Splints (Part 4) - Flexor and Extensor Tendon Injuries

[@Moezychan]

I have my COTA exam scheduled for August 6 and these videos have helped tremendously! I always want to pull my hair out when studying hand therapy but watching this series has seriously helped! Thank you so much!

[@mayerlingalvarez2076]

Great video. It is so helpful. I will recommend your channel to every one who is preparing for the exam. Thank you for sharing your knowledge.

[@annasamuels6509]

I would love more hand therapy videos! Splinting, treatment, evals, anything! I will be starting a Level II rotation in hand therapy soon!

[@OTOverEasy]

Oooh that's so exciting! I just recently posted a review of the brachial plexus, that would be good to check out. Hands is my specialty, so I'll definitely be adding more hand content in the future! Good luck with your placement :)

[@mamatapatel5084]

Thank you for this video. It is super helpful

[@parris376]

Hi! Your videos are so helpful and I have enjoyed watching while studying. I had a question about to positioning for the dorsal blocking splint. In other study material, I have seen that the dorsal splint is supposed to place the wrist in about 20-30 degrees of flexion and the MCPs in 50-70 degrees of flexion. Is that true? I heard you mention neutral but I am seeing different answers everywhere.

[@OTOverEasy]

Hi there! You are correct that the wrist can be positioned in slight flexion with a DBS. One of the most referenced protocol books for hand therapy is the Indiana Protocol guide, and in there they recommend 20 degrees of wrist flexion, MCPs about 60-70. I stated neutral since it is only slight flexion, and I think being able to visualize a position is more important for an entry level exam than getting caught up in the exact numbers (remember - big picture!). The main thing to remember is you don't want the wrist to be in extension, because that puts increased tension on the healing flexor tendons and increases risk of gapping at the repair site. Good catch, hope this helps!

[@parris376]

@@OTOverEasy Thank you so much!

[@MissingDogsUK.]

I damaged some fingers and went to a & e, did a x-ray, in mid February and nothing broke. It was swollen badly(still swollen a bit now & bruised) I couldn't straighten any of my fingers for quite a few weeks & my hand was like in a claw position, so stiffened up, have managed to straighten them all except my middle finger is bent especially in the middle joint of it. Extremely painful, had to litterly beg my doctor for physio and to see a hand specialist as not healed nearly 3 months later. On the waiting list now, I am sitting here now watching this as I've just made my own splint to put on two fingers, don't know if thats the right thing to do, but I'm trying to straighten it 😞 I think it might be the tendons torn etc, according to a multosketal person who works at the doctor's it's not. Should it of maybe gone in a splint to begin with do you think to help straighten all my fingers then my hand wouldn't stiffened up in a horrible position

[@OTOverEasy]

Hi! I can't really assess you or offer GREAT advice without being able to examine your hand in person, so I am glad you are getting in with a hand specialist! What was your initial injury, was it cut, crushed, something else? Are you unable to move your fingers using their own strength at all, or is it just joint stiffness stopping you (so unable to straighten even when using the other hand)?

[@MissingDogsUK.]

@@OTOverEasy thank you, I slammed my hand really hard when I fell over on my hard wooden flooring. Some of my other fingers won't bend properly even when I do it with my other hand, but I've managed to straighten them ones now, it's mostly my big one which was always worse, its bent at the middle joint part when I try and straighten it so won't straighten, and can't bend it at all when using my other hand to try. It still has a bit of swelling/bruising, didn't realise swelling could last that long as did it nearly 3 months ago. Thanks for your advice

[@OTOverEasy]

@@MissingDogsUK. Swelling can last a long long time in fingers! Some of my patients will still have swelling 6+ months after an injury in their hand. Sounds like your joints are stiff to passive resistance; even if you didn't break any bones, you may have injured some of the soft tissue (which wouldn't show on an x-ray!). I wouldn't splint your finger/s 100% of the time, or they may get even more stiff. However, splinting intermittently throughout the day to provide stretch to try to straighten them out may help. Good luck!

[@MissingDogsUK.]

@@OTOverEasy thank you, I did put it in a splint over night but really hurt the next morning so am just going to not use one atm, was just trying to straighten it a bit, as I've just got my hand specialist appointment through and it's not till June, thank you for your advice. I'm in the UK and sometimes our doctors aren't great or trying to get a doctor's appointment is quite difficult. That's why I was adamant that I needed to see a hand specialist or physio etc as it's still bent 3 months later so I need to see someone who may be able to help. Thanks again