Splints & Conditions - Fund. of Hand Thearpy, ed. Cynthia Cooper, 2007
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| Splints that maintain wrist, fingers, and thumb in correct position but do not address functional use | Night resting splints
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| 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
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| PIP & DIP flexion is passively limited when MP joint is passively EXTENDED indicates what condition? | Interosseus muscle tightness
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| PIP & DIP flexion is passively limited when MP joint is passively FLEXED indicates what condition? | Extrinsic extensor tightness
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| When PROM is greater than AROM at a joint, this indicates what condition? | Lag AKA contracture
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| 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
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| These types of splints position the tissue for lengthening and are remolded at intervals | Static serial splints
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| These splints provide mobilizing force using non-moving parts such as mono-filament, velcro, or screws | Static progressive splints
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| 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
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| 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
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| 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)
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| Purpose of tendon gliding exercises? | promote motion - standard exercises for conservative CTS tx.
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| Which splint is most effective with Erb's Palsy? | Elbow lock splint
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| 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)
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| 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)
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| 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
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| 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
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| 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
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| 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
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| Deformity assc. w/ LOW median nerve injury? | Ape hand deformity -- due to lost of thenar opposition, paralysis of FDS, loss of forearm pronation
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| Hand splint used for median nerve injury? | Static thenar web spacer splint
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| Deformity assc. w/ ulnar nerve injury? | Claw hand
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| Hand split for ulnar nerve injury? | Hand-based anticlaw splint w/ volar support
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| Dehiscence | Separation of the edges of a wound
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| 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
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| Splint for zone 2 flexor tendon repair | - dorsal blocking splint - early phase
- dorsal blocking splint w/ static IP positioning for passive flexion
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| Blocks full PIP extension -- allows/promotes full PIP flexion (for swan neck deformity) | Figure 8 splints, dorsal blocking splints, silver ring splints
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| Splint used for medial epicondylitis - why? | Volar wrist splint w/ wrist in neutral -- supports extrinsic flexors
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| Purpose of buddy straps (buddy taping) | Protects injured digit and allows initiation of early PROM
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| 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
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| Splint used for trigger finger - why? | Hand-based volar splint - supports involved MCP joint at 0 degrees, allows for full IP flexion
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| 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
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| Splint for boutonniere deformity - why? | Volar finger splint - finger splinted in extension to allow rupture of central slip to heal and correct flexion deformity
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| Deformity assc. w/ HIGH median nerve injury? | Benediciton Sign -- Loss of FDP to Index and Middle fingers, and FPL to index, middle, and thumb
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