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Splints
Splints & Conditions - Fund. of Hand Thearpy, ed. Cynthia Cooper, 2007
| Question | Answer |
|---|---|
| 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:
kjayala
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