Splinting For Our Hand Therapy Patients

Splinting services is provided in our hand therapy clinic to complement the physiotherapy services we provide. This service is provided by our hand therapists, who attends to disorders, diseases and dysfunctions of the upper extremities and hands. We provide splinting not only for the upper extremities, but also for the foot and knees (eg AFO - ankle foot orthoses and knee extension splint).

Splinting was introduced as an alternative to long-term immobilization, which, before, treatment for fractures and other injuries were traditionally treated in a rock-solid plaster cast. Plaster casts are uncomfortable, as they are heavy, cumbersome, non-porous material causes excessive perspiration that leads to itchiness, broken skin, and in some cases, infections. In more severe cases, during the first fitting of the plaster cast, as there is much swelling, the cast is of an enlarged size; after a week or so, patients end up having a loose, hot and heavy cast that will not provide them the protection their injured muscles or bones require.

The biggest danger of the using a plaster cast is the danger of potential and actual loss of mobility and function as a result of muscular atrophy and irreversible shortening and stiffening of joints caused by muscle shortening, capsular withering and cartilage degeneration.

The splints that we provide are custom-fabricated, bespoke to suit each individual's different size and shapes of their limbs or body. They are made on the spot, after an assessment of the joint, bone or limb shape, size and integrity is made by the hand therapist, using thermoplastic materials which are then cut according to size required, softened, and molded on the patients' limbs before being smoothed at the edges to provide a comfortable finish.

Straps are added to allow patients to remove and put on the thermoplastic hand splints on their own; to be removed intermittently for specific exercise physiotherapy and physiological stresses in order to stimulate the healing process and to ensure a smooth functional recovery.

The selection of thermoplastic splinting requires the patients to have some measure of self activation, cooperative and motivated, putting stringent demands of the splinting and bracing materials used. The good old plaster casting cannot meet this demands, which are better met by different thermoplastic materials that we use in our physiotherapy and hand therapy clinics.

Commonly Used Splints:

- Sugar Tong Splint
- Ulnar Gutter Splint
- Volar Wrist Splint
- Thumb Spica Splint
- Posterior Lower Leg Splint
- Posterior Full Leg Splint
- Posterior Elbow Splint
- Finger Splint
- Ankle Stirrup Splint
- Shin Splint

Common Conditions For Splinting:

Orthopaedic diagnoses

Neurological diagnoses

Neurological conditions due to trauma to the brain such as stroke (cardiovascular accidents),traumatic brain injury (TBI), muscular dystrophy and Parkinson's disease can cause muscle imbalance and resultant tone differences, and in some cases, severe tone and spasticity. Splinting will help to normalize tone, as well as distribute force evenly, normalizing the mobility and functionality of the affected limbs over time. They then, will be easier to engage in physiotherapy exercises

However, for clinical safety reasons, there are contraindication or precautions that we need to take for splinting: unstable fractures, compromised sensation, compromised healing, 'paper' skin syndrome, deep vein thrombosis, decreased mental state or non-compliance.

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To see a list of physiotherapy, hand therapy and occupational therapy conditions we treat in Singapore, please go here.

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