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.