Splinting Intro
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| SPLINT VS ORTHOSIS | splinting is temporary | orthosis is made of higher temp material |
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| Static splint | immobilizes | prevents deformities | prevents soft tissue contracture | substitute for loss of motor function |
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| Dynamic splint | control motion | correct deformity | fracture alignment | substitute for loss of motion |
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| Handling characteristics | memory- ability to return to its original shape | drapability ( ease of conformability with minimum effort | elasticity- resistance to stretch | bonding- ability to stick to itself | self finishing edges | shrinkage- shrinks when cooled
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| Splint components | c-bar, connector bar, cross bar, deviation bar | metacarpal bar, reinforcement bar, palmar phalangeal bar | cuff | thumb post | forearm trough, palmar trough |
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| Arches of hand | proximal transverse- croses distal carpals (wrist area- only rigid arch ) | distal transverse- crosses distal palmar crease | Longitudinal-runs long. through hand |
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| Creases | aligned with joints | shows where joints are and can help map out pressure points | distal palmar crease (MCP) | Thenar crease- (cmc of thumb) |
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| Abnormal patterns | occure due to mechanical or neurological change in hand |
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| Splinting positions hand to | substitute for motor control ( radial deviation splint prevents ulnar drifting of fingers) | prevent deformity- airplane splint keeps arms elevated to prevemt contractures in axilla (burns) | rest an extremity (hand splint, wrist cock up) |
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| Mechanical advantage | splint allows for distribution of force over a large area so force is minimized at most proximal and distal ends and therefore skin damage | (resitance arm/effort arm) x resistance force =effort force | mechanical advantage is at least 2:1 | 3 point pressure system- 3 forces with middle forces directed oppositely of the other 2 (unidirectional-forces on one plance)(multidirectional-forces in multiple planes) |
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| 4 ways skin and soft tissue can be damaged | degree- skin can become ischemic ( blocked circulation depending on load exertion) | Duration- low stress over time can eventually cause tissue damage | repittition- of stress like dynamic splinting can cause inflammation or redness | direction- 3 directions of force 1. distraction or tension 2. compression 3. shear |
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| Minimize stress repetition in dynamic splints by | distribute force | maintain 90 degree angle of pull to prevent compression (and distraction and streched ligament) | leverage |
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| Minimize compression by | maintain perpendicular force | avoid bony prominences | selection of strap width | conform material to body part | keep splint at 1/2 width of forearm and hand |
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