fan strapping

fan strapping

soft splintage applied to immobilize a painful first metatarsophalangeal joint (1 MTPJ); longitudinal application of 2.5-cm-wide strips of non-extensible strapping across 1 MTPJ (each strap overlying its neighbour by 50% at medial side of the hallux just proximal to interphalangeal joint, and fanning out as they cross the medial aspect of the 1 MTPJ, so that straps lie adjacent to one another at the midpoint of the shaft of the first metatarsal); see Table 1
Table 1: Techniques of strapping
StrappingApplication
Church doorThree lengths of strapping applied around the periphery of a pad, as a triangle
Goal postFour lengths of strapping applied around the periphery of a pad, as a rectangle
ShiplapSeveral lengths of strapping that are applied transversely across the pad from proximal to distal so that each subsequent strap overlaps the previous by one-third
FanSeveral lengths of strapping that are applied longitudinally across a joint (to form a soft splint), so that one end of each subsequent strap overlies the previous strap but the other end lies adjacent to the previous strap, so that the whole assemblage resembles a fan
Top strapThe distal transverse bar of goal post strapping, whose distal margin is shaped to reflect the line of the plantar webbing, allowing maximum plantar adhesion but minimal restriction of the toes
FlaskA strap cut to the shape of a bottle or flask, so that the 'neck' is applied to the pad, and the 'belly' to the skin
BananaA strap cut into the shape of a banana
Bow/false plantar fasciaLengths of strapping applied longitudinally along the sole of the foot from the heel to the plantar web line Figure 1
MaskSeveral layers of strapping laid one on another with a central hole cut to match the size of a lesion Figure 2
StirrupLengths of strapping applied to the ankle/subtalar joint area, applied from the medial to lateral malleolus (for a medial ankle sprain) or from the lateral to medial malleolus (for a lateral ankle sprain)
MetatarsalStrapping applied transversely across the plantar and dorsal surfaces of the forefoot to restrict metatarsal movement

Note: To aid retention, strapping should always be cut to create a smooth outline (e.g. corners are rounded) and applied firmly allowing for digital movement - unless the intention is to provide a soft splint to rest the part.

Figure 1: Bow strapping. A: Application of longitudinal straps B: Overlaying of transverse straps. This article was published in Neale's Disorders of the Foot, Lorimer, French, O'Donnell, Burrow, Wall, Copyright Elsevier, (2006).
Figure 2: Mask: several layers of adhesive strapping with a central hole into which a caustic ointment is placed (A), overlain by a cavitied felt pad (B), strapped into place (C). This article was published in Neale's Disorders of the Foot, Lorimer, French, O'Donnell, Burrow, Wall, Copyright Elsevier, (2006).