What Is a Radial Gutter Splint Used For?

A radial gutter splint immobilizes the index and middle fingers after a fracture. It's called "radial gutter" because it wraps around the side of the forearm formed by the radius bone.

A splint is a medical device made of wood or other rigid material. It is used to immobilize a fractured or dislocated bone. A splint usually helps to maintain any part of the body in a fixed position. The most common use of splints is in emergency settings to keep a detached bone in position until a surgeon can look at it.

• The radius and ulna are the two bones that form the forearm and join with the wrist and fingers.
• A radial gutter splint is a type of splint that is used to treat fractures of the index (second) and long (third) fingers. It is so named because these fingers lie on the radial (lateral) side of the hand.

A radial gutter splint is used to treat

• Soft tissue injuries to the second and third fingers
• Fractures of the second and third fingers
• Rheumatoid arthritis (swelling and pain of the joints)
• Deep cuts or lacerations over the joints of the second and third fingers

A radial gutter splint cannot be used for fractures with nerve damage or fractures where the overlying skin is broken. Such types of injuries require surgery and monitoring. A radial gutter splint is also not recommended when there is a severe deformity due to a birth defect or injury (angulated neck fractures) at second and third fingers.

A radial gutter splint is placed along the radial aspect (radial bone) of the wrist. It sandwiches the second and third fingers providing the optimal function of the second and third fingers, allowing maximum mobility of other digits. Radial gutter splinting is usually tolerated without anesthesia. However, anesthesia or analgesia may be required in cases where a minimal alteration is required.

Below are the steps of making a radial gutter splint:

• A splint is cut out into a three- or four-inch length, necessary to immobilize the wrist and injured fingers (usually second and third).
• A splint may be bisected lengthwise from the fingertips to the wrist.
• A dry gauze or cotton material may be inserted between the second and third fingers.
• The splint “tails” are folded so that it sandwiches the second and third fingers.
• The splint is secured in place using a bias wrap or an elastic bandage.

Complications of a radial gutter splint include

• Skin burns due to excess heat used during splinting
• Pressure sores
• Skin allergies
• Swelling and pain
• Joint stiffness and reduced movement

Usually, the patient may be recommended to rest and elevate the limb.

• The patient may report back immediately in the emergency department if there is increased weakness or numbness or color change (pale or blue) of the affected arm. The same should be done in case of pain that does not relent or a feeling of plaster constriction.
• Spreading redness or streaking should be immediately reported.
• The plaster should be kept dry and clean.
• The patient should not insert any items into the splint to scratch if it itches. Sticking objects into the splint can wrinkle the padding and lead to pressure sores. It may also cause a break of skin and infection that would be overlooked because of the presence of covers.
• The patient should visit the clinic or hospital within 48 hours of splinting for surgery or other treatment.