Splints

Question 1

Brachial plexus (C5-T1 resulting in whole UE involvement)

Answer 1

Injury flail arm splint: it provides the needed stability at both the shoulder and elbow for functional positioning of the hand.

Question 2

Erb’s palsy splint (injury to the 5 & 6 brachial plexus roots):

Answer 2

Elbow lock splint stabilized the elbow to enable that individual to position the hand closer ot or away from his/her body.

Question 3

Radial nerve palsy

Answer 3

dynamic wrist splint, finger & thumb extension splint

Question 4

Median nerve injury:

Answer 4

Opponents splint (thumb spica), C-bar (hand in C position)

Question 5

Ulnar nerve injury

Answer 5

static/dynamic splint to position MCPs in flexion

at wrist: Block fourth and fifth MCPs to 30°–45° flexion to prevent hyperextension

Question 6

Combined median/ulnar injury

Answer 6

figure eight or dynamic MCP flexion splint

Question 7

Spinal cord C6-C7

Answer 7

Tenodesis splint

Question 8

Tenodesis splint or wrist-driven flexor hinge hand splint:

Answer 8

is a dynamic splint, the effect that tenodesis has on tendon length will dictate in part the wrist position that will optimize forces directed at the digits.
The client with spinal cord injury (C6 & C7) gains considerable function with this splint.

Question 9

DeQuervains disease:

Answer 9

Thumb spica splint (includes wrist) IP joint is free

Question 10

Swan Neck :

Answer 10

silver rings or buttonhole splint (to prevent hyperextension of PIP joint)

PIP hyper extension block

Question 11

Boutonniere:

Answer 11

silver rings or dynamic PIP extension splint (to prevent flexion of PIP joint)

Question 12

Skier’s thumb:

Answer 12

hand based thumb splint

Question 13

CMC arthritis

Answer 13

hand based thumb splint, functional (C shaped) or safe splint, depending on stage

Question 14

Flaccidity:

Answer 14

resting splint: wrist at 20°–30° extension, thumb at 45° palmar abduction, MCPs at 35°–45° flexion, and PIPs and DIPs in slight flexion

Question 15

Spasticity:

Answer 15

spasticity splint (fingers abducted, thumb abducted) or cone splint

Question 16

Muscle weakness (ALS, SCI, Guillian-Barre):

Answer 16

balanced forearm orthosis (BFO), deltoid sling/over head suspension slings
1. mounts to w/c
2. individual must have shoulder/trunk movement
3. burns airplane splint

Question 17

Balanced forearm orthosis

Answer 17

Useful with muscle weakness such as Guillan-Barre syndrome, muscular dystrophy and brachial plexus injury. MUST HAVE MMT OF above 2 & coordination of elbow flexion (can be used with C5 quad) Overhead suspension sling Best suited for individuals presenting with proximal weakness & MMT of 1/5 to 3/5.

Question 18

Ulnar drift positioning splint

ulnar deviation splint

Answer 18

Ulnar drift positioning splint is to prevent ulnar drift while maintaining joint alignment for grasp and pinch activities.
-immobilze MCP joints and impeded functional use of hand to provide pain relieg, stability, alignment, and reduce stress on sublexed/deviated joints

Question 19

Flexor tendon injury:

Answer 19

Kleinert or Duran dorsal protection splint (dorsal block splint so fingers can’t extend very far)

Question 20

Carpal tunnel syndrome

Answer 20

Position WRIST COCK UP splint in NEUTRAL with MAX of 3* ulnar deviation and avoid wrist flexion activities.

Question 21

Pronator teres syndrome:

Answer 21

Elbow splint @ 90* with forearm/wrist in neutral

Question 22

Cubital tunnel syndrome

Answer 22

Elbow splint to prevent positions of extreme flexion (especially at night)

Question 23

Medial nerve laceration:

Answer 23

Dorsal protection splint with wrist positioned in:
1. LOW LESION: 30 deg flexion
2.** HIGH LESION:** include elbow (90deg flexion)

Question 24

Ulnar nerve laceration

Answer 24

Dorsal protection splint with wrist positioned in 30 deg of flexion if low lesion
1. HIGH LESION: include elbow (90deg flexion)
2. MCP flexion block splint

Question 25

Radial nerve laceration :

Answer 25

Dynamic extension splint

Cock-up splint, with dynamic finger extension assist optional

Question 26

Kleinert protocol:

Answer 26

Active extension of digits with passive flexion by using rubber band traction.
Uses a dorsal block splint

Question 27

Duran protocol:

Answer 27

Passive flexion and extension of digits.
Uses a dorsal block splint

Question 28

Long opponent’s splint:

Answer 28

Used for preventing radial and ulnar deviation

Question 29

Bilateral soft elbow splints

Answer 29

Fix elbow @ 20-30 degrees of flexion when using splint

Question 30

Wrist cock-up splint

Answer 30

Allows full MCP flexion while maintaining the functional position of the wrist and hand. Uses include resting wrist and hand in acute RA, carpal tunnel syndrome, & to reduce spasticity.

Question 31

Volar cock-up splints

Answer 31

Immobilize the wrist and put it in a functional position, but do not specifically address thumb functional

Question 32

Resting hand splint

Answer 32

Static wrist-hand orthosis used to immobilize the wrist, fingers and thumb. Used b/c MCPs and IPs are kept stretched (minimizing future joint contractures)
-provides localized rest to invovled joints, including hand/wrsit
-relieves pain, dec. muscle spasm, and protect joints
-dec acute inflammation
-can be utilized during the day and at night to manage symptoms

Question 33

• Night resting splints

Answer 33

can maintain the wrist, fingers and thumb in correct position, but do not address functional use.

Question 34

Volar pan splint for wrist and hand

Answer 34

is indicated for the wrist, fingers and thumb joints during acute synovitis. (Rheumatoid arthritis). The purpose is to rest the joints, prevent contractures and decrease pain.

Question 35

Static splint

Answer 35

No moving parts, utilized for external support, prevention of motion, aligning joints for healing or reducing pain.
-utilized to regain ROM or to maximize motion after surgical procedures
-apply less force on joints than dynamic splints

Question 36

Dynamic splint

Answer 36

Moving parts are included, utilized to increase passive ROM, assist weak motions or substitute for lost motion
-utilized to regain ROm or to maximize motion after surgical procedures
-apply greater force on joints than static splints

Question 37

Serial splint

Answer 37

Utilized to achieve a slow, progressive increase in motion by progressive remolding

Question 38

Serial casting

Answer 38

is used to decrease contractures and increase range of motion and does not address functional thumb use between therapy sessions.

Question 39

Dupuytrens disease

Answer 39

Requires EXTENSION splint INITIALLY 24 hours a day, 7 days a week. Scar management including scar massage, scar pad and compression garment.

Question 40

Lateral/Medial epicondylitis

Answer 40

Conservative treatment includes ELBOW strap and WRIST splint, ice and deep friction massage, and stretching.

Question 41

Plaster cylindrical splint

Answer 41

encourages a STATIC stretch of the PIP joint contracture.

Question 42

Dynamic outrigger splint

Answer 42

Form of PIP extension

Question 43

Soft neoprene gloves

Answer 43

provide the best support while facilitating active thumb use in grasp and release activities

Question 44

Buddy strap fingers:

Answer 44

helps provide passive ROM to the injured finger.

Question 45

Anterior interosseous

Answer 45

orearm neutral, elbow in 90° flexion
Radial tunnel syndrome: Wrist in 30° extension, forearm sup

Question 46

Radial tunnel syndrome

Answer 46

Wrist in 30° extension, forearm supinated, elbow in 90° flexion

Question 47

A 4-year-old child with right hemiparesis has a goal to pick up and hold toys with the right hand. What type of orthosis would be MOST appropriate to help increase functional use of the hand?

Neoprene thumb loop splint
Resting pan splint
Wrist cock-up splint
Ulnar deviation splint

Answer 47

Solution: The correct answer is A.

A neoprene thumb loop splint helps reduce spasticity and enables an optimal position to pick up and hold toys.

B: A resting pan splint promotes joint alignment and reduces stiffness.

C: A wrist cock-up splint promotes wrist extension.

D: An ulnar deviation splint prevents drift of the metacarpophalangeal joints toward the small finger.