Pressure Sores From Splints
Occasionally, protective splinting with plaster of Paris splints can create problems, particularly in patients with diabetes and loss of protective sensation who are readily susceptible to pressure sores. Such was the case with this patient with type 1 diabetes whose ankle had been temporarily immobilized in a splint after a minor fracture of the lateral malleolus. The pressure sore and skin condition that developed during the immobilization required considerably more treatment than did the fracture. In persons with diabetes who have insensate limbs, splints or casts should be applied only with extreme caution.
Ankle sprains or minor fractures are best managed by removing splints. Treat with ice and elevation and protect the ligaments with an air splint. This encourages early functional ankle motion and permits weight bearing with crutches, which in itself helps decrease swelling. This approach is applicable for both the acute sprain and the relatively undisplaced fracture of the lateral malleolus.