Houston Methodist. Leading Medicine

Hand FAQ

Question:

I am an old physical therapist with a new job in a hand clinic. I'm scrambling to catch up with all the new innovations in hand therapy. Yesterday, I heard the occupational therapists talking about a new splint for PIP contractures. I'm a bit sheepish about not wanting to admit I'd like to know more but embarrassed to ask. I use your website for everything else, so I thought, "Why not?" Maybe you can enlighten me about this "novel" new PIP splint?

Answer:

You may be referring to a recent case report published by a group of occupational therapists. They were treating one patient with proximal interphalangeal (PIP) joint contractures of the middle and ring fingers of his dominant (right) hand. The pain and stiffness in those joints were holdovers from immobilization for finger fractures following an ATV accident. The authors designed the splint themselves and are in the process of further study in hopes of developing it for commercial use. They have been awarded a provisional patent. The splint is designed to stretch the joint by applying a dynamic, low-load over a long period of time. And the results? Excellent recovery after daily wearing for six hours over a period of three months. The hand therapists treating this individual describe many advantages in using this new splint with only a few potential downfalls. Some of the benefits included:
  • Easy to get on and off the finger: flexible material allows the patient to just roll it on and off the finger.
  • Easy to keep the finger clean and avoid any skin breakdown with long-term use.
  • Spreads the load evenly over the finger.
  • Designed to cover just the middle (PIP) finger joint, leaving the other two joints free to move. In other words, the splint does not interfere with daytime use of the hand and fingers during daily activities.
  • Useful for older adults who need the use of their hands and arms to push up out of a chair or walk with assistive devices such as a cane or walker.
  • Has an opening at the end to allow for visual inspection of the tip of the finger (this makes it possible to see if circulation to the end of the finger is okay; something a regular splint or cast would not allow).
  • Light-weight and not bulky so it doesn't catch on clothing or weigh the finger down causing fatigue.
  • Available in 5 different sizes for variations in finger size from patient-to-patient; most patients need at least two different sizes to adjust for daily fluctuations in swelling and stiffness.
  • Considered a dynamic splint because it allows the person to bend the finger against the splint while getting help extending (straightening) the finger. The hand therapists who worked with this patient were very favorably impressed with the roll-on splint. They suggest it is a simple yet effective treatment for challenging cases of proximal interphalangeal (PIP) joint stiffness. There were a couple of disadvantages reported. Ronit Wollstein, MD, et al. A Novel Splint for Proximal Interphalangeal Joint Contractures: A Case Report. In Archives of Physical Medicine and Rehabilitation. October 2012. Vol. 93. No. 10. Pp. 1856-1859.

    *Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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