STATIC SPLINTING: ORTHOTIC DESIGN & FABRICATION

Question 1

🧠 Purpose of Static Splinting

Answer 1

Support → pain relief, promote healing

Alignment → maintain functional position

Prevent deformity

Stabilization → joint subluxation

Immobilization → rest (CTS, tenosynovitis)

Positioning → tone management

Blocking → isolate joints for exercise

Improve function

Question 2

🔍 Splint Classification (MOCS + ASHT)

Answer 2

Articular vs. Non-Articular

Location (digit, hand, thumb, forearm, arm)

Joint(s) involved & torque direction

Intent

Design options (custom vs. pre-fab)

Descriptive terms

Question 3

Intent:

Answer 3

Immobilization

Mobilization

Restriction

Question 4

MOCS

Answer 4

MODIFIED
ORTHOTIC
CLASSIFICATION
SYSTEM

Question 5

Digit based-

Answer 5

Origin digit, allows MP motion & possibly extends to distal phalanx.

Question 6

Hand based-

Answer 6

Origin hand, allows wrist motion & possibly extends to distal phalanx.

Question 7

Thumb based-

Answer 7

Origin thenar or thumb,
including one or more joints of thumb.

Question 8

Forearm based-

Answer 8

Origin forearm, allows elbow
motion & possibly extends to distal phalanx.

Question 9

Arm based-

Answer 9

Origin upper arm & possibly
including WR, EL, and /or SH joints

Question 10

Circumferential-

Answer 10

Encompassing perimeter of body
part.

Question 11

Gutter-

Answer 11

Including radial or ulnar portion.

Question 12

Radial-

Answer 12

Incorporating the radial aspect of the body.

Question 13

Ulnar-

Answer 13

Incorporating the Ulnar aspect of the body.

Question 14

Dorsal-

Answer 14

Traversing the dorsal aspect of hand or forearm.

Question 15

Volar-

Answer 15

Traversing the volar aspect of hand or forearm.

Question 16

Anterior-

Answer 16

Traversing the anterior of hand or
forearm.

Question 17

Posterior-

Answer 17

Traversing the posterior aspect of hand or forearm

Question 18

Types of Static Splints

Answer 18

Protection
Immobilization
Stabilization
Prevent further deformity
Blocking
Position
Combination

Question 19

Protection splint =

Answer 19

Post-fracture, surgical healing
(structures)

Question 20

Immobilization splint =

Answer 20

Inflammation, overuse injury

for rest, i.e. CTS, tenosynovitis

Question 21

Stabilization splint =

Answer 21

Painful joints, instability

joint sublux

Question 22

Prevention splint =

Answer 22

Prevent contractures, subluxation

joint sublux

Question 23

Blocking splint =

Answer 23

For exercises (e.g., ulnar claw)

Question 24

Positioning splint =

Answer 24

Tone modulation, resting posture

flaccid hand, spastic hand

Question 25

Combination splint =

Answer 25

protect, immobilize, position i.e. for a burn or trauma

Question 26

Fabrication Process (PROCESS / PRoCESS)

Answer 26

Pattern creation (based on MD referral & exam) Refine pattern (test on unaffected limb, mark changes) Options (choose materials based on purpose) Cut & heat Evaluate fit while molding Strapping & components Survey completed orthosis (check comfort, fit, function)

Question 27

How does an orthosis get created?

Answer 27

Rx (orders from the physician)- specific conditions, dates (DOI & DOS), prognosis (op fix/repair) Get specific instructions- immobilize proximal & distal to injury? Ask questions if needed If you as the OT are initiating the orthotic fabrication process, request Rx from the MD

Question 28

What do you need to know before you start?

Answer 28

What is the exact condition, disease, injury, or deformity? What is the splint supposed to do? What does it look like? Pattern? When should a splint be introduced? How long should it be worn? Remember splinting is only part of the total rehab program

Question 29

Principles of Fabrication

Answer 29

Maintain arches (2 transverse, 1 longitudinal) Use skin creases to guide joint inclusion/exclusion Accommodate bony prominences (pad/stay clear) Incorporate dual obliquity (hand not symmetric) Reduce pressure Eliminate friction Patterns

Question 30

Arches:

Answer 30

Maintain the arches o f the hand throughout treatment (2 transverse and 1 longitudinal) Proximal transverse arch- fixed distal carpal row (capitate) . Distal transverse arch- mobile MCP heads. Longitudinal arch- carpal , metacarpal phalanges

Question 31

Reduce pressure:

Answer 31

Pressure = force/area Wider/longer splints better than narrow/short

Question 32

Eliminate friction:

Answer 32

Splint should cover 2/3 forearm length and ½ body part circumference Use smooth/rounded edges

Question 33

The best possible way to ensure splinting compliance and function is to:

Answer 33

make the splint as comfortable as possible

Question 34

Material Selection:

Answer 34

Thickness: 1/8", 3/32", 1/16" Perforation: solid vs. optiperf Properties: Drape (malleability) Rigidity Memory Resistance to stretch

Question 35

Patterning Tips

Answer 35

Start with accurate paper towel pattern Trace with pencil upright Use anatomic landmarks Always adjust before cutting final material

Question 36

Use skin creases =

Answer 36

Skin creases usually correspond to underlying joints , but not always . To permit motion stay proximal to crease don’ t go over thenar crease if you want to retain thumb mobility Stay behind DPC to allow for full MCP flexion , PPC for IF To block motion or joint go past crease to most distal aspect

Question 37

Accommodate bony structures

Answer 37

Pad or blow-out Ulnar styloid & Head for dorsal splints. Radial styloid for radial based or radial gutter splints. Dorsal MCP heads-pad. Base of 1st CMC joint. Dorsum of fingers, hand and wrist-pad. Medial & lateral epicondyles, olecranon. Over joints volar and dorsal.

Question 38

Ulnar styloid & Head for __ splints.

Answer 38

dorsal

Question 39

Radial styloid for ___ splints.

Answer 39

radial based or radial gutter

Question 40

Incorporate dual obliquity concepts

Answer 40

metacarpal length decreases from radial to ulnar = splint should be higher on the radial side than ulnar metacarpal height decreases from radial to ulnar = splint should not be perpendicular to the long axis of the forearm

Question 41

Reduce/disseminate pressure

Answer 41

Pressure= force /area a continuous force should not exceed 50 g /cm2 (200 g /4cm2) on tissues increase area o f application to decrease pressure

Question 42

___ splints are more com for table than ___ splints

Answer 42

Wider, longer short, narrow

Question 43

___ edges on the proximal & distal aspects of palmar and dorsal splints cause less pressure than do ___ edges

Answer 43

Rolled straight

Question 44

___ pressure over a bony prominence is preferred to ___ pressure

Answer 44

Continuous uniform unequal

Question 45

Contour around ____

Answer 45

thenars, hypothenars, palm, forearm

Question 46

*Reinforce by strapping ___

Answer 46

farthest proximal and distal (fess)

Question 47

The length of the splint needs to be ___

Answer 47

2/3 down the forearm

Question 48

The height of the splint should be ____

Answer 48

½ the circumference of the body parts