The material cured in several minutes to a rigid, radiolucent state. The device was placed on the anterior aspect of the limb, permitting support for the digits, hand and wrist while allowing access for placement of surgical instrumentation and hardware. Material used: 3 mm (1/8”) perforated Rolyan Ezeform thermoplastic (Warrenville, IL, USA), heated to 75☌ prior molding directly on the patient. The template was transferred to the thermoplastic stock and the material cut and subsequently softened in a heated hydrocollator. These were again transferred to the template material, permitting development of a 2-dimensional representation of the device to be designed. Additional anatomic points were obtained MCP obliquity to the wrist crease, the 2nd and 3rd digit webspace and the distance from the MCP to the tip of the 3rd digit. A 50% circumference of proximal forearm, distal anterior wrist crease and MCP joints were transferred to a template along with their respective longitudinal separation distances. Additionally, allowance was made in the splint for a potential increase in edema and the application of postoperative dressings.Īppropriate anatomic landmarks were obtained by the hand therapist using direct reference on the limb to determine dimensions of the device ( Fig. A removable piece of thermoplastic material is attached on the ulnar aspect of the splint providing further support to the hand and device limiting collapse when drilling the MC (green arrow in Fig. An integral component positioning the thumb in radial abduction was employed to assist maintaining forearm pronation when on the operating table (red arrow in Fig. This permitted the hand intrinsic muscles to be in a mid-range length minimizing load on the fracture site or through the metacarpophalangeal (MCP) joints. Final adjustments were made by the clinical specialist hand therapist at the time of fabrication to ensure appropriate positioning of the wrist and hand in a position of comfort balancing tensions across joints and musculotendinous structures, in preference to James’ POSI. The device was custom fabricated preoperatively molded directly on the patient to provide a suitable base of support for the hand.
0 kommentar(er)
