Principles of Splinting

‹Anatomical

‹Physiological

‹Mechanical

‹Design

Anatomical principles of
splinting
‹ the arches of the hand,
‹ dual obliquity of the hand,
‹ alignment of joints,
‹ skin creases,
‹ bony prominences,
‹ collateral ligaments of the digits,
‹ the blood and nerve supply
‹ compression and traction of joints,

Physiological principles of
splinting
‹tensile strength of tissues

‹tissue response to tension

‹cause of limitation

‹tissue response to pressure

 Mechanical considerations
of splinting

‹force

‹pressure

‹torque

Force
‹an influence which produces
motion or changes in motion.

‹Measured in amplitude

PRESSURE

TOTAL FORCE
_______________________
AREA OF APPLICATION
 Torque
= turning effect.
Force x moment arm
(the moment arm - the perpendicular distance
from the lines of force to the fulcrum)

Design principles
‹purpose ‹weight
‹comfort ‹skin/splint
‹cost interface
‹durability ‹cosmesis

‹adjustability ‹patient variables

Functional position

‹ Trombly & Radomski ‹ Pedretti & Early (2001)

(2002) ‹ Wrist: 350 ext
‹ Wrist: 10 -300 ext ‹ MCP’s: 700 flex
‹ MCP’s: 70 -900 flex ‹ IP’s: 10 -200 flex
‹ IP’s: 0 -150 flex
‹ Thumb: palmar abd
 Anti deformity - Safe position

‹ Trombly & Radomski ‹ Pedretti & Early (2001)

(2002) ‹ Wrist: 20 -300 ext
‹ Wrist: 10 -200 ext ‹ MCP’s: 45 -600 flex
‹ MCP’s: 70 -900 flex ‹ IP’s: 150 flex
‹ PIP’s: 00 flex(ext)
‹ Thumb: palmar abd.

Resting position
‹ Trombly & Radomski ‹ Pedretti & Early (2001)
(2002) ‹ Wrist: 20-300 ext
‹ Wrist: 10 -200 ext ‹ MCP’s: 45-600 flex
‹ MCP’s: 20 -300 flex ‹ IP’s: 15 -300 flex
‹ PIP’s: 0 -200 flex
‹ DIP’s: slight flex
‹ Thumb: CMC, slight
ext, IP slight flex

Precautions:
‹Immobilisation
‹Excessive pressure
‹Excessive torque forces
‹Incorrect alignment of forces
‹Stress to adjacent joints
‹Skin irritation
 Patient Education
‹ Understands:
purpose and general reason for splint
wearing time
precautions
‹ agrees with therapeutic treatment goal
‹ accepts responsibility
‹ independent in application and removal

Problem Solving Process

‹ Establish clients occupational needs
‹ Identify limiting factors
‹ Identify enabling interventions eg use of
orthosis
‹ Include Anatomical, Physiological,Mechanical &
Design Principles
‹ Evaluate outcome