Extension orthoses and the stiff PIP joint following hand trauma:  A review of current clinical practice in the Australian context. — YRD
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 Extension orthoses and the stiff PIP joint following hand trauma:  A review of current clinical practice in the Australian context. (1832)

Celeste Glasgow 1 2 3 , Mary Little 2 , Steven McPhail 4 , Jenny Fleming 2 5 , Mark Ross 1
  1. Brisbane Hand and Upper Limb Research Institute, Brisbane, QLD, Australia
  2. Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
  3. EKCO Hand Therapy, Brisbane, QLD, Australia
  4. School of Public Health and Social Work, Queensland university of technology, Brisbane, QLD, Australia
  5. Occupational Therapy Department, School of Health and Rehabilitation Sciences, University of QLD, Brisbane, QLD, Australia

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Background

“Fixed flexion deformity (FFD)” (loss of PIP joint extension) is a common complication of hand trauma.1-2 Orthoses, are considered the treatment of choice for stubborn joint contracture.3 However, there is a lack of empirical evidence to guide therapist choice of orthosis, in a given clinical situation.

Aims

1 To examine clinical practice patterns in prescription of extension orthoses for the stiff PIP joint within Australia.

2 To identify factors influencing therapist clinical reasoning in choice of extension orthosis.

Method

An online survey was distributed to AHTA members.

Results

195 therapists responded. “Off the shelf” capeners, custom  made capeners, static finger troughs and serial casts  were the most popular orthoses.  Perceived effectiveness was the primary factor influencing splint choice (60%), followed by ease of patient application (18%) and previous experience with the splint design (13.8%). Respondents identified other key factors that influence splint choice, and these will be detailed.

 Conclusion

These survey findings provide important contextual information from which future research in this area can be planned.

1 Boccolari P, Tocco S. Alternative splinting approach for proximal interphalangeal joint contractures: No-profile static progressive splinting and cylinder combo. Journal of Hand Therapy. 2009; 22(3): 288-293.

2 Freeland AE, Hardy MA, Singletary S. Rehabilitation for proximal phalangeal fractures. Journal of Hand Therapy. 2003; 16(2):129-142.

3 Wilton JC. Hand Splinting Orthotic Intervention.2nd ed. Freemantle: Vivid Publishing; 2013.