HCPs should stabilize any suspected fracture or joint abnormality of the long bones distal to the elbow and knee (radius/ulna, tibia/fibula).
- Manage wounds as per CPG 14 and then apply splints (e.g., SAM splints) to immobilize the fracture site, ensuring the joints above and below the fracture site are immobilized. Apply buttresses made of layers of cast padding or non-adherent dressing around footpads and any wounds. Apply about twice as much cast padding as is used for people. Generally, it is best to leave the nails of the middle two toes exposed, to allow monitoring for swelling.
- Cast application is not recommended, as cast pressure or friction sores are extremely common with MWDs and complicate recovery. MWDs tolerate splints and bandages poorly, so any MWD with a bandage or splint applied must wear a device to prevent self-mutilation or bandage removal (See Figure 21 and Figure 22).
- Splints and bandages generally need to be changed at least every other day. Change more frequently if soiled, wet, or loose.