Hand: Splinting 3

Question 1

Which splint is close to an anti-deformity position?

Answer 1

resting hand splint

Question 2

Why is a resting hand splint not functional?

Answer 2

hand sits in a “pan”

Question 3

resting hand splint: gutter

Answer 3

first and fourth phalanges

Question 4

parts of a resting hand splint:

Answer 4

• thumb trough
• C bar
• pan
• forearm trough

Question 5

With a resting hand splint, make sure to consider these

Answer 5

• contact with styloid processes

- don’t want rubbing on bony prominences

Question 6

With a spica, what happens with the thumb?

Answer 6

fully encapsulated with plastic

Question 7

concerns with a spica

Answer 7

• can’t see tissue underneath
• skin breakdown
• must be big enough to allow for swelling but not so big that it doesn’t allow movement

Question 8

spica and movement

Answer 8

• doesn’t allow any movement

- may allow IP flexion if cut low enough

Question 9

Which dx will not get a spica?

Answer 9

DeQuervain’s tenosynovitis

Question 10

What does an opponens bar do?

Answer 10

stops opposition

Question 11

What can be added to a splint to make it functional?

Answer 11

outriggers

Question 12

What is a dorsal dynamic outrigger?

Answer 12

If a pt can’t extend

• pulleys grab onto the fingers and passively pull them into extension
• pt has to have flexor strength to overcome pulleys and grab something

Question 13

Outriggers must be here to facilitate grasping

Answer 13

dorsal surface of hand

Question 14

forces for outriggers

Answer 14

• pull should be at a 90˚ angle

- finger loops go around the finger for the pulley

Question 15

If the outrigger is not pulling at 90˚, what can happen?

Answer 15

• compression
• distraction
• shear

Question 16

What should happen with outriggers as the pt progresses?

Answer 16

must change the pull

Question 17

finger loops

Answer 17

• don’t make them too tight

- should be big enough to displace forces

Question 18

outriggers on the palmar side

Answer 18

not generally used