Splinting

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Splinting

• Elizabeth Spencer Steffa, OTR/L, CHT
• Highline Hand Therapy

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• To every action, there is an equal and opposite
  reaction
• - Newton

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Pounds per square inch
Pressure Force Pounds PSI
Area Square Inch
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Splinting

• Support
• Prevent Deformity
• Decrease/Correct Muscle Imbalance
• Immobilize
• Protect (Joints, Muscles)
• Mobilize Joints
• Strengthen Muscles (?)

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Patient Evaluation

• Intellectual and Emotional Status
• Patients primary problem
• What will the splint provide?
• What joints mobilized or immobilized?

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Patient Education

• Apply Splint Correctly
• Hygiene
• Demonstrate Exercises
• Receive Written Program
• Precautions

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Static Splint

• No moving parts
• Functional position
• Used with an exercise program

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Arches of the hand

• Distal transverse metacarpal arch
• Longitudinal metacarpal arch
• Proximal transverse metacarpal arch

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Flexion Creases

• The distal edge of a hand splint usually
  terminates proximal to the distal palmar crease
  to allow full MP motion

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Pounds per square inch
Pressure Force Pounds PSI
Area Square Inch
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Splint Design

• Outlining
• 2/3 Principal
• Three Point Pressure

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A Properly Fitted Cock-up Splint Allows

• MP Flexion
• Thumb Adduction, Abduction, Extension-Abduction,
  Flexion and Opposition

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A Cock-up Splint Should Prevent

• Flexion
• Lateral Wrist Motion

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Skin Care

• Air Dry Skin
• Cleanse with Rubbing Alcohol
• Wear Cotton Stockinet
• Do not apply creams prior to splint wear

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Ankle Foot Orthotics

• Ankle Sprain
• Foot Drop
• Heel Stabilizer
• Metatarsal Support

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Know and Control

• Force How much?
• Dispensed through what surface?
• For how long?
• To what structure?
• By what leverage?

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Know and Control (continued)

• Against what reaction?
• For what purpose?
• Avoiding what harm?
• Warned by what signs?

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Material Heating/Handling

• Heat the material (e.g., Aquaplast, Reveals)
  until completely transparent when molding the
  splint.
• Drape the material over the patient and stroke
  it to conform to the patient.

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