VOLUME I
Mechanical and biomechanical considerations

ISBN 9080433829

Handsplints have become essential rehabilitation tools indicated in all fields of physical rehabilitation. To construct splints quickly, economically and efficiently, dexterity is not the only requirement. There must be an understanding of the mechanical and technical features relating to the design and fabrication of the splints. There is also a need to undestand medical conditions to evaluate the biological impact of the treatment, and to further be able to evaluate a protocol for wearing the device, based on scientific information.

Volume 1 is truly unique as it clearly describes a methodology to design a complete splint therapy. The spirit of the work is regarded as a new splint phylosophy, which has been taught all over the world since the early 90’s, and is now applied by thousands of splintmakers.

 

What will you find in this book?

This book discusses the design, manufacture and application of splints for the upper limb and specifically the hand.
Splints are defined as mechanical “appliances” applied to a limb to influence its anatomical and physiological characteristics.
To use these appliances, theoretical and practical skills are necessary.

This book covers all aspects of the hand, such as clinical anatomy, biomechanics and pathology, insofar as they are directly linked to splinting.


Why a new book about hand splints?

Books about modern splinting have been available since the beginning of the 20th century and were mostly written for prosthetists. These books described splints made from “heavy” materials, using the “heavy” tools necessary to manufacture appliances for the lower limbs (for example hip, knee and ankle splints) and for the trunk (e.g. corsets). These books seldom referred to hand splints, and those that did mention them did so only in passing and gave no information about different functions and types of material available.
Books that cover hand splints specifically are more recent and have been written for hand surgeons or therapists, mainly occupational therapists. They put more emphasis on the splint’s anatomical and pathological requirements than on their technical aspects. Generally these books have been broken up into segments and suggest recipes for the treatment of specific pathologies without justifying these choices. They often reflect the therapeutic experiences contemporary philosophy of one therapist in a given geographic area.
Many novice and even experienced splintmakers are hampered by the lack of a rational thought pattern, when they have to choose a certain splint. It becomes quite frustrating when a splint that works for one person is totally unsuccessful for another, who appears to have an identical problem. Why does this happen?
The authors have found a logical answer to this question that has led to the development of a certain splinting philosophy. Their practice and training is based totally on this philosophy. Feedback from colleagues has shown that this philosophy is meaningful and that it considerably simplifies the splinting process.


What is a splinting philosophy?

A splinting philosophy is a systematic, rational and logical way of thinking to find the most efficient splint for a particular patient.
The authors have developed a specific philosophy based on the requirements of an individual patient and not on a series of possible splints of which one may be chosen.
While keeping the pathological deformities and the functional requirements in mind, a splint designer must answer several questions asked systematically in a specific sequence.

1. What requires treatment? A fracture? A joint? Soft tissues?

2. How should this treatment take place? Should the body part be mobilised or immobilised? If mobilisation is necessary, in which direction should this take place? Should movement be restricted or guided? Must pressure be applied?

3. Which modality is best? Static or dynamic? Continuous or alternate?

4. Which forces will be most efficient (when mobilising)? Pushing, pulling, or rotating forces?

5. Where can the splint be supported?

6. What is the patient’s general condition? Condition of the skin, perfusion, allergies, sensibility, pain tolerance.

7. Which of the patient’s personality characteristics will affect splinting? Is the patient helpful, conscious, and motivated?

8. What is the splint’s immediate purpose? Prevention? Rehabilitation? Functional assistance?

9. What materials are available?

10. What are the splint designer’s technical possibilities and preferred techniques?

Each answer provides information to ensure that the pre-design develops into an effective definitive design.
The good thing about this method is that different splint makers usually opt for the same splint pattern or use identical options for the same patient.


Who should use this book?

This book is meant for everyone who manufactures hand splints or intends to make them and requires insight into the possibilities and the limitations of splinting. The professionals include orthotists, occupational- and physiotherapists, plaster room attendants and in some countries the surgeon, who is responsible for all aspects of treatment.

This book provides students and occasional splint makers with a splinting philosophy that will enable them to follow a so-called cookbook more efficiently.

Advanced splint designers will obtain a rational explanation for positive as well as negative experiences that they may have had in the past. This will ensure that many splint patterns which have been used for years without much thought, receive the attention that will make them more efficient and easy to apply. Possible mistakes will be easier to detect and to correct, thus reducing the time spent on continuous adjustments.

In this book experts find information which can rectify certain misconceptions. They should use it to evaluate splints even more critically. For the perfectionists, exciting material has been collected which has not previously been published in splinting literature. The information is comprehensive enough to enable the splintmaker to calculate splint force prior to splint fabrication.



What you should not look for in this book

- An inventory of available pre-fabricated splints.
- A recipe book for the treatment of specific conditions.
(which patient requires which splint)
- Therapeutic instructions for various splint designs
(what is to be used for what purpose).
- Practical instructions
(how splinting materials should be moulded and processed).
- An evaluation of good or bad splint designs.
- An evaluation of products according to brand names.
- A repetition of general descriptive anatomy.
- Hand evaluation techniques.

 

A clooser look to content

- Mechanical rationales pertaining to sound splint design and construction.

- Technical analysis of current splinting materials and accessories.

- Review of the hand biomechanics as related to splinting.

- Biological considerations proving the sens and nonsens of splint therapy.

- Functional aspects to hence active splint use in activities of daily living.

160 pages of professional notes accompanied by over 200 well made technical drawings, funny cartoons and life photographs: a perfect manual to help to design friendly hand splints.

Volume 1 is not a piece of work for overnight reading but it is an indispensable reference book that makes the understanding of the basic concepts of splinting so much easier.