Definition • Derieved from Greek expression “making straight”

• An appliance used to support, align, prevent or correct deformity of a body part or to improve the function of a movable part of body

Function

• Increase range of motion (ROM)

• Immobilise - promote tissue healing

• correct / prevent contractures / deformities

• Assist in providing enhanced function

• Block unwanted movement of a joint

General Classification• Function

– Static / Dynamic

– Assistive / Substitutive / Protective / Corrective

• Duration of action – Temporary / Semi permanent / Permanent

• Site of Action – Hand orthosis / Wrist Hand orthosis

– Forearm and Elbow Orthosis

– Shoulder orthosis

Protective SO - Single strap

Indications

• Support the arm or shoulder in Strain or sprain

– Fractures and dislocation• emergency management

• post-operative splinting

Incorrect

Incorrect

Correct

• Flexion of the elbow > 90 degrees

• Aids in– limb elevation– decreases dependent edema

• Wrist also to be supported

PROTECTIVE Multi-strap

• Figure-8 harness/clavicular brace

• stretch across the chest

• retract scapulae• restrict motion

• allow for tissue healing

Multi-strap

Ordinary Shoulder immobiliser

Special shoulder

immobiliser

Corrective Shoulder Abductor Orthosis

• Airplane Splint • After shoulder surgery

– rotator cuff rupture, acromioplasty,

– injury of the shoulder

-arm regions

• Axilla burn

• Paralytic Adduction

contracture

Shoulder arm orthosis – protective

• Sarmiento Functional arm

brace

– Used in

humeral

shaft

fractures

Elbow orthosis

• Protective – Static or dynamic splints

– Bands

– Braces

• Corrective – Turnbuckle Elbow orthosis

Elbow Orthosis protectiveStatic and Dynamic splints

• Immobilization after traumatic/infective/arthritic conditions

• Olecranon/Epicondyle Fractures

• Ligament injuries• Instabilities

• 90 degrees flexion in mid-prone position

Elbow orthosis – bands

• Tennis elbow band –– Prevents translation of extensor

tendon movements from the distal end to the proximal site of pathology

Elbow Orthosis Corrective• Turnbuckle Elbow orthosis Treatment of elbow flexion and

extension contractures

Wrist hand orthosis

• Protective – Cock up splint / carpal tunnel splint– Thumb spica splint

• Assistive– Dynamic cock up splint– Flexion / extension outrigger splints

• Corrective– Static splints – Flexion / extension outrigger splints

Position of safe Immobilisation

• James position

Wrist Hand Orthosis –cock up splint

• Provides proper support to the wrist

• Functional positioning splint• Post cast fracture

immobilization

• Post tendon transfer support

Wrist hand orthosis –carpal tunnel splint

• Relieves the median nerve of excess pressure and subsequent ischaemia in persistent flexion posture

Wrist Hand Orthosis - AssistiveDynamic splints

•Dynamic cock up splint:•Used in radial nerve palsy•Maintains passive range of movements at joints•Maintains length of the extensor tendons and allows time for recovery of the nerve

Wrist Hand Orthosis – Corrective Static splints

• Splints to achieve correction of MCP joint stiffness

Wrist Hand Orthosis corrective dynamic splints

• Stretches collateral ligaments in extension contracture of MCPjoints

• In flexor tendon injury post-operative mobilisation ( Klienert’s protocol)

Dynamic Flexion Outrigger Splint

Wrist Hand Orthosis thumb opposition

• Sprains, fractures and strains

• Maintaining the thumb ROM• Restrict motion in patients with

arthritis• Stabilize the thumb in opposition in

patients with peripheral nerve injuries

• Tendon transfers/repairs

Hand Orthosis

• Protective

• Assistive static / dynamic

• Corrective

Hand orthosis – static splints - Mallet Splint

• Mallet Finger deformity due to trauma

• After Closed Fixation Of Fracture Fragment

• When Hyperextension of D.I.P. joint is necessary

Hand Orthosis – static splints

Finger extension splints

Hand Orthosis for Thumb static splints

• Thumb web spacer splint / thumb spica opposition splint

– Post surgery after 1st web space release

– Post fracture/ligament fixation

Hand Orthosiscorrective static splints - straps

• Flexion straps – Serial correction of extension

contractures of the IP joints

Hand Orthosis –corrective static splints

• Serial correction of flexor stiffness/ contractures of the IP joints

Hand Orthosis IP Flexionassist –Knuckle Bender• Dynamic anticlaw deformity splint

• Flex MCP, allow active MCP extension

• correct hyperextension of MCP

• promote active IP extension

Hand Orthoisis IP Flexion Assist

• Block PIP extension

• Swan neck deformity,

• Trauma - PIP volar plate injury

Hand Orthosis IP Extension assist

• Dynamic Splint for Boutonnieredeformity

• Central slip avulsion injuries

• Extend PIP & DIP

• Allow active PIP flexion

Summary

• Defintion and function of a splint

• Nomenclature

• Types of splints – Site of action

– Type of function• Protective / substitutive

• Assistive / corrective

• Dynamic / static