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This page describes products and general use; it is not medical advice.
A sugar tong splint is a U-shaped plaster or fiberglass splint that wraps around the elbow, so one strip of material runs along each side of the forearm. This page is for clinic staff, buyers and students who need to know how the splint is built, what it is made from, and how it differs from other upper-limb splints.
What a sugar tong splint is
A sugar tong splint is a long, padded strip of casting material shaped like a pair of sugar tongs. According to the American Academy of Family Physicians (AAFP), the single sugar-tong splint runs from the proximal palmar crease along the volar forearm and around the elbow to the back of the metacarpophalangeal (MCP) joints, and is listed for acute management of distal radial and ulnar fractures. It stabilizes the wrist and elbow and limits, but does not eliminate, forearm supination and pronation. Source: AAFP, checked 2026-10-30.
Who uses it: emergency, urgent care and orthopedic clinicians, who apply it as a temporary (acute) splint; buyers in those settings stock the padding, casting material and wraps it is built from.
How a sugar tong splint is built
A splint is not a circumferential cast. AAFP notes that casting involves circumferential application of plaster or fiberglass, whereas a splint leaves part of the limb’s circumference open. A sugar tong splint is assembled from layers:
- Stockinette: the Merck Manual lists stockinette long enough to extend past the metacarpophalangeal (MCP) joints to the mid-humerus.
- Roll padding: AAFP describes two or three layers of cotton padding; Merck lists roll padding 7.5 cm (3 inches) wide.
- Plaster or fiberglass splinting material: Merck lists 7.5 to 10 cm (3 to 4 inches) wide. AAFP gives an average adult upper-extremity splint as six to 10 sheets of casting material.
- Elastic bandage: Merck lists one 7.5 to 10 cm (3 to 4 inches) wide to hold the splint in place.
AAFP also notes that prepackaged splints made of fiberglass and padding wrapped in a mesh layer exist, and that they are more expensive and not always available. For the materials themselves, see our guides to plaster bandage and cast tape, and the comparison fiberglass cast vs plaster cast.
Single vs double sugar tong and related splints
The names below are used for different extents of immobilization. Every row is taken from AAFP, “Splints and Casts: Indications and Methods” (checked 2026-10-30).
| Splint | Extent | Typical use (AAFP) | Forearm rotation |
|---|---|---|---|
| Single sugar tong | Proximal palmar crease, along the volar forearm, around the elbow, to the dorsum of the MCP joints | Acute management of distal radial and ulnar fractures | Limits, but does not eliminate, supination and pronation |
| Double sugar tong | Adds a second splint from the deltoid insertion distally around the 90-degree flexed elbow | Acute management of elbow and forearm injuries, including Colles fractures | Greater immobilization against pronation and supination |
| Posterior long arm | From the axilla over the posterior surface of the 90-degree flexed elbow | Acute and definitive management of elbow, proximal and mid-shaft forearm, and wrist injuries | Not stated in the source row |
| Volar or dorsal forearm | Dorsal or volar mid-forearm to the distal palmar crease | Temporary immobilization of carpal bone dislocations or fractures (excluding scaphoid and trapezium) | Does not limit supination and pronation |
| Ulnar gutter | Proximal forearm to just beyond the distal interphalangeal (DIP) joint | Nondisplaced, stable fractures of the head, neck and shaft of the fourth or fifth metacarpal | Not stated in the source row |
Sugar tong vs long arm splint
A sugar tong splint wraps around the elbow with one strip on each side of the forearm. A posterior long arm splint, per AAFP, starts at the axilla and runs over the back of the 90-degree flexed elbow. A sugar tong controls forearm rotation to a degree; a volar or dorsal forearm splint does not limit it.
Posterior, volar and ulnar gutter splints
These are named for the side or region they cover. The “posterior” splint in AAFP’s list is the long arm version above. A volar splint lies on the palm side of the forearm, and an ulnar gutter splint covers the little-finger side of the hand and forearm for fourth and fifth metacarpal injuries. For finger-level splints see finger splint types.
Is a stirrup splint a sugar tong?
No. In AAFP’s article a stirrup splint is an ankle splint that runs from the lateral mid-calf around the heel to the medial mid-calf. It is not a forearm splint, so it is a different product from a sugar tong.
Widths and materials that matter
Widths below are the equipment lists in the Merck Manual Professional procedure pages (checked 2026-10-30). They describe the supplies named for each splint, not a recommendation for a particular patient.
| Item | Sugar tong arm splint | Ulnar gutter splint |
|---|---|---|
| Roll padding | 7.5 cm (3 inches) | 5 cm (2 inches) |
| Plaster or fiberglass splinting material | 7.5 to 10 cm (3 to 4 inches) | 7.5 cm (3 inches) |
| Elastic bandage | 7.5 to 10 cm (3 to 4 inches) | 5 cm (2 inches) |
AAFP gives general padding widths of 2 inches for the hands and 2 to 4 inches for the upper extremities.
Safe use and handling basics
The Merck Manual lists these complications for upper-limb splinting: thermal injury from the exothermic reaction between plaster or fiberglass and water; pressure sores, neurapraxia or ischemic injury from excessive pressure; and compartment syndrome. AAFP states that adequate padding at the olecranon, ulnar styloid and antecubital fossa prevents skin breakdown. Application and aftercare belong to a trained clinician following the product’s instructions for use.
Common mistakes
- Treating “sugar tong” as one product. Single and double versions differ in extent and in how much rotation they control (AAFP).
- Assuming it blocks all forearm rotation. AAFP says the single sugar tong limits but does not eliminate supination and pronation.
- Confusing the stirrup splint. The stirrup splint in AAFP is an ankle splint.
- Underestimating padding. AAFP and Merck both identify pressure and skin breakdown as risks that padding at bony points is meant to reduce.
FAQ
Is a posterior splint the same as a sugar tong splint?
No. AAFP describes a posterior long arm splint as running from the axilla over the back of the flexed elbow, while a sugar tong wraps around the elbow in a U shape.
What is the difference between a sugar tong and a long arm splint?
The sugar tong runs along both sides of the forearm and around the elbow; the posterior long arm runs from the axilla over the back of the elbow.
What is a volar splint?
A splint on the palm side of the forearm. AAFP lists the volar or dorsal forearm splint for temporary immobilization of certain carpal injuries and notes it does not limit supination and pronation.
What is an ulnar gutter splint used for?
AAFP lists it for nondisplaced, stable fractures of the head, neck and shaft of the fourth or fifth metacarpal; it runs from the proximal forearm to just beyond the DIP joint.
What is a stirrup splint?
An ankle splint running from the lateral mid-calf around the heel to the medial mid-calf (AAFP). It is not a forearm splint.
Sources
- American Academy of Family Physicians, “Splints and Casts: Indications and Methods”, aafp.org/afp/2009/0901/p491, checked 2026-10-30.
- Merck Manual Professional Edition, “How To Apply a Sugar Tong Arm Splint”, merckmanuals.com (sugar tong arm splint), checked 2026-10-30.
- Merck Manual Professional Edition, “How To Apply an Ulnar Gutter Splint”, merckmanuals.com, checked 2026-10-30.
Related: splint kit contents.
