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Wrist Splints vs. Wrist-Hand-Finger Orthotics

by Aubrey Bailey

Wrist, hand and finger injuries often require a period of rest during the healing process. Splints are used to immobilize injured joints to prevent movement and reduce pain. Different types of splints are also used to improve movement of stiff joints. These devices are categorized based on the joints supported in the splint: wrist splints or wrist-hand-finger orthotics. There are many types of splints in each category.

Overview

Splints fall into four categories: static, dynamic, serial static and static progressive. Static splints hold the wrist, hand and finger in one position. These splints are commonly used to rest the injured area or provide external support for weak muscles. Splints are typically made by a specialized occupational or physical therapist. Dynamic splints are used to stretch tight joints. They are usually wrist-hand-finger orthoses, with rubber bands or spring coils providing the stretch. Dynamic splints apply a stretch the entire time they're worn. If the joint moves, the stretch continues in the new position. These splints are used to stretch tight fingers to address stiffness after finger surgery. They are worn for a specific amount of time, which varies and typically ranges from 15 minutes to several hours at a time. Serial static splints are custom-molded with the hand and fingers in a stretched position. For example, if the middle knuckle of a finger is stuck in a bent position, the splint is molded while the therapist gently stretches the joint into a straight position. These splints are remolded as the finger gets straighter, usually every few days. Wrist and wrist-hand-finger splints do not typically fall into this category. Static progressive splints have a design similar to dynamic splints. A stretch is applied at a particular joint and applied for a period of time specified by the treating health care provider. Static progressive splints apply pressure in a single position. The joint is put in a stretched position and left there for a specific amount of time. The joint is stretched a little further each time the splint is used. These splints apply less pressure than dynamic splints, but are used for the same purpose, to make a stiff joint more flexible.

Wrist Splints

Wrist splints hold the wrist in a particular position after an injury, typically covering half of the length of the forearm, ending in the palm. The fingers are left free to allow some function. Wrist splints are often worn to support a broken wrist after the cast has been removed, or to rest wrist tendons with tendinitis. They are also used to support arthritic joints to decrease pain and hold them in position to improve function. Static and static progressive wrist splints are sometimes used to alleviate wrist stiffness and increase forward and backward bending of the joint. These splints are worn for a prescribed amount of time -- often several hours each day-- to stretch tight structures. They may be needed for several months. Wrist stiffness is common after a fracture because the joint tightens while the wrist is in a cast.

Wrist-Hand-Finger Orthoses

Wrist-hand-finger orthoses, or WHFOs, are typically used to treat injuries specifically involving the fingers. The wrist and hand are also immobilized for two reasons: The splint is attached with straps around the hand and wrist; and the tendons that move the fingers are powered by muscles in the forearm. Healing finger tendons can't fully rest unless the wrist is held in one position, often for several weeks. Static WHFOs are made by a therapist to prevent movement after tendon repair or a fracture. These splints are worn for a specified amount of time, typically four to six weeks. Depending on the injury, the splint may be removed to clean the skin and perform specific exercises. Static progressive WHFOs are often used to improve bending of the large knuckles in the hand. These joints are often stiff after a hand fracture. Finger loops are attached by string, and the fingers are pulled down into a stretched position and held in place by fastening straps. Low-temperature thermoplastic material is used and remolded to maintain a stretch as the finger becomes more flexible. Dynamic WHFOs are frequently used to straighten the fingers in injuries affecting the extensor tendons. The wrist and hand component of the splint are secured in place and metal attachments with finger slings are used to hold the fingers straight. This type of splint allows the patient to bend his fingers, then lifts them back into a straight position.

Considerations

Splints are often used short term after an injury or surgery, typically one to two months. These devices may be used to prevent movement as structures heal or stretch tight muscles after the healing process is complete. Splints are also used long term for chronic conditions such as arthritis to decrease pain with daily activities. Splints that do not fit appropriately can cause skin breakdown or further injury to healing structures. Seek medical attention if red marks remain on your skin for more than 10 to 15 minutes after the splint is removed, if your fingers tingle or go numb or if your pain increases.

About the Author

Aubrey Bailey has been writing health-related articles since 2009. Her articles have appeared in ADVANCE for Physical Therapy & Rehab Medicine. She holds a Bachelor of Science in physical therapy and Bachelor of Arts in psychology from the University at Buffalo, as well as a post-professional Doctor of Physical Therapy from Utica College. Dr. Bailey is also a certified hand therapist.

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