Splinting mcp s in flexion and ip s extended intrinsic plus positioning safe position forearm based or hand based gutter splint position of mcp joints collateral ligament stablility.
Gutter splint mcp.
Cut out a 3 or 4 inch splint material to the length necessary to immobilize the wrist and mcp joint.
Mcp joints in 70 90 degrees flexion.
Forearm based ulnar gutter versus hand based thermoplastic splint for pediatric metacarpal neck fractures.
Splint from the proximal forearm to slightly beyond the fourth and fifth finger dip joints.
Dip joints in 5 10 degrees flexion.
Bisect the splint longitudinally from the fingertips to the wrist.
The radial gutter splint provides both volar and dorsal splint immobilization of these metacarpal injuries.
If there is a pip flexion contracture a prefabricated dynamic three point extension splint might be used or a static splint can be adjusted serially with the goal of achieving full passive pip.
Leave the thumb index and middle fingers freely mobile.
The goal of splinting for boutonniere deformity is to maintain pip joint extension while keeping the mcp and dip joints free for about 6 to 8 weeks.
Insert a dry gauze or cotton material between the 2nd and 3rd fingers.
Use of a hand based thermoplastic splint for treatment of isolated fifth metacarpal neck fractures in pediatric patients has not previously been studied in a randomized blinded trial the authors conducted a blinded 1 1 allocation two arm parallel group.
A blinded randomized trial.