendations and/or know what questions to ask. It's best not to delay diagnosis since earlier identification of the problem and adequate treatment often provides the best results.

  • References:

    « Back

    *Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

    All content provided by eORTHOPOD® is a registered trademark of Mosaic Medical Group, L.L.C.. Content is the sole property of Mosaic Medical Group, LLC and used herein by permission.