Experimenting with custom splint design

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This family wanted the support of thermoplastic splint with the comfort of neoprene, so I combined both. 

I made the custom splint in a traditional manner by tracing her hand, melting aquaplast, and forming it to her hand. I left the forearm trough as a plastic stay to keep the wrist straight. 

I measured her forearm for the neoprene and sewed straps and d-rings to it. I attached the neoprene to the aquaplast with rivets because I thought it would be the most secure option. I lined the inside with padding to make it nice and comfortable.

I used 1/16″ aquaplast and there is a little give to them. I find a slight dynamic component is so important. The client tolerates them well and is maintaining her range of motion.

Dynamic Elbow Extension Splint

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I’m not going to lie, I was kind of proud of myself with this one. I had no idea how I was going to pull this off, even as I was making it. This is an elbow extension splint that I made for a 12 year old girl with Cerebral Palsy: hemiplegia. She was lacking 40 degrees of elbow extension. I had tried to teach her stretches to do on her own, but her understanding of the task was limited and there was not great follow through with the family. I could have done a static elbow extension splint, but I really wanted to be able to give a progressive stretch. We don’t have the funding to buy something like this out of a catalogue, so I decided to try to make it myself.

I used 1/8” Aquaplast for the upper arm and forearm. I folded the Aquaplast on top of itself for extra stability to make the bars. I used socket screws for rivets and covered up the back of the flat bolt with Sugru (a self-curing rubber/silicone) in order to avoid any rough edges near the arm. Additionally, she postures her arm in shoulder internal rotation. I was concerned about possible pressure points and/or rubbing that could cause redness. I cut that side down as much as I could without hindering the integrity of it, and then I covered it in Sugru. I attached the bars by punching holes through the bars and the base and forming a rivet out of Aquaplast pellets. I then formed two cylinders out of the Aquaplast. One of them I formed around a long screw, the other one I left open. I used a heat gun to attach each cylinder to the upper arm and forearm pieces. The end of the screw is inserted into the hole of the cylinder on the forearm. As she stretches, the wing nut can be twisted to push the elbow into further extension, and voila!

Dynamic Wrist Extension Splint

I had a client with juvenile rheumatoid arthritis who was limited in wrist extension. Her doctor had requested I make a splint to increase range of motion in wrist extension. I could have made a static splint and remolded it as she progressed, but it didn’t seem like the best option. I did a little research online, and found a dynamic design. I’ve never made a dynamic splint before, but I was willing to try it. 
 On this splint, there is a piece that fits on the dorsal side of the forearm and the fingers slide into the oval shape and rest at the MCP joints. There are two small hooks. One at the far side of the forearm and one at the fingers. A rubber band is secured around the hooks and provides a consistent stretch into wrist extension. The hinge at the wrist allows her to flex her wrist and use her hand functionally. As she progressed, I used tighter rubber bands and eventually twisted them around several times to provide a greater stretch. She went from neutral wrist extension to 70 degrees.

I had a client with juvenile rheumatoid arthritis who was limited in wrist extension. Her doctor had requested I make a splint to increase range of motion in wrist extension. I could have made a static splint and remolded it as she progressed, but it didn’t seem like the best option. I did a little research online, and found a dynamic design. I’ve never made a dynamic splint before, but I was willing to try it.

On this splint, there is a piece that fits on the dorsal side of the forearm and the fingers slide into the oval shape and rest at the MCP joints. There are two small hooks. One at the far side of the forearm and one at the fingers. A rubber band is secured around the hooks and provides a consistent stretch into wrist extension. The hinge at the wrist allows her to flex her wrist and use her hand functionally. As she progressed, I used tighter rubber bands and eventually twisted them around several times to provide a greater stretch. She went from neutral wrist extension to 70 degrees.

Pencil Grasp Assist for Muscular Dystrophy

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This is an adaptive device I made that is used with clients who have difficulty grasping a pencil. It maintains the fingers in a pinch. It is typically used for people with muscular dystrophy.

*Disclaimer: this is not my original design

Elbow Flexion Assist Harness

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I made this for a client who was unable to bend their elbows. There was some bony limitations, but they were also lacking bicep muscles. There is a harness that fits over the trunk and rests on the shoulders, then there are two wrist splints. A piece of Theraband is attached to the shoulder and to the wrist, which allows them to extend their arm, but also stretch it back into flexion. It also allows the person to bring something to their mouth for self-feeding.