Hand immobilization splints Somaya Malkawi Ph D Hand

Hand immobilization splints Somaya Malkawi, Ph. D

Hand immobilization splints l l Also called resting hand splints (RHS) It immobilizes fingers and wrist Thumb may or may not be included Purpose: 1. 2. 3. 4. Immobilize Position in functional alignment Retard further deformity Maintains balance between extrinsic and intrinsic muscles of hand 5. Provide localized rest to the tissues of wrist, thumb, fingers

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Description of the RHS Pan C bar Forearm trough Thumb trough

Pre-molded hand splints Pre-cut splint kit Customized splints What are the advantages and disadvantages for each

Hand immobilization splints l Volar based resting hand splint is better used when you require a great amount of forearm support l Dorsally based RHS is used when there is sutures, sores, rashes, or intravenous needles. Also used for someone who has hypertonicity

Hand immobilization splints l Two types of positions are accomplished by this splint depending on diagnostic indication 1. Functional position 2. Anti-deformity (intrinsic-plus) position

Functional position l The resting splint is positioned in resting or mid-joint position l Place the wrist in 20 -30 degrees of extension l Thumb CMC in 45 degrees of palmar abduction l Fingers MCP joints 35 -45 degrees of flexion l PIP and DIP of fingers joints in slight flexion

Anti deformity position Often used to place the hand to maintain l tension/distraction of anatomic structure To avoid contractures and promote l function l Wrist: 30 -40 ext l Thumb: 40 -45 palmar abduction l Thumb IP: in full ext l MCPs: 70 -90 flex and PIPs and DIPs in full l ext.

Diagnostic indications Condition Wearing schedule Splint, wrist position RA Worn until exacerbation is over. Wrist: 20 -30 ext. MCP: 15 -20 flex. Thumb: comfort. Hand burns Continuously worn until Dorsal or volar healing begin, removed for dressing changes, therapy, and hygiene. Wrist: (V) 30 -40 ext. Wrist: (D) 0 ext. MCP: 70 -90 flex. PIP, DIP full ext Thumb: palmar abd & ext. Burn acute phase Worn all time except for therapy. As ROM improves decrease wearing time. Same as above. Burn: Skin graft Worn all times for 5 days! Antideformity. 12

Diagnostic indications Condition Wearing schedule Splint, wrist position Burn: rehab phase. Only at night time. Antideformity. Dupuytren’s After surgery, worn at night times, removed for hygiene and exercise. Wrist: neutral or slight extension. MCPs, PIPs, & DIPs: full extension. Crush injuries of the hand At night, or periods of Wrist: 0 -30 ext. pain MCP: 60 -80 flex. Thumb: palmar abduction & extension. CRPS All times, removal for hygiene and ADL. Weaned with decreseaed pain and improved function considering comfort 20 degrees wrist ext, thumb palmar abd, MCP: 70 flex, 13 PIP: 010 flex