Hand: Splinting 2

Question 1

What are the positions of the hand used for splinting?

Answer 1

• functional position of the hand

- anti-deformity position of the hand

Question 2

What is the functional position of the hand

Answer 2

• wrist in 20-30˚ extension
• MCP at 35-45˚ flexion
• PIP 45˚ flexion
• DIP relaxed flexion
• thumb at palmar abduction

Question 3

Why does the wrist need to be extended?

Answer 3

• can do more

- think typing

Question 4

Why does the thumb need to be at palmar abduction for the functional position?

Answer 4

• gives ability to do functional things

- if the splint allows

Question 5

Why use an anti-deformity position for splinting?

Answer 5

reduce likelihood of deformity when someone has to be immobilized by a splint

• post-surgically
• ranging is contraindicated

Question 6

What is the anti-deformity position?

Answer 6

• wrist at 30-40˚ extension
• MCP at 60-90˚ flexion
• MCP at 60-90˚ flexion
• PIP and DIP in full extension
• thumb at palmar abduction

Question 7

Why is it important to get a pt in an anti-deformity position (extension)

Answer 7

easier to get them into flexion if they already have extension than to get them to extension from flexion

Question 8

What are the splint types?

Answer 8

• volar wrist cock-up splint
• dorsal wrist cock-up splint
• resting hand splint
• spica
• hand based thumb spica splint
• opponens bar

Question 9

most common type of splint

Answer 9

volar wrist cock-up

Question 10

Who gets a volar wrist cock-up splint?

Answer 10

• CTS

- RA

Question 11

What are you trying to do with splinting (think hand characteristics)

Answer 11

consider dual obliquity

Question 12

volar wrist cock-up splint accommodates for

Answer 12

• thenar eminence

- allows opposition

Question 13

parts of a volar wrist cock-up splint

Answer 13

• metacarpal bar
• hypothenar bar
• forearm trough

Question 14

dorsal wrist cock-up splint: used for

Answer 14

• incisions
• burns
• pt trying to go into flexion and want to encourage extension

Question 15

dorsal wrist cock-up splint: knuckles

Answer 15

don’t want to go over knuckles unless you’re trying to limit MCP extension

Question 16

dorsal wrist cock-up splint: straps

Answer 16

big to disperse forces

Question 17

parts of a dorsal wrist cock-up splint

Answer 17

• metacarpal bar
• dorsal forearm trough
• gutters

Question 18

most common type of gutter

Answer 18

ulnar

Question 19

Who often receives an ulnar gutter?

Answer 19

RA pts