1. Innovative Splinting options for the Thumb MP joint
Kathleen Snelgrove OTR/L, CHT
University Orthopedics Inc.
Providence, RI

2. Thumb MP Joint Anatomy
The thumb MP joint allows flexion, extension, abduction, adduction, and a limited range of rotation.
Normal Flexion is highly variable from only a 5 degree to over 100 degree flexion extension arc.

3. Indications for Thumb MP Joint Splinting
Common injuries of the Thumb MP joint include:
Ulnar Collerateral Ligament injuries: Commonly referred to Gameskeeper’s or Skier’s Thumb
Radial Collerateral Ligament injuries
Dislocations of the MP joint with or without Volar Plate injury
Volar Plate injuries
Sesamoid Fractures
Osteoarthritis

4. Factors to consider when choosing a splint design
Stability of the joint
Immobilization of non-involved joints
Materials used and environmental factors
Stability: Complete UCL or RCL tears vs partial tears Healed fractures or VP injuries require less lateral support
Immobilization of non involved joints limits ability to work and play sports.
Materials need to be considered if under a glove, to be used in sports, and with skin irritation.

5. Prefabricated Splints
Ryno Lacer Wrist and Thumb Support
Tee Pee Thumb Protector
By Med Spec
Short Thumb Spica by Exos

6. Thermoplastic Options
Thumb Spica Forearm Based
Thumb Spica Hand Based
Galindo-Lim Thumb MP Joint Stabilization Splint
UOI Design Thumb MP Lateral Support Splint

7. UOI Design Thumb MP Lateral Support Splint
Materials and Pattern
You will need:
Thermoplastic Material such as NCM Vanilla 3/32 or thin Aquaplast
Kinesiotape, Coban or other adhesive taping.
Elastic based Velcro may be used in some cases
The splint pattern as shown

8. UOI Design Thumb MP Lateral Support Splint
To make the splint:
Make the pattern, place onto material, cut it out and apply it to the patient’s hand.
Position the cut out oval over the MP joint. Widen the opening depending on lateral stability required and MP flexion desired.
Tag the Proximal Phalanx piece and place thumb in slight opposition with MP positioned in vary degree of flexion depending on goal of splint.

9. UOI Design Thumb MP Lateral Support Splint

10. UOI Design Thumb MP Lateral Support Splint

11. References WWW.Northcoastmedical.com WWW.Medspec.com
(Exos)
Galindo A, Lim S. A Metacarpophalangeal Joint Stabilization Splint. Journal of Hand Therapy 2002; 15: (1)