TECHNIQUE

Bandages, Slings, Splints & Casts in Birds (Disease Investigation & Control - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Control / Treatment & Care / Techniques:
Synonyms and Keywords External Coaptation
Description The following description outlines the procedure as described by Bennett & Kuzma (J2.23.w2), Harcourt-Brown (B11.16.w13), Bennett (B12.42.w5), Degernes (B13.16.w11) and Coles (B14).

External support. Should immobilize the joints proximal and distal to the fracture site.

  • Radius, ulnar and carpometacarpus fractures - Figure-of-eight bandage: Tape crosses on the lateral surface of the wing, encircling the carpus cranially and the elbow and flight feathers caudally. Should be applied high into axillary region and incorporate the tertiary covert feathers, to avoid slipping. Should not extend more than about one-half-bandage-width below the elbow joint. Avoid applying too tightly. Three to five weeks of bandaging may be required for most fractures. Bandages should be changed weekly and the wing given careful physical therapy.
  • Humerus, coracoid, scapular, furcular fractures - wrapping wing to body: May be most useful for proximal humerus fractures in which the surrounding muscle mass assists in providing stability and preventing displacement. a) tape wrapped around the body over the shoulders, second tape wrapped around the body at the elbows, plus tape along the back (dorsally) to prevent the wraps from slipping; b) figure-of-eight bandage around the whole body, encircling both carpi cranially and both elbows caudally, with the cross of the tape on the back; c) figure-of-eight bandage as above, after which the wing is wrapped to the body.
  • Carpus, metacarpus and digit fractures: Appropriate sized piece of disused X-ray film or similar, bent over the wing along the leading edge and sutured to the skin and underlying ulnocarporemigial aponeurosis posterior to the carpus and metacarpus (B14).
  • Femur or tibiotarsus: Spica splint (small birds) (J2.23.w2, B13.16.w11).
  • Tarsometatarsus fractures: e.g. Schroder-Thomas splint (B12.42.w5), or in small birds (e.g. up to 100g) use of zinc oxide plaster or similar tape; matchsticks or similar may be incorporated into tape splints to provide increased support (B14).
  • Digits (toes): Ball, ball of bandage, or flat splint (J2.23.w2, B11.16.w13, B13.16.w11, B14).

(J2.23.w2, B11.16.w13, B12.42.w5, B13.16.w11, B14).

Appropriate Use (?)
  • Treatment of some types of Impact Injury, Brachial Paralysis, Perosis, Crushing.
  • Temporary stabilization of fractures prior to surgical treatment.
  • Very small birds (too small for internal fixation).
  • Very young birds.
  • Birds in which anaesthesia and surgery would be particularly risky.
  • Minimally displaced fractures.
  • Highly comminuted fractures in which primary repair would be impractical.
  • Where return to good limb function is not required.
  • Wing fractures where return to flight or normal anatomical alignment is not necessary.
  • Fractures of the radius or ulna, but not both.
  • Some lower leg fractures.

J2.23.w2, B10.20.w16, B12.42.w5, B13.16.w11, B13.42.w15, B14, P4.1992.w1, P7.1.w5

Notes
  • Provides protection for the fractured limb.
  • More comfortable than simple cage rest.
  • Requires little time and involves low infection risk for closed fractures.
  • Should immobilize the wing to the body to avoid further damage due to the powerful pectoral muscles.
  • Adhesive tape is not usually considered suitable for use in slings, bandages and splints on the layer directly against the bird, as the glue may damage feathers and skin. It is however used as a splinting material for e.g. metatarsal fractures in some small birds.
  • Figure of eight bandage used with proximal fractures of the radius and ulna may result in cranial overriding which may force the distal segments into the local artery and vein and the radial nerve, with resultant vascular and neurological compromise.
  • Light weight materials should be used.
  • Padding should be minimal - limit to amount required to allow for soft tissue swelling.
  • Must be monitored at least weekly for slippage, soiling, evidence of vascular compromise etc..

J2.23.w2, B12.42.w5, P4.1992.w1

Complications/ Limitations / Risk
  • Often requires long term convalescence; this may lead to secondary complications such as bumblefoot and stress.
  • Fracture segments may override, particularly the humerus (pull of pectoral muscles) and femur (pull of gastrocnemius).
  • Malalignment, joint ankylosis, limb shortening, tendon contracture, entrapment of tendons are frequent problems and result in poor limb function.
  • Must avoid compressing the sternum (interferes with breathing).
  • Avoid obstructing the vent.
  • May be difficult to align bones accurately in a conscious bird.
  • Some birds may be intolerant of the bandaging required for adequate stabilization of fractures.
  • Figure-of-eight bandages applied too tightly may result in vascular compromise of the wing distal to the carpal joint and sloughing of flight feathers.
  • Excessively bulky wing bandages may upset the balance of the bird.
  • Prolonged bandaging may result in stiff joints, bony changes, muscle atrophy from disuse, occasionally slough of flight feathers.
  • Schroeder-Thomas splints are not suitable for femur or proximal 2/3 tibiotarsus fractures - proximal portion of the splint may act as a fulcrum and interfere with immobilization (B13.16.w11).

(J2.23.w2, B12.42.w5, B13.16.w11, B13.42.w15, B14)

Equipment / Chemicals required and Suppliers
  • Tape - cohesive (self-adhesive) e.g. Vetrap .
  • Conforming gauze.
  • Conforming padding.
  • Splinting materials e.g. tongue depressors, aluminium rods.
  • Lightweight casting material e.g Orthoplast (Johnson & Johnson Products inc., New Brunswick, New Jersey USA), Hexcelite (Hexcel Medical, Dublin, California USA). Malleable when heated in hot water, may be moulded to form to the shape of the limb, light and comfortable.
  • Adhesive tape - may be used as a top layer, keeping the bandage clean and dry.
  • Tape such as zinc oxide tape as a splint material in small birds.
  • Appropriate solvent e.g. ether or Zoff for removal of zinc oxide tape.
  • The use of Animalintex as a splint, applied wet, bandaged into place and allowed to dry, has also been reported, used on swans (P8.3.w1).

(J2.23.w2, B12.42.w5, B14)

Expertise level / Ease of Use Basic bandaging and splinting are simple procedures and relatively little expertise is required (B12.42.w5).

However, correct bandaging technique improves considerably with experience.

Cost/ Availability Generally inexpensive (B12.42.w5).
Legal and Ethical Considerations Inappropriate use or poor application of this technique may cause further suffering to the bird and have implications under animal welfare legislation.

In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery."(see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).).

Author Debra Bourne
Referee --
References J2.23.w2, B10.20.w16, B12.42.w5, B13.16.w11, B13.42.w15, B14, P4.1992.w1

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