Hand: Splinting 2 Flashcards
What are the positions of the hand used for splinting?
- functional position of the hand
- anti-deformity position of the hand
What is the functional position of the hand
- wrist in 20-30˚ extension
- MCP at 35-45˚ flexion
- PIP 45˚ flexion
- DIP relaxed flexion
- thumb at palmar abduction
Why does the wrist need to be extended?
- can do more
- think typing
Why does the thumb need to be at palmar abduction for the functional position?
- gives ability to do functional things
- if the splint allows
Why use an anti-deformity position for splinting?
reduce likelihood of deformity when someone has to be immobilized by a splint
- post-surgically
- ranging is contraindicated
What is the anti-deformity position?
- wrist at 30-40˚ extension
- MCP at 60-90˚ flexion
- MCP at 60-90˚ flexion
- PIP and DIP in full extension
- thumb at palmar abduction
Why is it important to get a pt in an anti-deformity position (extension)
easier to get them into flexion if they already have extension than to get them to extension from flexion
What are the splint types?
- volar wrist cock-up splint
- dorsal wrist cock-up splint
- resting hand splint
- spica
- hand based thumb spica splint
- opponens bar
most common type of splint
volar wrist cock-up
Who gets a volar wrist cock-up splint?
- CTS
- RA
What are you trying to do with splinting (think hand characteristics)
consider dual obliquity
volar wrist cock-up splint accommodates for
- thenar eminence
- allows opposition
parts of a volar wrist cock-up splint
- metacarpal bar
- hypothenar bar
- forearm trough
dorsal wrist cock-up splint: used for
- incisions
- burns
- pt trying to go into flexion and want to encourage extension
dorsal wrist cock-up splint: knuckles
don’t want to go over knuckles unless you’re trying to limit MCP extension
