Materials

  • Stockinette
  • Splinting material (padded fiberglass or 8-10 layers of plaster)
  • Padding
  • Elastic bandaging

Instructions

Landmarks

  • Proximal: Mid-forearm
  • Distal: Mid-distal phalanx

Splint Position

  • Extend down radial forearm including 2nd and 3rd digits.
  • Because of the cut out detailed below, the thumb will remain free.
  • Forearm in neutral position.
  • Wrist and hand in "intrinsic-plus" position.
  • Wrist extended approximately 30º.
  • MCPs in 70º to 90º of flexion.
  • Proximal interphalangeal and distal interphalangeal joints in full extension.

Application

  • Cut hole in stockinette for the thumb and apply to hand/arm.
  • Pad the hand and wrist evenly, paying particular attention to the area between the thumb and index finger and distal radius.
  • Pad between the 2nd and 3rd digits.
    -Either cut a hole in the splinting material for the thumb, or split the splinting material in half starting at the base of the thumb so that it runs up the volar and dorsal metacarpals and digits while leaving the thumb free.
  • Place the splinting material on the radial side of the arm/wrist/fingers, wrapping the material around the thumb to leave it free. Mold the splinting material to maintain the intrinsic-plus position.
  • Wrap in elastic bandage.
  • Reassess pulses, motor and sensation.