Evaluation of modern splinting materials for use in low- and middle-income countries: a cost-benefit analysis

Background Musculoskeletal (MSK) injuries pose a significant global health challenge, affecting 1.71 billion people worldwide. Low- and middle-income countries (LMICs) face amplified difficulties in managing MSK injuries due to limited resources and trained personnel. Conventional MSK injury treatment involves splinting, historically using Plaster or fiberglass materials. However, there is a lack of research on the suitability of these materials for LMICs. This study evaluates various splinting materials, including plaster, silicone rubber, fiberglass, resin, thermoplastics, woodcast, and aluminium moldable splints, with a qualitative analysis of potential use in LMICs. Methods A comprehensive literature review was conducted on PubMed, considering factors like intrinsic strength, moldability, setting time, ease of application, and cost/availability for each material. A targeted search on the application of these materials in LMICs was also performed. Results Plaster emerged as cost-effective, but is brittle, non-waterproof, and challenging to apply correctly. Fiberglass offers superior strength but is less cost-effective. Other materials are either cost-ineffective or present application challenges. Aluminium moldable splints show promise for their ease of application and cost-effectiveness, but there is limited research available regarding this newer material. Conclusions While no single material emerged as clearly superior for all splinting requirements of LMICs, plaster remains widely utilized. Other materials have cost and technical limitations that may limit their potential for universal use in LMICs. Aluminum moldable splints present a potentially viable alternative, offering a balance between cost and ease of application. However, further research is needed to confirm their suitability and effectiveness in LMIC settings.