Splints Flashcards
Brachial plexus (C5-T1 resulting in whole UE involvement)
Injury flail arm splint: it provides the needed stability at both the shoulder and elbow for functional positioning of the hand.
Erb’s palsy splint (injury to the 5 & 6 brachial plexus roots):
Elbow lock splint stabilized the elbow to enable that individual to position the hand closer ot or away from his/her body.
Radial nerve palsy
dynamic wrist splint, finger & thumb extension splint
Median nerve injury:
Opponents splint (thumb spica), C-bar (hand in C position)
Ulnar nerve injury
static/dynamic splint to position MCPs in flexion
at wrist: Block fourth and fifth MCPs to 30°–45° flexion to prevent hyperextension
Combined median/ulnar injury
figure eight or dynamic MCP flexion splint
Spinal cord C6-C7
Tenodesis splint
Tenodesis splint or wrist-driven flexor hinge hand splint:
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.
DeQuervains disease:
Thumb spica splint (includes wrist) IP joint is free
Swan Neck :
silver rings or buttonhole splint (to prevent hyperextension of PIP joint)
PIP hyper extension block
Boutonniere:
silver rings or dynamic PIP extension splint (to prevent flexion of PIP joint)
Skier’s thumb:
hand based thumb splint
CMC arthritis
hand based thumb splint, functional (C shaped) or safe splint, depending on stage
Flaccidity:
resting splint: wrist at 20°–30° extension, thumb at 45° palmar abduction, MCPs at 35°–45° flexion, and PIPs and DIPs in slight flexion
Spasticity:
spasticity splint (fingers abducted, thumb abducted) or cone splint
Muscle weakness (ALS, SCI, Guillian-Barre):
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
Balanced forearm orthosis
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.
Ulnar drift positioning splint
ulnar deviation splint
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
Flexor tendon injury:
Kleinert or Duran dorsal protection splint (dorsal block splint so fingers can’t extend very far)
Carpal tunnel syndrome
Position WRIST COCK UP splint in NEUTRAL with MAX of 3* ulnar deviation and avoid wrist flexion activities.
Pronator teres syndrome:
Elbow splint @ 90* with forearm/wrist in neutral
Cubital tunnel syndrome
Elbow splint to prevent positions of extreme flexion (especially at night)
Medial nerve laceration:
Dorsal protection splint with wrist positioned in:
1. LOW LESION: 30 deg flexion
2.** HIGH LESION:** include elbow (90deg flexion)
Ulnar nerve laceration
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
Radial nerve laceration :
Dynamic extension splint
Cock-up splint, with dynamic finger extension assist optional
Kleinert protocol:
Active extension of digits with passive flexion by using rubber band traction.
Uses a dorsal block splint
Duran protocol:
Passive flexion and extension of digits.
Uses a dorsal block splint
Long opponent’s splint:
Used for preventing radial and ulnar deviation
Bilateral soft elbow splints
Fix elbow @ 20-30 degrees of flexion when using splint
Wrist cock-up splint
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.
Volar cock-up splints
Immobilize the wrist and put it in a functional position, but do not specifically address thumb functional
Resting hand splint
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
• Night resting splints
can maintain the wrist, fingers and thumb in correct position, but do not address functional use.
Volar pan splint for wrist and hand
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.
Static splint
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
Dynamic splint
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
Serial splint
Utilized to achieve a slow, progressive increase in motion by progressive remolding
Serial casting
is used to decrease contractures and increase range of motion and does not address functional thumb use between therapy sessions.
Dupuytrens disease
Requires EXTENSION splint INITIALLY 24 hours a day, 7 days a week. Scar management including scar massage, scar pad and compression garment.
Lateral/Medial epicondylitis
Conservative treatment includes ELBOW strap and WRIST splint, ice and deep friction massage, and stretching.
Plaster cylindrical splint
encourages a STATIC stretch of the PIP joint contracture.
Dynamic outrigger splint
Form of PIP extension
Soft neoprene gloves
provide the best support while facilitating active thumb use in grasp and release activities
Buddy strap fingers:
helps provide passive ROM to the injured finger.
Anterior interosseous
orearm neutral, elbow in 90° flexion
Radial tunnel syndrome: Wrist in 30° extension, forearm sup
Radial tunnel syndrome
Wrist in 30° extension, forearm supinated, elbow in 90° flexion
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
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.
