Hand Therapy Education

Video on how to make a Resting Hand Orthosis using Orfit Multifit splinting material. 

Video on how to make a dorsal wrist orthosis using Orfit Multifit splinting material.

A wrist and thumb orthosis can serve to immobilize the wrist, the basal joint and the MCP joint of the thumb. This type of immobilization splint is recommended during the treatment of several indications, including the following: – Post surgical thumb basal joint arthritis, Thumb and wrist sprains, De Quervain’s tenosynovitis, Rheumatoid arthritis, and Follow-up treatment of scaphoid fracture.

Material Used: Orfit Colors NS

Available in Hot Green, Atomic Blue, Sonic Silver, Dominant Black or Ocean Blue. The same orthosis can be fabricated by designing this same pattern out of an Orfit Colors 2.0mm sheet.

The Dorsal Wrist Cock-Up Orthosis immobilizes the wrist joint to allow healing and rest or protection of injured structures. It can be used to help support the wrist in an extended position to allow for functional grasp and release, alleviate pressure on the median nerve while supporting the wrist in neutral or slight flexion, or substitute for weakened or absent wrist extensor muscles. The advantage of the dorsal design is that the sensory surface of the palm is not blocked by thermoplastic material. The dorsal design also provides an excellent base for outrigger attachments as demonstrated here.

The outrigger is fabricated using Orfit Industries’ patient pleasing, low profile Dynasyst mobilization system. This mobilization system of Orfitubes and Orfitube adjustors provides an easy to align and easy to adjust outrigger attachment. In this featured video, the Orfitube outrigger passively supports the Metacarpo-phalangeal (MCP) joint in extension while allowing full flexion of the digit. This type of orthosis is typically prescribed post-operatively for extensor tendon repair or following MCP joint arthroplasties. A recently published systematic review of rehabilitation protocols following extensor tendon repairs (Zones V-VIII) highlights the advantages of dynamic splinting protocols over static splinting protocols for superior patient outcomes. (Sameem et al. A Systematic Review of Rehabilitation Protocols after Surgical Repair of the Extensor Tendons in Zones V- VIII of the Hand. 

Journal of Hand Therapy. 2011;24:365–73) Additional support for dynamic orthoses following tendon repair is also offered in a recent Level V paper. (Evans. Managing the Injured Tendon: Current Concepts. Journal of Hand Therapy. 2012; 25:173–90). The Orfitube outriggers can also be used to provide low load prolonged stretch to stiff joints on either the volar and dorsal surfaces of any orthosis to facilitate lengthening of tight capsular structures.

Material used: Orfilight Black NS (3.2 mm) with an Orfitube Outrigger.

Injury to the ulnar nerve may cause an abnormal hand posture typically referred to as “clawing” of the ring and little fingers. This posture includes hyperextension of the Metacarpo-phalangeal joints (MCP)’s and flexion of the Proximal-interphalangeal (PIP) and Distal-interphalangeal (DIP) joints and is emphasized when the person attempts to straighten their fingers. The ulnar nerve injury affects the intrinsic muscles of the hand which not only abduct and adduct the fingers but also help to flex the MCP joints. Without these functioning intrinsic muscles, the MCP joints are pulled into hyperextension from the force of the unopposed long extensors. The intrinsic muscles also contribute to extension of the IP joints and without them, the PIP and DIP joints flex. The combination of hyperextension at the MCP and flexion at the IP joints gives the hand its claw like appearance. The anti-claw orthosis, also known as a lumbrical blocking splint or MCP blocking splint, positions the MCP joints in 90° of flexion and prevents hyperextension. The orthosis facilitates PIP joint extension, while allowing for full grasp. Maximal functional use of the hand is maintained.

Material used: Orfit Colors NS, 3.2 mm.

The primary purpose of the short opponens orthosis, also commonly known as a short thumb spica or basal joint orthosis is to immobilize the thumb carpometacarpal (CMC) and metacarpo-phalangeal (MP) joints to allow for healing, rest, and /or protection of the involved structures. This demonstration features Orfit’s precut gauntlet thumb post orthosis. This short thumb opponens orthosis can also improve functional use of the thumb by proper positioning of the thumb in slight opposition. While molding, have the patient lightly oppose the thumb to the index finger tip. This design works well for CMC or MP joint arthritis, thumb ulnar and radial collateral ligament injuries, and low median nerve injuries. This precut design features use of the thinnest material possible, yet still provides the required strength to immobilize the joints.

Material used: Orfit Colors NS, 1.6 mm.

A video on how to make an outrigger dynamic orthosis with the new isoforce outrigger attachment and the versatile Orficast more thermoplastic tape material.

A video on how to make an outrigger static progressive orthosis with the new isoforce outrigger attachment and the popular Orfit Colours NS in 2.0mm thickness.

A video on how explaining the trick to attach a hook and loop velcro strap to wet Orficast splinting material to create a variety of orthosis’s.

This video demonstrates how to make an orthosis for a tendinous mallet finger in hyperextension using a wrap technique.

Used material: Orficast Black (width: 3 cm)

This video demonstrates how to make a functional orthosis for patients with ulnar drift of the MCP joints of the fingers.

Used materials: Orficast Blue (width: 6 cm)

This video demonstrates how to fabricate a radial gutter immobilization orthosis for patients with a diagnosis of De Quervain’s tenosynovitis, a tendinitis of the extensor tendons of the first dorsal compartment.

Used materials: Orficast Blue (width: 6 cm), hook and loop tape.

This movie demonstrates how to make an Epicondylitis Counterforce Brace, useful for lessening the tension on the wrist extensor tendon muscles during activity.

Used materials: Orficast Black (width: 6 cm), hook and loop tape.

This movie demonstrates how to fabricate an anti-wrist radial deviation orthosis with a dynamic pull on the ulnar side, used for example in case of rheumatoid arthritis of the wrist.

Used materials: Orficast Blue (width: 6 cm), Orficast Black (width: 3 cm), hook and loop tape, Orfitube, elastic thread.

This movie demonstrates how to make a functional orthosis for patients with basilar joint arthritis.

Used materials: Orficast Blue (width: 6 cm), hook and loop tape.

This video demonstrates how to make a hinged orthosis which will allow full flexion of the PIP joint but will block full PIP joint extension.

Used materials: Orficast Blue (width: 6 cm), Orficast Black (width: 3cm).

This movie demonstrates how to make a trigger finger orthosis. This design consists of a small ring fabricated around the base of the involved finger. It can also be used for a pulley protector after flexor tendon surgery with pulley reconstruction.

Used materials: Orficast Black (width: 3 cm), hook and loop tape.

This movie demonstrates a PIP dynamic extension orthosis with Orficast and Orfitubes.

Used materials: Orficast Black (width: 6 cm), Orfitube, Orfitube ends, elastic thread.

This movie demonstrates a yoke orthosis for the middle finger. This orthosis can be used in a post-operative extensor tendon rehabilitation protocol. It can also be used to restrict motion at one PIP joint and to encourage motion at another PIP joint.

Used material: Orficast Blue (width: 6 cm)

This movie demonstrates a yoke orthosis for the index finger. This orthosis can be used in a post-operative extensor tendon rehabilitation protocol. It can also be used to restrict motion of one PIP joint and to encourage motion at another PIP joint.

Used material: Orficast Blue (width: 6 cm)

This movie demonstrates how to fabricate buddy tapes, a common treatment for sprained finger joints. The goal of buddy tapes is to protect an injured finger by taping it to an adjacent finger to rest the injured joint ligaments as they heal.

Used material: Orficast Black (width: 3 cm)

This movie demonstrates how to make a functional orthosis in case of root arthrosis.

Used materials: Orficast Blue (width: 6 cm), hook and loop tape.

This movie demonstrates how to fabricate a “thumbs up” orthosis, worn in cases of mild thumb sprain, keeping the trapezium free. This orthosis does not fully prevent adduction and/or abduction of the thumb.

Used materials: Orficast Black (width: 6 cm), hook and loop tape.

This movie demonstrates how to make an immobilization orthosis for the thumb CMC. 

Used materials: Orficast Black (width: 6 cm), hook and loop tape.

This movie demonstrates how to make an immobilization orthosis for the thumb CMC. Used material: Orficast

Used material: Orficast Black (width: 6 cm), hook and loop tape.

This movie demonstrates how to fabricate an orthosis to prevent the claw-hand deformity.

Used material: Orficast Black (width: 6 cm)

This movie demonstrates a PIP dynamic extension orthosis with Orficast and Orfitubes.

Used materials: Orficast Black (width: 6 cm), Orfitube, Orfitube ends, elastic thread.

This movie demonstrates a dynamic extension orthosis, known as the Capener orthosis. The goal of this orthosis is to increase the range of motion of the PIP joint by exerting light traction of the tight ligamentous structures.

Used materials: Orficast Black (width: 6 cm), 2 finger coil springs

This movie demonstrates a full finger immobilization orthosis using the pinch method. The goal of this orthosis is to immobilize the finger in a resting position to help with pain management and edema control.

Used materials: Orficast Black (width: 3 cm), hook and loop tape

This movie demonstrates a full finger immobilization orthosis using the wrap method. The goal of this orthosis is to immobilize the finger in a resting position so it can heal.

Used material: Orficast Black (width: 3 cm)