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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