Distal radius fractures traditionally require a sugar tong splint to prevent the patient from ranging the wrist and elbow. The sugar tong splint essentially sandwiches the forearm with a splint, folded at the elbow. At this elbow fold, however, the splint often uncomfortably and inconveniently buckles and wrinkles when a wrap is applied.

Trick of the trade

Reverse sugar tong splint

A reverse sugar tong splint accomplishes the same degree of immobilization as a classic sugar tong splint by stabilizing the volar and dorsal aspect of the wrist and elbow. The splint fold, is located distally at the first webspace of the hand, instead of the elbow.

  • At the mid-length of 3-inch fiberglass splint material, transversely cut the splint such that the entire fiberglass material is cut through, leaving a “bridge” of padding intact.
  • Rest the padding bridge in the first webspace of the patient’s hand, folding the two halves of the splint to sandwich the volar and dorsal aspect of the wrist, forearm, and elbow. The ends of the splint should overlap each other and curl snugly around the elbow.

The reverse sugar tong splint provides an equally effective alternative to the traditional sugar tong splint, while avoiding splint buckling at the elbow.

Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD