Splints

Question 1

Thumb Hole Wrist Cock- Up

Answer 1

Materials of Choice: Polyform, Polyflex, Aquaplast
Diagnoses that may require use of this splint:
- Carpal tunnel syndrome
- Lateral epicondylitis
- Carpal fractures
- Carpal fusions
- Ganglion cyst
- Radial nerve injury
General position guide: wrist neutral to 15 degrees extension (at the max)
Purpose: decreases pain; protect/ immobilize’ provide rest
Wearing Schedule: continuous with the exception of ROM, bathing, unless otherwise specified

Question 2

Thumb Spica (Forearm based)

Answer 2

Materials of choice: Polyflex, Polyform, Aquaplast
Diagnoses that may require use of this splint:
- DeQuervain’s Tenosynovitis
- CMC osteoarthritis
- Thumb fractures
- Carpal (wrist) fractures
- Joint replacement of thumb
- Fusion of MP or CMC of thumb
General position guide
- Wrist: 15 to 20 degrees of extension
- Thumb: Palmarly abducted and extended
Purpose
- Protection; immobilization; rest; decrease pain
Wearing Schedule: continuous except for exercises (when appropriate) and bathing

Question 3

Resting Pan/ Functional/ Mitt Design

Answer 3

Materials of choice: Synergy, Aquaplast, Ezeform
Diagnoses that may require use of this splint:
- Burns
- Multiple trauma injuries such as crushes, replantations
- Dupuytren’s contracture- s/p surgery (flat pan to keep palm open)
- Arthritis
- CVA: flaccid extremity or mild spasticity
General Position guide:
- Wrist: 15- 30 of extension
- MCP’s 45- 55 flexion (80 for the burns)
- PIP’s 20- 30 flexion (0 for burns)
- Thumb: in opposition or abduction, depending on design
- Purpose: protection; prevention of contracture/ deformity; decrease pain
- Wearing schedule: burns and trauma- at all times except for ROM, dressing changes; others- night only or as needed

Question 4

Dynamic Extension Outrigger

Answer 4

Materials: Aquaplast, Polyform, Polyflex
Diagnoses that may require use of this splint:
- Radial n. palsy/ laceration
- s/p MCP joint arthroplasty (RA)
- s/p replantation of one or more digits
- MP or PIP joint contracture after injury/ fracture

General position guide:

• Wrist: neutral to ^15 degrees extension
• MCP’s: neutral to slight hyperextension
• PIP’s: neutral extension

Purpose: protect/ immobilize; increase ROM; compensate for lost of motor function
Wearing schedule: continuous except for bathing and exercises for nerve palsies, s/p joint replacement, and replantation; as needed for other diagnoses