SPLINITS

 

SPLINTS

Technically the term splint refers to a temporary device that is part of a treatment program.

 

Classification

• Static

• Dynamic.

 

Static Splints

Static splints have no moving parts, prevent motion and are used to rest or rigidly support the splinted part.

 

Uses: These are used to stretch joint contractures progressively or align specified joints after a surgical procedure for optimal healing. A static splint should never include joints other than those being treated and should be discontinued the moment its usefulness is over.

 

Disadvantages: Immobilization causes atrophy and stiffness.

 

Dynamic Splints

Dynamic splints are moving splints; their parts permit, control, or strengthen movement. The movement in a dynamic splint may be intrinsically powered by another body part or by electrical stimulation of the patient’s muscles. Extrinsic power may be provided by elastic bands or pulleys.

 

Uses: Dynamic splints provide prehension and also static positioning of the hand in a functional position.

 

General Functions of Splinting

• To prevent undesirable movements

• To provide a functional position for the hand.

• To reduce pain

• To hold fractured bone ends in position until they are united.

• To maintain the position after reduction of a dislocation until the joint capsule is healed.

• To strengthen specific muscles.

• To promote grip and pinch.

• To diminish muscle spasm

 

TYPES OF STATIC SPLINTS

 

Aeroplane Splint 

The Aeroplane splint maintains the shoulder in abduction and external rotation. It immobilizes shoulder and elbow joint. It consists of chest, arm, fore arm and wrist pieces joined to one another almost at right angles.

 

Indications

1. Erb’s palsy.

2. Supraspinatus tendon rupture

3. Avulsion of the greater tuberosity of the humerus.

4. Tuberculous arthritis of the shoulder joint.

5. Paralysis of the deltoid muscle

6. Abduction fracture of the neck of the humerus.

 

Advantages and Disadvantages

• The advantages of this splint are that it keeps the shoulder joint in its optimal position and does not confine the patient to the bed.

• The disadvantages are that it is inconvenient to the patient and that it tends to slide down the torso.

 

Cock-up Splint

The cock-up splint immobilizes, or stabilizes the wrist in dorsiflexion with volar or dorsal support . It may be static or dynamic. It allows full metacarpophalangeal flexion and carpometacarpal motion of the thumb. The splint should be worn all the time except during exercise and bath.

 

 

Indications: Wrist drop (radial nerve palsy) , hemiplegia.

 

 

Knuckle Bender Splint

Maintains the metacarpophalangeal joint in 90° flexion and interphalangeal joint in extension.

 

Function

• Immobilization of fingers.

• It provides support and stabilizes the wrist in extension.

• It maintains the transverse palmar arch.

• It assists in prehension.

Indication

• Total claw hand in case of medial and ulnar nerve injury, as in Hansen’s disease.

• Ulnar claw hand.

 

Hand Position: This splint comprises a light padded bar across the dorsal aspect of the proximal phalanges of the third and fourth fingers and a similar one over the upper end of the metacarpal. These are attached to another padded bar in the palm of hand by a small spring which pulls the metacarpophalangeal joints into flexion but allows the patient to extend them.

The interphalangeal joints of fingers are placed in extension. This is a typical example of a splint using the 3-point principle.

 

C-Splint

This splint maintains the thumb in abduction and partial rotation under the second metacarpal and supports it. It also stretches the first web space.

 

Indications

• Median nerve injury

• Contracture

• Burns.

 

OPPONENS SPLINTS

Short Opponens Splint

The short opponens splint maintains thumb in abduction and partial rotation under the second metacarpal. The wrist and other fingers are free.

Functions

• Immobilization of the thumb

• Improves prehension by providing a stable position against which the fingers can pinch.

• Protects the joint from pain.

• Stretches the web space.

 

Indications

• Low median nerve injury.

• Opponens transfer (6 weeks after surgery postoperative splint).

 

Dorsal Long Opponens Splint

This splint holds the thumb in abduction and partial rotation under the second metacarpal, and in addition supports the wrist dorsally in a functional position. The wrist is in 20° to 30° of dorsiflexion, and the thumb is abducted and rotated under the 2nd metacarpal, with the metacarpophalangeal joint in 0 to 5° of flexion. The interphalangeal joint is free unless required to be held in extension. Other fingers are free.

 

Function: To immobilize and protect the thumb.

 

Indications

• Scaphoid fracture

• Bennet’s fracture

• de Quervains tenosynovitis.

THOSE ABOVE ARE COLLECTED FROM SOME BOOKS AND WEBSITES..

(TEXTBOOK OF REHABILITATION-SUNDER.S)

THANK YOU,

 SRIKUMARAN PHYSIOTHERAPY CLINIC & FITNESS CENTER