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Splints

Splints & Conditions - Fund. of Hand Thearpy, ed. Cynthia Cooper, 2007

QuestionAnswer
Splints that maintain wrist, fingers, and thumb in correct position but do not address functional use Night resting splints
Anti-deformity splint places wrist, fingers, and thumb in what position? Wrist in neutral - MP's in flexion - IP's in extension - thumb in ABd and opposition -- maintains length of collateral ligaments
PIP & DIP flexion is passively limited when MP joint is passively EXTENDED indicates what condition? Interosseus muscle tightness
PIP & DIP flexion is passively limited when MP joint is passively FLEXED indicates what condition? Extrinsic extensor tightness
When PROM is greater than AROM at a joint, this indicates what condition? Lag AKA contracture
These types of splints are used to immobilize tissues, to prevent deformity, to prevent contracture of soft tissue, and to provide substitution for lost motor function - can contribute to disuse, stiffness, atrophy, should not be used more than necessary Static splints
These types of splints position the tissue for lengthening and are remolded at intervals Static serial splints
These splints provide mobilizing force using non-moving parts such as mono-filament, velcro, or screws Static progressive splints
These splints use moving parts such as rubber bands or spring wires to apply a gentle force - used to correct deformity, to substitute for absent or impaired motor fxn., to provide controlled mvmt., to promote wound healing Dynamic splints AKA mobilization splints
What can be incorporated into splinting regimes to maximize lymphatic flow and minimize stiffness and adherence that would otherwise worsen as a result of edema? Chip bags - cotton stockinette bag filled with small foam pieces of various densities
5 positions for tendon gliding exercises? Straight digits - hook fist - composite fist (thumb wrapped over digits) - tabletop (MP's flexed, IP's ext.) - straight fist (thumb ext., MP's & PIP's flexed, DIP's ext)
Purpose of tendon gliding exercises? promote motion - standard exercises for conservative CTS tx.
Which splint is most effective with Erb's Palsy? Elbow lock splint
What splint assists hand function for a radial nerve injury? Dynamic extension splint -- increases the hand's ability to open and release objects (outriggers are on dorsum side of hand)
Used for SCI C1-3, C4, C5 - why? Long Opponens Splint AKA long thumb spica -- stabilizes thumb in ABduction, supports thumb & CMC joint, aligns wrist in neutral (hand does not have flexors or extensors at this level)
Used for SCI C6, C7, & C8 (initially) - why? Short opponens AKA short thumb spica -- provides CMC joint immobilizaiton while allowing a wider spectrum of hand use
Used for SCI C6, & C7 (initially) - why? Wrist driven flexor hinge AKA tenonesis -- aids in positioning middle fingers in opposition to thumb for prehension & grasp -- activated by wrist extension
Used for SCI C4, C5 and some C6 - why? Powered tenodesis -- for patients unable to pick-up or grasp objects or for wrist ext. MMT of a 0-3 on a 0-5 scale -- and little to no finger flexion
Deformity assc. w/ radial nerve injury? (radial nerve most commonly injured of the 3 major peripheral nerves in UE) Wrist drop - due to paralysis of the wrist and finger extensors, results in a loss of tenodesis action
Deformity assc. w/ LOW median nerve injury? Ape hand deformity -- due to lost of thenar opposition, paralysis of FDS, loss of forearm pronation
Hand splint used for median nerve injury? Static thenar web spacer splint
Deformity assc. w/ ulnar nerve injury? Claw hand
Hand split for ulnar nerve injury? Hand-based anticlaw splint w/ volar support
Dehiscence Separation of the edges of a wound
Splints used after surgical treatment of Dupuytren's - Dorsal static protective splint to limit extension - Composite flexion splint (outriggers on palmer splint side) 2-3 wks post surgery
Splint for zone 2 flexor tendon repair - dorsal blocking splint - early phase - dorsal blocking splint w/ static IP positioning for passive flexion
Blocks full PIP extension -- allows/promotes full PIP flexion (for swan neck deformity) Figure 8 splints, dorsal blocking splints, silver ring splints
Splint used for medial epicondylitis - why? Volar wrist splint w/ wrist in neutral -- supports extrinsic flexors
Purpose of buddy straps (buddy taping) Protects injured digit and allows initiation of early PROM
Splints that may used for De Quervain's tenosynovitis - why? - Forearm based thumb spica splint -- leaves iP joints freet o prevent painful motions - Radial/volar splint - allows more UE function, use only if patient can wear without pain
Splint used for trigger finger - why? Hand-based volar splint - supports involved MCP joint at 0 degrees, allows for full IP flexion
Splint for mallet finger deformity - why? DIP joint is splinted in full extension for 6 weeks (variety of commercial splints available) -- allows terminal tendon to heal
Splint for boutonniere deformity - why? Volar finger splint - finger splinted in extension to allow rupture of central slip to heal and correct flexion deformity
Deformity assc. w/ HIGH median nerve injury? Benediciton Sign -- Loss of FDP to Index and Middle fingers, and FPL to index, middle, and thumb
Created by: msmaus on 2013-01-28



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