Introduction to Splints
(Orthoses) and Splinting
Splint
Terminology:
The term splint and orthosis are terms that are often used
interchangeably. Technically, the term splint refers to a temporary device that
is part of a treatment program, whereas the term orthosis refers to a permanent
device to replace or substitute for loss of muscle function. Usually, splints
are made by therapists, and orthoses are made by Orthotists. With the advance of
pre-fabricated splints, the terms orthoses and splints have become even more
synonymous. Pre-fabricated adjustable splints such as Comfy Splints are now
becoming the splint (orthosis) of choice when dealing with common problems in
positioning or stabilizing of a joint. In our discussion below the term splint
will be known to mean both splint and orthoses. Splints is the proper term for
the group of devices variously called orthopedic appliances, braces, splints,
and supports. A splint is defined
as ?any medical device applied to, or around, a bodily segment in the case of
the physical impairment or disability.?
Specific
Terminology is used to describe the type of joint control desired. Free motion (
no control) assisted motion, resisted motion, stopped motion and restrained
motion.
A splint may permit free or unencumbered motion in a
given plane, may assist motion by the application of an external force to
increase the range, velocity, or force, of a desired motions, using a spring,
elastic band, motor, or weighted counterbalance to compensate for the for the
effects of gravity.
A splint may also deliberately resist motion to
decrease the velocity or force of an undesirable motion.
A splint may stop motion or limit the range of
motion. The prescription should indicate the specific motion to be stopped and
when the stop is to be engaged.
A splint may also hold by eliminating all motion of
the joint at a specific position.
Splints may be designed to prevent deformity by
substituting for weak or absent muscle strength as in peripheral nerve injuries,
spinal cord injuries and neuromuscular diseases. They may be used to support,
protect. Or immobilize joints, allowing healing to occur after tendon, vascular,
nerve, joint or soft tissue injury or inflammation. Correction of existing
deformity represents another commonly encountered reason for splint application.
To achieve the full potential of active joint motion of the hand, the remodeling
of joint and tendon adhesions often requires the prolonged slow, gentle, passive
traction that can best be provided by splinting. Splints also may provide
directional control for coordination problems and sever as a basis for the
attachment of specialized devices that may facilitate and enhance hand function.
Static Splints have no moving pars and are used to provide
support and immobilization while dynamic splints employ traction devices such as
rubber bands, springs, cords or Velcro strips to alter the range of passive
motion of a joint or joints.
Basic to the uses of any splint are factors such as
prevention of deformity by proper positioning, support of weakened segments,
control or stabilization of joints proximally to those activated, or prevention
of substitution. Splints may also be used to correct present deformities. They
are both therapeutic and functional.
Splint
Uses:
Splints are used for the following functions:
- Stabilize
(immobilize) joints in a desired position to rest the joint, tendons,
ligaments, and muscles or maintain a certain bone alignment.
- Prevent
contracture or deformity
- Prevent
unwanted motion
- Gradually
stretch contracture to increase joint range of motion
- Provide
support for flaccid hand and wrist, knee and elbow.
- Maintain
gains achieved by manipulation, corrective surgery or reconstructive
procedures
- Relieve
pain.
- Facilitate
palmar hygiene
- prevent
pressure sores or facilitate healing of existing pressure areas.
Simply stated, splints do the following:
a.
protect- for it may protect weak muscles from being
stretched and therefore prevent contractures.
b.
Support The splint can support a joint or an arch in
substitution for weak muscles. While supporting, the splint immobilizes, or puts
to rest a joint so that it can heal.
c.
Corrective A splint can be used to force the involved joint
into a correct or near correct alignment
Splints not only immobilize but also mobilize, position and
protect a joint or a specific body part. Design and fabrication of splints
ranges from simple to complex depending on the goals established for a
particular condition.
Splints are usually classified as static or dynamic. Static
splints are designed to provide support to areas of the body and have no
moveable parts. Dynamic splints are designed to mobilize areas of the body and
have one or more movable parts. According the American Society of Hand
Therapists splints are classified as 1.mobilization,2 immobilization, 3.
restrictive. Mobilization splints are designed to move or mobilize primary and
secondary joints. Immobilization splints are designed to immobilize primary and
secondary joints. Restrictive splints ?limit a specific aspect of joint range
of motion for the primary joints.
Static
Splints: The purpose of static (immobilization or restrictive)
splints is threefold: to immobilize, to help prevent further deformity and to
prevent a soft tissue contracture. Static splints provide rest to the joint or
several joints. Therapists commonly use splints that immobilize with diagnoses
such as rheumatoid arthritis, carpal tunnel syndrome, fractures, and soft tissue
repairs. Static splints also provide support for joint laxity and ligament
injury. Static splints help prevent further deformity by maintaining stretch on
soft tissue to increase range of motion and help correct joint alignment.
Static splints can also help prevent soft-tissue
contractures by maintaining joints in their most functional positions.
Dynamic
Splints: Dynamic (mobilization splints) may have many purposes
including:
- Substitution
for loss of motor function
- Correct
an existing deformity
- Provide
controlled motion
- Aid
in fracture alignment and wound healing. Therapists may use dynamic splints
to correct contractures by applying force to soft tissue contractures to
mobilize affected joints.
Splints should fulfill the following criteria:
1.
Fitted early after trauma or injury
2.
be easily adjustable and re-adjustable
3.
efficient and adequate in support
4.
simple and direct in design
5.
light in weight
6.
pleasing to the eye so that they can be accepted by the patient
7.
comfortable to the individual
8.
free of pressure areas.
There are several pre-fabricated splints on the market.
Comfy SplintsTM have many features that make them so popular with therapists and
Orthotists.
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Designed by occupational therapists and M.D.'s Lenjoy
strives to make the best quality , pre-fabricated, adjustable
orthotics. Comfy Splints easy adjustability at multiple
joints, allows them to be used for multiple indications and
deformities to optimize functionality. Hand splints are
available in standard static model , or as dynamic splints
with Spring Loaded Goniometer.
Each Model is available in our popular navy blue absorbent,
terrycloth or upon request in a variety of colors. They are
also available in navy or gray headliner material. One size
fits most adults.
Ambidextrous
Splints Except:
Comfy splints are available with an extra washable cover(102
Models) or with one cover (model 101). All models can be used
on either hand, elbow or knee, except for the Opposition Hand
(OPH) and Dorsal Hand Splint (DorsH), and CuddlerTM
Opposition Thumb, for which the left or right hand must be
specified.
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