splinting cases test one Flashcards
- Gladys : 72 year old Osteoarthritis Right Dominant Thumb CMC
Pain with use, Pain at rest
Type of Splint: CMC immobilization splint
- Alternate Names: short opponens
- Describe Position : rest reduce pain
Purpose Wear Schedule
PRN during activity
Osteoarthritis - bone on bone, some kind of breakdown.
- Rose - 77 years old: Swan neck deformity of index finger
Progressive over time due to Rheumatoid arthritis
Rx: Ring splint
Type of Splint: PIP extension restriction splint
- Alternate Names: Button hole or ring splint
- Describe Position
Purpose: Aide function and prevent hyperextension Wear Schedule
prn for function
rheumatoid arthritis- autoimmune disorder where the body is attacking itself because their is extra proteins that is foreign in the body and it try’s to rid it. Causing systemic reactions to organs.
- Malcolm - 74 years old: RA with ulnar drift
Two prescriptions: 9a. Night Resting Splint
9b. Functional Day splint
9a. Type of Splint #1 (RA Night) : night resting splint: wrist hand immobilization splint
- Alternate Names: resting hand splint
- Describe Position; wrist at 20 to 30 degrees, thumb in position of comfort. PIP/DIP/MP at slight flexion
Purpose: rests joints in functional position, calm inflammation Wear Schedule: H/S
- ------------------------------------------ 9b. Type of Splint #1 (functional day splint): MP ulnar restriction splint - Alternate Names: ulnar drift splint - Describe Position: warm joints and place MP in neutral,slight flexion
Purpose: aide function by reducing position of ulnar deviation Wear Schedule: prn during activity
- Darlene – 56 years old: Rheumatoid Arthritis. -1 week s/p MCP joint replacement
Type of Splint: MP extension controlled mobilization splint
- Alternate Names:
- Describe Position: position the MCP joint during healing
Purpose: allow functional activity Wear Schedule
at night switch to hand immobilization splint
___________________________Splinting for Soft Tissue Repair_______________________
11. John 48 year old: Carpal Instability
Works as lineman for electric company
Type of Splint: wrist immobilization splint
Alternate Names:
-Describe Position: wrist neutral
Purpose: reduce inflammation, promote healing Wear Schedule: 24/7 for 4 to 6 weeks
then prn during heavy work
- Maria: 42 year old: Lateral Epicondylitis
- due to overuse on assembly line at factory
Type of Splint: proximal forearm strap or wrist immobilization splint
Alternate Names
-Describe Position:
Purpose: reduce stress to wrist extensor group. Wear Schedule: during activity
Lateral epicondylitis- Infection or inflammation of an epicondyle.
- Adam, 22 year old; DeQuervain’s Tenosynovitis
Overuse as toll booth collector: progressively worse over past 3 months
Type of Splint: wrist thumb cmc /mp immobilization splint
Alternate Names: long opponens and thumb spica
-Describe Position:
Purpose: promote healing, then protection during activity Wear Schedule: 24/7 for 2 weeks then prn for activity
DeQuervain’s Tenosynovitis-Inflammation of tendons on the side of the wrist at the base of the thumb. These tendons include the extensor pollicis brevis and the abductor pollicis longus tendons.Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon.
- Tiffany - 32 year old: FCR, FCU Tendonitis
Over-use from caring for twins newborns
Type of Splint: wrist immobilization splint
Alternate Names: prefabricated splint
-Describe Position: wrist neutral
Purpose: reduce inflammation
Wear Schedule: 24/7 for two to three weeks remove for hygiene
Tendonitis- inflammation of tendons and of tendon-muscle attachments
- Sam - 17 years old: UCL sprain of MP of thumb – 4 weeks ago
Injured during forward skiing fall when pole stuck in snow bank
Rx: Splint for skiing
Type of Splint: Thumb cmc mp immobilization splint
Alternate Names: short opponens
-Describe Position: CMC 30 degrees, MP neutral to slight flexion. MOLD AROUND SKI POLE
Purpose: prevent reinjury
Wear Schedule use for activity
The ulnar collateral ligament is a thick triangular band at the medial aspect of the elbow uniting the distal aspect of the humerus to the proximal aspect of the ulna.
- Henry: 78 year old Retired Mason: Dupytren’s Middle Digit
s/p surgical release 2 days ago
Type of Splint: Dorsal MP/PIP/DIP 3rd digit immobilization splint
Alternate Names
-Describe Position: max extension and adjacent digit if little/ ring
Purpose: healing, prevent contracture Wear Schedule; 24/7, remove for therapy and wound care
- Betty – 75 years old: Trigger finger ring: A-1 Pulley -Flexor Tenosynovitis
developed over time, retired factory worker. Crochets daily
Type of Splint: 4th MP immobilization splint
Alternate Names:
-Describe Position: MP at 0 degrees
Purpose: reduce inflammation and rest A-1 pulley Wear Schedule: 24/7 for 2 to 3 weeks
Nerve & Tendon Injuries and Repairs
18. Joanne: 62 year old clerk: Carpal Tunnel Syndrome
completes data entry with intermittent tingling/pain
wakes with tingling at 2 am
Type of Splint: wrist immobilization splint
Alternate Names:prefabricated
-Describe Position: 0 degrees, neutral
Purpose: to reduce pressure to median nerve by promoting neutral position
Wear Schedule: HS optional activity use
Carpal Tunnel Syndrome -Compression and irritation of the median nerve as it passes under the transverse carpal ligament in the wrist.
- Jane - 36 years old: Flexor Tendon laceration 3 days ago, FDS, FDP of ring and little
cut palm on tuna fish can lid, surgical repair today.
Rx: Duran Protocol
Type of Splint: wrist MP/DIP/PIP dorsal extension restriction splint
Alternate Names:
-Describe Position: wrist 20 degrees flexion and MP 50 degrees flexion and PIP/DIP slight flexion
DURAN: with rubber bands
Modified Duran no rubber bands
Purpose: block active extension, allow passive flexion Wear Schedule: 24/7
- Tom - 45 years old: Radial neuropathy
Excessive intoxication, slept heavily with arm in full flexion
Rx: radial nerve palsy splint 20a. Splint for daytime 20b. Splint for night
What is potential deformity? inability to extend wrist, loss of finger extension at MCP joints, and inability to extend and abduct thumb.
20a. Type of Splint: wrist MP/ thumb extension mobilization splint at night wrist immobilization splint
Alternate Names
-Describe Position:
Purpose: allow tenodesis function and prevent over stretch of extensors Wear Schedule: one or the other continuous, remove for exercise and hygiene.
Radial neuropathy-It is most often due to prolonged compression of the radial (musculospiral) nerve, and, depending upon the site of nerve injury, is sometimes accompanied by weakness and extension of the elbow. paralysis of the extensor muscles of the forearm and sometimes the triceps, due to a lesion of the radial (musculospiral) nerve.
- Amy - 37 year old: s/p repair of lacerated ulnar nerve at wrist
knife injury while washing dishes
What is potential deformity? 4 and 5 MCP extension restriction splint
Type of Splint
Alternate Names
-Describe Position: MP at 60 degrees
Purpose: allow function and prevent over stretch of intrinsics. Transfer power to IP joints Wear Schedule
continuous, remove for exercise and hygiene
Ulnar nerve dysfunction is a problem with the nerve that travels from the shoulder to the hand. This is called the ulnar nerve. It helps you move your hand and wrist
Splinting for Spasticity, Pediatrics, & Burns__________________
22. Lewis 67 yo: CVA with spastic hemiparesis of LUE (increased flexor tone
Type of Splint: wrist hand immobilization thumb / finger abduction
Alternate Names: finger spreading splint
-Describe Position:
Purpose: reflex inhibiting pattern reduces flexor tone.
Wear Schedule: HS or during ambulation depending on severity
Hemiplegia is caused by damage to central nervous system (brain and spinal cord): the execution orders of movements are not transmitted to the muscles. In addition to motor problems, other functions can be altered as memory or sensitivity.spastic hemiplegia with spasticity of the affected muscles and increased tendon reflexes.
- Madison 3 y.o.: thumb web space contracture from well healed burn
Type of Splint: wrist hand immobilization
Alternate Names
-Describe Position: thumb in radial abduction
Purpose: gentle end range stretch for scar remodeling
Wear Schedule: HS
- Jose 8 yo with burns covering left chest and axilla following fire pit accident.
Type of Splint: axillary elbow mobilization splint
Alternate Names: airplane splint
-Describe Position: gentle end range stretch for remodeling
Purpose:
Wear Schedule: 24/7 or at HS dependent of patient level of healing
notice jobst garment
- Benjamin 26 yo. Burn to hand following house fire
Type of Splint: wrist hand immobilization splint
Alternate Names:
-Describe Position: may increase flexion to 60 degrees to protect intrinsics from shortening. Often thumb in radial abduction to prevent thumb we space contracture.
Purpose: to prevent or correct contracture
Wear Schedule: HS or 24/7 dependent on stage of healing and opportunity’s for functional use
Paul: 22 year old Rugby Player: 4th Proximal Phalanx Fracture
-Fracture during rugby match
Type of Splint: 4th and 5th ray immobilization splint
Alternate Names
-Describe Position: 20 to 30 degrees for any immobilization splint accept carpal tunnel
Purpose: fracture healing
Wear Schedule: 24/7 until dr says healed then buddy tape for protection post splint
