Anatomic location

Arm: area from shoulder to elbow (humerus) Antecubital fossa: depression at the bend of

the elbow Forearm: area from elbow to wrist Carpal: wrist or carpal bones Fingers: thumb, index, middle, ring, little Numbering fingers: I, II, III, IV, V (thumb) Palmar = volar: ant aspect of hand and

forarm Radial : thumb side / Ulnar: little finger side

Muscles and function nerve supply

Study table 4-4 on page 59

Arches of the hand

1. longitudinal arch 2. Distal transverse arch3. Proximal transverse arch Functional significance Never splint the hand flat .. Creates

deformity Specially with tendon and nerve injury

Creases of the hand

Three main palmar creases: distal, proximal and thenar creases

The distal palmar crease extends from the fifth MCP joint to a point midway between the second and third MCP joints. This is important for allowing motion of the MCP’s for a wrist immobilization splint

Creases of the hand

Important for landmarks when making splint pattern and molding

Figure 4-11 When splinting to immobilize a join, the

crease should be included in the splint When mobilizing a joint? What happens with:

› Edema › Paralysis › disuse

Correct Biomechanics of Splint Design Splints are simply machines and levers

that work together. Optimal client outcomes rely on

biomechanics Weak muscles are supported, and the pull

of stronger muscles is counteracted. Reduces risk of skin irritation due to

pressure Ultimately may lead to patient comfort,

compliance, and function

three point pressure Mechanical advantage (F1*D1 =

F2*D2) Torque Pressure and stress

› 1. degree › 2. duration › 3. repetition › 4. direction

The skin is the least tolerating tissue to stress

Skin becomes ischemic as load increases

Even low stress can cause capillary damage and lead to ischemia

Splints may do that, this is why it is advised to distribute pressure over a larger area of skin

It could lead to inflammation and skin breakdown

You have to remember that some diseases (lymph and vascular involvement) leads to an altered sense of tolerance

Small and sharp edges lead to stress

You have to remember that there are three directions of stress:

1. Compression 2. Tension 3. Shear Pressure = Total Force/ Area of force

application