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

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.

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

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.

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

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

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

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.

UOI Design Thumb MP Lateral Support Splint

UOI Design Thumb MP Lateral Support Splint

References WWW.Northcoastmedical.com WWW.Medspec.com WWW.DJOglobal.com (Exos) Galindo A, Lim S. A Metacarpophalangeal Joint Stabilization Splint. Journal of Hand Therapy 2002; 15: (1) 83-84.