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WHO
wrist hand orthosis
EWHO
Elbow - wrist - hand orthosis
SEWHO
shoulder - elbow - wrist - hand orthosis
Splinting material handling characteristics
 
žMemory
žDrapability
žElasticity
žHeating Time
žSelf Finishing Edges
žBonding
žWorking Time
žShrinkage
 
Splinting material performance characteristics
 
žComformability
žFlexibility
žDurability
žFinish
žMoisture Permeability & Air Exchange
žRigidity
žColor
žThickness
 
 
dynamic splint

 
A splint that aids in initiating and performing movements by controlling the plane and range of motion of the injured part. Also called active splint , functional splint
 
 

static splint
 
A splint that prevents motion of one or more degrees of motion at a targeted joint. Goal is to rest or protect the joint or joints
 
outrigger splint
allows protected motion
  Purpose of Splinting: STATIC
 
¡Immobilize & support
¡Prevent deformity
¡Prevent soft-tissue contracture
¡Allow attachment of assistive devices
¡Block joint segment
 
  Basic Components of a static splint
 
žC-Bar
¡Crossbar
¡Forearm trough
¡Thumb post 
¡Thumb trough
  Upper Extremity Orthosis
 
žFinger and thumb Orthosis — DIP  — PIP   žHand Orthosis —Volar or dorsal hand orthosis —Universal Cuff   žWHO —Cock - up splint —Resting hand splint —Thumb spica —Antispasticity splints  
  Diagnostic Indications of splints
 
žFractures
žTendon injuries
žCrush injuries
žAmputation
žArthritis
žCarpal tunnel release
žArthroplasty
žTendon transfer
žTumor excision
žReconstruction of congenital defects
žOveruse syndromes
žCumulative trauma disorders 
 
  Treatment Goals for splints
 
žPrevent or decrease edema
žAssist in tissue healing
žRelieve pain
žAllow relaxation
žPrevent, misuse, disuse and overuse of muscles
žAvoid joint jamming or injury
žRedevelop motor & sensory function
 
  Finger Orthosis ( DIP )
 
žType —Static or dynamic žRegion —Volar or dorsal —Joint crossed žFunction  
  Finger Orthosis ( PIP )
 
¡Static Three point orthosis
¡Boutonniere deformity
 
  Wrist Cock-Up Splint (WHO)
 
žMaintain the wrist in the neutral or mildly extended position

  Wrist Cock-Up Splint (WHO)

žImmmobilizes the wrist while allowing full MCP flexion and thumb mobility
 
Wrist Cock-Up Splint (WHO) Contraindications:
 
žActive MCP synovitis
žJoint inflammation resulting to volar subluxation and ulnar deviation 
  
 
Wrist Cock-Up Splint (WHO) Disadvantages:
žInterferes with tactile sensibility on the palmar surface of the hand
žDorsal strap can impede lymphatic flow
  Dorsal Wrist Cock-Up Splint
 
žStronger mechanical support of wrist and freeing up some of the palmar surface for sensory input
žDistributes pressure over the larger dorsal wrist surface area
žBetter tolerated by edematous hand
 
  C-bar
  Cross bar
pan and thumb trough
forearm trough
thumb post
 
Static Volar
DIP Extension Splint
  Boutonniere deformity
  Static Three point orthosis
immobilize finger splint
swan neck finger splint
boutonniere
mallet finger splint
lateral deviation finger splint
finger splint trigger finger
 
Static Dorsal Hand Orthosis With an MP
Block
 
  Hand Orthosis is used for...
hand orthosis - universal cuff
  Dorsal Wrist Cock-Up Splint
  Resting Hand Splint (WHO)
  Resting Hand Splint (WHO)
 
žImmobilize to reduce symptom
žPosition in functional alignment
žRetard further deformity
 
  Special Considerations Resting Hand Splints
 
žFor burns:  
make adjustments as bandage bulk changes
Special Considerations Resting Hand Splints
 
žPreventing infection:
when open wound has exudates, clean splints with warm soapy water, hydrogen peroxide, or rubbing alcohol
 
Special Considerations Resting Hand Splints
 
žPatients in the ICU:
use sterile materials; follow protocol of the facility
 
Special Considerations Resting Hand Splints
 
žRA patients benefit from
thin thermoplast
   ( less than 1/8 inch )
 
  Thumb Spica Splint  (WHO)
 
žHelp stabilize CMC, MCP and IP joints
 
  EVIDENCE IN PRACTICE
 
¡A review of studies conducted by Oldfield and Felson (2008) regarding the effects of wrist orthotic device use on pain and functionality in patients with RA reveal that the splints improved wrist pain and functionality without compromising dexterity
 
  Purpose of Splinting: DYNAMIC
 
¡To  substitute for loss of motor function
¡To correct an existing deformity
¡Provide controlled directional movement
¡Aid in fracture alignment and wound healing
 
  Antispasticity Splints
 
Static Dorsal Elbow Orthosis
 
  Shoulder slings
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