Waterproof Radial and Ulnar Gutter Splints
Explore FlexiOH gutter splints for hand immobilization. Radial and ulnar configurations support different parts of the hand; your treating clinician determines the appropriate fit for your injury.
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Waterproof Radial and Ulnar Gutter Splints — What They Are and When They’re Used
A radial gutter splint and an ulnar gutter splint are two of the most commonly applied hand immobilization devices in urgent care and orthopedic settings. They are used for metacarpal fractures — fractures of the long bones in the hand — and are distinguished by which side of the hand they immobilize.
The radial gutter splint immobilizes the index and middle fingers and the 2nd and 3rd metacarpals. It is used for fractures of the 2nd and 3rd metacarpals, index finger fractures, and some proximal phalanx injuries. The ulnar gutter splint immobilizes the ring and small fingers and the 4th and 5th metacarpals. It is the standard treatment for boxer’s fractures — fractures of the 4th or 5th metacarpal neck — which are among the most common fractures seen in urgent care settings.
FlexiOH offers both radial and ulnar gutter configurations as part of its 8-configuration waterproof casting system. Unlike traditional plaster gutter splints, FlexiOH gutter splints are 100% waterproof, breathable, radiolucent, and removable with a zipper — making them an option for everyday cast care during the 4–6 week immobilization period.
- Both radial and ulnar gutter configurations available
- 100% waterproof — shower and bathe without any covering
- Radiolucent — follow-up X-rays without removing the splint
- Zipper closure — no cast saw, no plaster mess at removal
- 46% exposed skin — breathable, reduces itching and skin breakdown
- Application and curing typically take 3–10 minutes, depending on size
- ISO 10993-10 certified biocompatible foam inner lining
Radial Gutter Splint vs. Ulnar Gutter Splint — Key Differences
Index & Middle Finger Metacarpals
Immobilizes: 2nd and 3rd metacarpals, index and middle fingers, wrist in slight extension.
Used for: 2nd metacarpal fractures, 3rd metacarpal fractures, index finger fractures, middle finger proximal phalanx fractures, and some hand injuries requiring radial-side immobilization.
Position: Wrist in 20–30° extension, MCP joints in 70–90° flexion, IP joints in slight flexion (intrinsic-plus position).
Ring & Small Finger Metacarpals
Immobilizes: 4th and 5th metacarpals, ring and small fingers, wrist in slight extension.
Used for: Boxer’s fractures (4th and 5th metacarpal neck fractures), ring finger metacarpal fractures, small finger fractures, and ulnar-side hand injuries. Boxer’s fractures are the most common metacarpal fracture and the most common indication for an ulnar gutter splint.
Position: Wrist in 20–30° extension, MCP joints in 70–90° flexion, IP joints in slight flexion (intrinsic-plus position).
FlexiOH is backed by a prospective, multicentric, open-label clinical study published in the Journal of Medical Sciences and Health (2024), demonstrating a published adult wrist-fracture study in fracture patients. The study confirmed the system’s radiolucency, ISO 10993-10 biocompatibility, and documented decreased pain medication requirements over the treatment course. While the published study focused on distal radius fractures, the same immobilization technology and materials are used across all FlexiOH configurations including the radial and ulnar gutter splints.
Source: Bali T, et al. JMSH. 2024;10(1):104–110. DOI: 10.46347/jmsh.v10.i1.23.10Boxer’s Fracture — The Most Common Ulnar Gutter Splint Indication
A boxer’s fracture is a fracture of the 4th or 5th metacarpal neck — the most common metacarpal fracture, typically caused by punching a hard surface. It accounts for approximately 20% of all hand fractures seen in urgent care and emergency settings. The standard treatment is an ulnar gutter splint for 4–6 weeks, with the MCP joints held in the intrinsic-plus position.
The problem with traditional plaster ulnar gutter splints is the same as with all traditional casts: patients cannot shower, bathe, or wash their hands for the entire immobilization period. For a boxer’s fracture patient — who is typically a young, active adult — this is a significant quality-of-life issue. The FlexiOH waterproof ulnar gutter splint solves this completely. Patients can shower, wash their hands, and maintain normal hygiene throughout the 4–6 week recovery period.
The FlexiOH ulnar gutter splint also eliminates the cast saw at removal — a significant advantage for patients who are already anxious about their injury. Removal takes seconds with the zipper closure. And because FlexiOH is radiolucent, follow-up X-rays to assess fracture healing can be taken without removing the splint, saving time at every follow-up appointment.
Why Providers and Patients Choose OrthoHeal for Gutter Splints
OrthoHeal is the authorized national dealer for FlexiOH waterproof cast and splint systems in the United States. We supply all 8 FlexiOH configurations — including radial and ulnar gutter splints — directly to orthopedic practices, urgent care centers, and hospital systems nationwide.
ISO 10993-10 Biocompatible Materials
Ask your treating clinician about skin sensitivity and whether FlexiOH is suitable for you. Product documentation and application guidance are available on request; skin irritation or concerns should be discussed with your clinician.
FDA Registered Medical Device
FlexiOH is an FDA-registered medical device manufactured under ISO 13485 quality management standards. Every unit is manufactured to the same quality specifications used for all orthopedic immobilization devices.
Authorized National Dealer
We are the official authorized dealer for FlexiOH in the United States. Every unit is sourced directly from the manufacturer, ensuring authenticity, quality control, and full clinical documentation.
Direct Support — Providers and Patients
Whether you are a provider looking to order gutter splints wholesale or a patient looking for an authorized provider near you, our team is available at (937) 776-7801 to help.
Product and study context: A 2024 open-label study evaluated the FlexiOH Short Arm Immobilizer in 137 adults aged 18–80 with distal-radius fractures. The authors reported healing at the third follow-up. This was not a controlled comparison of healing speed, and its findings do not establish pediatric outcomes or guarantee an individual result. Healing time is not shortened by choosing a waterproof cast. Application and curing vary by size. Read the adult wrist study and the manufacturer’s guidance.