Slings
by Duncan McGuire
Learning objectives
- Understand the basic types of slings used for upper limb injuries.
Introduction
There are three types of slings used for upper limb injuries in orthopaedics:
- Shoulder immobiliser
- Collar and cuff
- Broad arm sling
When applying, position the elbow in the corner of the shoulder immobiliser. Ensure that the strap at the back of the neck is adequately padded so that the sling is comfortable. For a properly positioned sling, the forearm should be in a horizontal position parallel to the ground when standing.
Broad arm sling
Triangle Sling
Collar and Cuff
Shoulder immobiliser
This is most commonly prescribed after an injury or surgery to a shoulder or an elbow. The shoulder immobiliser comes pre-packaged in various sizes. The part of the sling that the forearm rests in is made of material and it encloses the forearm with velcro straps. There is a strap that extends from the forearm component around the neck and back onto the forearm component. There is an optional strap that goes around the body to prevent the arm moving away from the body. This strap is usually only used when the intention is to not allow shoulder abduction.
Collar and cuff
The collar and cuff is made from sponge. It has a loop that goes around the neck and another loop through which the hand passes. The arm is supported with the wrist resting in the loop. The loop around the wrist should be loose enough that the patient is able to put in and take out their hand themselves.
The collar and cuff is very easy to apply and is cheaper than the shoulder immobiliser. It does not support the elbow, so in certain conditions where elbow support is required, the shoulder immobiliser may be better. Examples of this include clavicle fractures and acromioclavicular joint injuries. The collar and cuff is ideal for conditions where there is a plaster of Paris cast, brace or bulky bandage around the upper arm or elbow, where the bulkiness would interfere with the elbow fitting into the shoulder immobiliser. Examples include humerus fractures that are immobilised in a U-slab and where there is a bulky bandage around the elbow following surgery.