Splinting Flashcards
static/dynamic splinting, prefabricated and custom splints
basic goals of splinting
protection
assistance
stabilization
support
substitution
transfer of power
tissue remodeling
joint stretching
strengthening
what should every splint do
adhere to certain biomechanical principles
fit comfortably
don/doff easily
be aesthetic
meet goals/needs of pt but restrict fxn as little as possible
2 types of splints
static/dynamic
custom/prefabricated
most splints work on a
pressure system
to achieve intended goals
static splints
no moving parts designed to support or limit joint activity
purpose of static splint
protection of tissue through joint immobilization
maintain or correct joint alignment
prevention of contractures
supports/stabilization
maintain or increase joint ROM
position hand to improve fxn
when would you use a static splint for protection or immobilization/rest
arthritic joint
healing fx
carpal tunnel syndrome
tendon/nerve repair
ligamentous injury/volar plate
joint replacement
rest inflamed joint
when would you use a static splint for joint alignment
arthritic joints RA/OA
s/p nerve injury
when would you use a static splint for joint alignment –> arthritic joints
anti-ulnar drift splint
when would you use a static splint for joint alignment –> s/p nerve injury
ulnar N. anticlaw splint
median N. short opponens
when would you use a static splint for prevention of contractures
surgical scars
burns
s/p nerve injury
serial splinting
when would you use a static splint for support and stability
ligamentous injuries –> skiers thumb
dislocations
hypermobility
when would you use static splinting to maintain ROM
maintenance of ROM gained from exercises +/or dynamic splinting
when would you use static splinting to position the hand to improve fxn
radial N palsy wrist extension allows for finger fxn
median N thumb positioned in ABD/OPP for fxn
what is a static progressive splint
incremental, periodic application of stress relaxation (SR) loading
SR loading
tissue is stretched and held at a constant length
amount of force is reduced over time
when do therapist apply SPS
manually when treating stiff tissues
what devices provide SPS
JAS (brand name)
JAS
for home use as an adjunct to clinic therapy
dynamic splinting
the application of a moving force through traction
what is dynamic splinting trying to achieve
support
increase joint mobility
controlled mobility after injury to surgery
purpose of dynamic splinting
provide resistance
provide prolonged stretch
joint positioning
purpose –> DS –> provide resistance
strengthening
enhancement of tendon glide
purpose –> DS –> provide prolonged stretch
plastic tissue deformation
mobilization of stiff joints
stretching tight soft tissue
dynamic splinting is a substitution for
assist or replace fxn of weak or absent muscle
ex: radial N splint
purpose of tendon rehab splints
allow controlled passive glide of repaired tendons
dynasplint systems
aid in restoring range of motion to stiff joints
dynasplint systems have
low load
prolonged duration stretch (LLPS) permanent CT deformation
additional principles of dynamic splinting
check dynamic components regularly and replace if necessary
wearing time vary by pt and goals
record measurable gains
custom made splints materials
low temp thermoplastics
strapping and closures
velcro hook and loop
betapile polyethylene foam
adhesive and non-adhesive
d-rings
posts
dynamic components
rubber bands
strings
slings
hinges
bars
springs
hooks
tubes
turnbuckles
precautions when splinting
friction
pressure
friction
resistance of skin against movement of the splint
skin against skin
what does friction cause
potential “hot spots”
where does friction usually occur
over bony prominences
pressure
excessive force by splint can cause undue pressure
where does pressure usually occur
bony prominences, must be careful
what could excessive pressure cause
ischemia –> tissue breakdown –> “hot spots”
how do we avoid pressure
padding and rolling edges
example of hot spots
elbow
design considerations
pt individuality
pt acceptance and compliance
pt individuality –> design considerations
age
mental status
support system
medical status
proximity/transport to clinic
insurance
prices
pt acceptance and compliance –> design considerations
simple to don/doff
cosmetic –> low profile
comfortable
easily adjustable
light weight
fxnal
allows for max sensory surface
prefabricated splints
CVS or pharmacy
off the shelf
