Posts filed under ‘splint’

Would a splint be contraindicated in this case?

We all know that one of the purposes of splinting by occupational therapists is for joint protection and to preserve function and range of motion.  I have blogged before about my experience with fabricating below knee amputation (BKA) splints, used to preserve knee extension for being able to fit orthoses at a later date.

Sometimes, however, I wonder if a patient really needs the splint.  For example, I once had a 85 year old patient who had severe Alzheimer’s dementia, was completely bedbound at a nursing home at baseline and had a BKA due to gangrene.  While normally I would make a splint, I wasn’t sure that it was indicated in this case.

First, the patient was bedbound at baseline, and therefore an unlikely canditate for a prosthetic.  Second, a patient is very likely to develop skin breakdown and sores from a splint if the splint schedule isn’t adhered to, or frequently monitored.  Third, splints aren’t generally the most comfortable things.

Providing a splint would not increase or improve quality of life, and so it would seem to me that a splint would not be indicated in this case for the reasons listed above.  What are your thoughts?


November 17, 2008 at 8:09 pm 22 comments

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

I made a splint!

I made my first splint independently last week. I’ve made lots of splints in my time, especially footplates (to prevent foot drop), but every time I ever made a splint before, I had a clinical instructor or someone else right there to help me out. This splint I did all by myself. And I did a really good job, too 🙂 It was a relatively simple splint, a knee extension splint for a below knee amputee (BKA), but I’m happy that I was able to do is all by my lonesome self.

August 27, 2007 at 8:08 pm Leave a comment

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