Long leg splints can be used for the definitive management or temporary immobilization of fractures. A multi-physician team often is necessary to stabilize the painful leg and apply a long leg splint in patients with an intra-articular distal femur fracture, unstable multiligamentous knee injury, tibial plateau fracture with coronal instability, tibial shaft fracture, or pilon fracture with proximal extension. Despite the team effort, small movements by each physician may result in substantial pain stimulus for the patient.

At our institution, we routinely use two gauze wraps, which are woven repeatedly under the injured leg and around the rails of a stretcher, to maintain the leg in an elevated position. With this technique, only one physician is required for the application of a long leg splint (with one assistant to hold the foot to prevent rotational instability), resulting in a less traumatic experience for the patient. Although careful attention must be paid to properly pad the extremity, this technique is associated with no known contraindications. This video demonstrates the single-physician technique for the atraumatic application of a long leg splint.