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Submitted by: Methodist Occupational Health Centers
During the acute phases of a hand, wrist, or elbow injury or surgical
procedure, the main treatment priority is to immobilize the injured body
part in order to allow rest and healing. Occasionally, this can be
accomplished through the use of “off the shelf” or prefabricated braces.
Frequently however, such braces do not adequately immobilize the injury
site due to the type of materials used and the fact that they are not
custom fit to the patient. They may be uncomfortable or they may
immobilize areas that need to be free to move.
Therefore, a custom splint is often fabricated by an occupational
therapist that has received education on the theories behind splinting
as well as training in splint fabrication skills. The occupational
therapist is able to design a splint that meets the specialized needs of
an individual patient. Most custom splints are fabricated from a
thermoplastic material that can be heated, cut, and molded to the
patient. The splint can be designed to immobilize only the structure
that needs to be protected, while allowing adjacent joints to remain
free. This means undue stiffness and swelling can be avoided and the
patient is able to function more easily while wearing the splint.
When a patient receives a splint, he is also given specific instructions
by the occupational therapist regarding wearing schedule, care
instructions, and how to apply and remove the splint correctly. The
therapist provides splinting instructions based on his or her knowledge
of the diagnosis or surgical procedure and how far along the patient has
progressed in the phases of healing. It is important that the patient
follow these instructions to gain maximum benefit from the splint.
Typically, a patient is instructed to wear the splint at all times
except during daily hygiene activities or during post-operative
exercises as prescribed by the therapist. As a patient’s pain and
swelling subside and the injury or surgical site is sufficiently healed,
wearing time is gradually decreased. Use of the splint while at work is
usually the last component of the splinting program to be weaned, since
the work environment can sometimes be unpredictable and the patient can
be at risk of re-injury.
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