Posts filed under ‘ortho’

Splints I have Fabricated

Here’s a list of some of the splints I have either fabricated myself or got assistance in fabricating:

  • Several below knee amputation splints
  • Resting hand splints (actually, these are pre-fabricated)
  • Humeral fracture brace (two pieces; protects the humerus from getting bumped by others; limits some shoulder range of motion if the doctor chooses)
  • Several posterior gutter splints (usually for protection of an elbow status post ORIF; often, the splint starts along the forearm and extends down to the carpals)
  • Yesterday, I helped with two splints (both on the same person, one for each hand): Ulnar gutter splint that involved providing slight MCP flexion for the 4th and 5th digits; and a resting hand splint that only provided ‘rest’ for the index finger through the MCP, but allowed for free range of motion of the PIP and DIP, and the rest of the fingers.

Sometimes the orders can be very complicated and specific, such as the ones highlighted in the last bullet above.  But I really enjoy making the splints, and am more and more strongly considering to specialize in splinting.


February 21, 2008 at 10:05 pm 6 comments

Why do occupational therapists splint?

The above title was used as a search engine query to get to this blog.  I think that this is a good question.  Why do we splint?  Why not PT’s?  Or orthopedic technicians?

The obvious answer is that we make splints for functional purposes, whether it is an extension splint for a below knee amputation (I made my second one last week!), or a resting hand splint to prevent hand contractures. But this is not always consistent, as I’ve seen only PT’s making referrals for certain types of splints, such as multi-podus boots to prevent foot drop. The good thing is that when it comes to splinting, the occupational therapists are the ones that get called for the most part.

I enjoy splinting.  Back when I was a student, I made tens of foot-plates.  We had patients who had external fixators attached to their legs, and we would make foot-plates to prevent foot drop (multi-podus boots wouldn’t work as the ex-fix got in the way, see picture for example).  As my experience grows in acute care, I’d like to see my experience in splinting grow as well.  I am even considering specializing in splinting.

December 16, 2007 at 10:49 pm 8 comments

Hip Precautions

For one of my Level II fieldworks, I did a three-month internship in an acute orthopedic unit at an area hospital. As such, I saw predominantly hip and knee replacements, as well as several limb-lengthening patients. One day, I was looking something up on Wikipedia about something hip related and noted that there was no article on hip precautions. As occupational therapists, we’re worried about patients being able to complete their ADL‘s while being safe. I figured that I would write an article about hip precautions on Wikipedia, and it hasn’t been edited since I created it, so I’m happy it was well written. Hopefully, it was well described as well.

Here is the article:

Hip precautions refer to certain things that one should not do after having a hip replacement. Since the hip joint is very weak from surgery, doing any of these three things can greatly increase the risk of hip dislocation.

The three hip precautions are:

  • Bend
  • Cross
  • Twist

One should not bend the hip past an angle of 90 degrees (L-shaped). This is especially difficult when sitting on toilet seats, which tend to be low. Therefore, an occupational therapist will educate patients in techniques on sitting on low toilet seats, as well as telling them to obtain raised toilet seats.

Crossing refers to any time one leg crosses the other. Since it is difficult not to cross your legs when sleeping, many doctors will recommend that a patient sleep with abductor pillows, which keep the legs separated.

Twisting refers to putting a lot of weight on one leg and twisting to retrieve an object. For example, if one is cooking a light meal, they should not twist their bodies to retrieve a pot from a high shelf, rather, they should shuffle over sideways, retrieve the pot, and then shuffle back to the starting point.

I’m thinking that I should add a bit about how because of these precautions, patients with hip replacements can’t do basic ADL’s like putting socks on. After all, that is why we give them our wonderful hip kits.

March 16, 2007 at 2:52 am 12 comments

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