Although spica splints are used infrequently, they can be a helpful means of external coaptation in patients with selected musculoskeletal abnormalities. Spica splints are most commonly used for temporary immobilization of the shoulder or elbow following open or closed fracture reduction, particularly when surgery is delayed or the patient requires transport before fixation. Spica splints are rarely used for primary management of humeral fractures because of the availability of more viable treatment options. However, spica splinting may be considered in a young animal with a greenstick fracture of the humerus.
Proper application and management are critical to ensure safe use of the spica splint, so named for the method of attaching the splint to the body by a “spica” or figure-of-8 bandage shape. In dogs and cats, however, the bandage is modified so it is only half of a figure-of-8. During application, the bandage material begins at the digits and continues proximally around the torso. The splint should extend over the scapula (or hip) to the dorsal midline and be secured around the contralateral shoulder or hip. Although the spica splint is most often applied to the thoracic limb, it can be used for reduction of the pelvic limb. However, bandaging the pelvic region can be difficult, especially in male dogs.
Because extensive manipulation is required, the patient should be heavily sedated or under general anesthesia. Additional wounds should be treated appropriately and covered with a dressing before the splint is applied. Although the torso is included in the bandage, tape stirrups should be placed to prevent it from slipping, possibly obscuring assessment of the digits. After the splint has been applied, ambulation may be cumbersome, so appropriate assistance (eg, sling support) should be provided.
Complications & Monitoring
Because spica splints are generally well padded and used only for a brief period, there is minimal opportunity for complications. Also, because the splint must be secured firmly around the torso, slippage is less common. The patient should still be monitored closely, however, for abrasions or bandage sores in the axillary or inguinal region.
With extended use, joint contracture or loss of range of motion can occur, especially when the spica cast is used for fracture management. During bandage application, care must be taken to avoid compressing the patient’s thorax and compromising respiratory function, especially in patients with preexisting thoracic trauma (eg, pneumothorax, pulmonary contusions).
What You Will Need:
- Cast padding
- Rolled gauze
- Cast material (eg, fiberglass, thermoplastic material) or splint rod
- Casting gloves
- Bandage tape or self-adhesive stretch tape
Step-by-step: Applying a spica splint