Fx_RadiusUlnaPadding copyDistal radius fractures are among the most commonly encountered fractures in the emergency department (ED). They have been reported to account for around 25% of pediatric fractures and up to 18% of fractures in the elderly.1 Reducing minimally displaced distal radius fractures is a procedure that can be greatly facilitated by the presence of finger traps, which help hold traction while you reduce the fracture.2 Often While working in small 5-bed, free-standing emergency department (ED), I found myself needing to perform this vital procedure and finger traps were unavailable.

Trick of the Trade: Gauze roll finger traps

While I searched the Internet for an answer, a nurse brought me a gauze roll and asked me if it might be helpful. After some trial and error, we found a method of tying the gauze roll around the fingers in such a way that we could easily use it as a substitute for the traditional finger traps. After the procedure we made a video showing how to do it:

Technique and Lessons Learned

  1. Tie one end of the gauze roll with a simple knot on the thumb, then wrap the free end around the index finger 2 times at the base of the finger
  2. Slip the free end into the proximal loop and out the distal loop towards the finger tips.
  3. Tighten until firm.
  4. Repeat the process for the middle and ring fingers. After the 4 fingers are prepared, take the end and wrap it around the index and middle fingers proximal to the previous knots (closer to the base of the fingers) 2 times.
  5. From the palmar side, take the free end and go underneath the gauze you just wrapped around the index and middle finger, and out through the dorsal side, always keeping the free end proximal to the previous loops.
  6. After that, make sure it’s tightened, and attach the free end to an IV pole.
  7. You are ready to commence your reduction.

 

1.
Nellans K, Kowalski E, Chung K. The epidemiology of distal radius fractures. Hand Clin. 2012;28(2):113-125. [PubMed]
2.
Wolfe SW. Distal radius fractures. In: Green’s Operative Hand Surgery. 6th ed. Churchill Livingstone; 2010:561-638.
Jacob Avila, MD RDMS

Jacob Avila, MD RDMS

Clinical instructor and Ultrasound fellow
Department of Emergency Medicine
University of Kentucky
Jacob Avila, MD RDMS

@ultrasoundMD

https://t.co/gFS9UMjaJv. University of Ky, Lexington. Ultrasound technologist, Battlestar Galactica. Views are my own.
Ben Smith, MD

Ben Smith, MD

Director of Emergency Ultrasound, Associate Program Director
Department of EM, UTCOM;
Attending Physician, Erlanger Hospital
Creator of www.ultrasoundoftheweek.com
Ben Smith, MD

@ultrasoundjelly

[emergency medicine | critical care ultrasound | innovative online education | coder] #FOAMed #FOAMus #FOAMcc