Making an Anti-Claw Splint (and why you should know)
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[00:00:00] Please Coke Zero, can you sponsor this video and podcast? Thank you very much. Okay, so anti claw splints are made specifically if you have someone with an ulnar nerve issue and their fingers, their MPs go into hyperextension and their PIPs go into flexion. So there's a lot of different ways to make an anti claw splint.
This is my video. Go take a look and leave me comments if you have any questions below. My thing here, it's about this long in terms of around the finger, right? So the key thing here when you're cutting is that you want, this is going around, this is going around someone's finger, and it has to be very nice and smooth so that it doesn't feel jagged.
Alright, [00:01:00] so I'm going to make it
a little bit on the thin side because she's got thin fingers. Alright, so here, see this? Between the MP and the PRP, I don't want it to be too thick. Just because she's got small dainty hands, right? So here's what it looks like to come down around. Oh, my hands are much bigger than yours because these are long.
That's okay. It's almost better to be long Than to be too short, right? So i'm gonna go ahead And heat this up and mold it to you So the key thing i'm going to show you because I have to go kind of fast once it's heated Is I'm always going to start on the palm and then I'm going to take the material and I'm going to loop it [00:02:00] around and I come down to this palm to the distal palmar crease, right?
And then because I'm doing that I'm going to now loop it around. Go between the fingers. I already know where my potential problems are. My potential problem is always here in between the fingers, right? So I need to make sure that that area doesn't get irritated, right? And I also know that when you bend your fingers, you flex at the MP, the fingers come together.
And I don't want to together. So I'm going to make sure that this is nice and smooth. And I'm going to put my finger the side of my finger between the side of her finger. And I make a little indentation. This side is relatively easy. I don't have to pay too much attention to that. Right. My other thing is in order to make this between the fingers nice [00:03:00] and easy.
A lot of times I'll do a little stretch over. So because I stretch it, the material, the split material will get nice and thinner right here between the crease. Does that make sense? If you use a hydrocollator and you drop your small piece of material in there, you're done. All
right. So let's get you in the camera. I'm going to start here at the palm. I'm going to give it a little stretch over, come down around. I'm going to make sure to move my strap wherever I need it to be. So I don't want it to be too, too, too far in. And then I'm going to go in between here and I'll make a little indent crease.[00:04:00]
And that's it.
In a minute, once it cools, then I can turn it. And I can also pull in between here, right? So here we're gonna turn it
and you'll see it's in the palm like this. So it's this long. I'm gonna cut it and it looks like a heart shape. Now right here in the, um, the web space, That's where my potential problem is, right? So one of the things you could do is dip it right there and just make sure you smooth it out, right? But you don't want to flare or roll [00:05:00] because then that's also in that spot too, right?
So boom. So if I hold it down like this as if I had my bar. Open and close, right? So you're able to open. So it's going to hold you like this. It's going to, you're going to open your fingers. So open your other ones. Right? Yeah, open your other ones and this is going to stay closed, right? It's bothering you right there.
So that allows me to see it. So I can go ahead and smooth that part out before I make my other component. Yeah, yeah, you can. It's the best thing. Um, or you can just shift it. Right. So I'm always going to do the easiest thing first before I start cutting. Right. But I haven't even built in my other parts yet.
So I want to build in my other part first. Now, a lot of times, I'll do the palmer part first and then I'll do [00:06:00] this part. So, however way you want to do it, you can do that as well. Here's my second piece.
Here's my second piece. I'm a fan when I do things inside the palm. I'm a fan of stretching.
You don't have to,
but I'm a fan of stretching. So you see in my split material, I'm a little thicker on one side than the other side. I'm going to put the tape on. So I'm going to go from the second metacarpal, and I'm going to give it a little stretch [00:07:00] over.
So for the most part, I want the MPs to sit into flexion. So I want to make sure, so I'm stretching the radial side, because I don't want the splint to get in the way of the thumb and the MP. Most important part about the palmar aspect. keeping that, that, um, that arch, that transverse arch. So when I put my, when I'm molding it, I've got my thumb in here to maintain that arch.
So there's a little cup curvature part to it, right? And then I'm stretching from here because of the web space. I'm stretching that piece across and I just rolled it down a little bit so it doesn't get in the way, right? And then so [00:08:00] when you open and close, it's not gonna be, it's not gonna be in the way.
So it kind of looks like this. So then what we have to do is we're going to connect. So this part goes here, right? And it's a little bit long. I tend to like it a little bit shorter so I can use a strap to connect it. And then we're gonna connect it here, right? So once I connect it here with my heat gun,
once I connect it here with my heat gun, I'm gonna mark it where I want it to connect down here. So I'm gonna use my pen. I'm gonna mark it here. And I'm gonna mark it here So I need to trim this spot here and this spot here And then I can heat both ends with the heat gun and connect it because it's gonna get real [00:09:00] sticky Creating this in a two step part makes it a anti claw orthosis really much easier to make because you can do it in two parts.
Do the palmar part and then you can do this part or you can do this part and then you do the palmar part and then you connect the dots together, right? Now if you have someone who's really, really strong that works against it too strong, they're not, it's not an exercise. So they're not supposed to try to break it.
It's supposed to just support them a certain amount so their eyepiece moves. Alright, so it's this hand. Um, So I'm going to put this on. Okay. And I'm going to mark it.
I'm going to mark it where I want it to be. [00:10:00] So, let's see. One on that side, one on that side, there you go. So I just marked, kind of marked where I want my, my thing to sit.
I'm just going to heat
this up.
I'm gonna heat up both sides just a little bit. So I usually just move it very, very little.[00:11:00]
So here we go. So I just heated it up.
So you want to heat this side a little bit and then the ends of this side a little bit. And you have to work really, really fast. And then when you press it, I just want to make sure that you're pressing on both sides of the splint so that you can still retain the shape here, right? There you go. And that's it.
And then sometimes if you want to, to confirm, I'll run the whole thing over and then just smooth this end part out.
And [00:12:00] that, in a nutshell, is your anti claw orthosis, right? So this is your anti claw orthosis, and to end it, you want to put a little piece of Velcro over here and over here, and then you're gonna strap it. So it's just a very small strap, it's just to ensure, but you see how it's How light and flimsy this is.
It's a orthosis with this material. It's just meant to help someone who's got the range of motion position the MPs in a certain way to allow better flexion and extension um, of the IPs. Now, the key things with this to consider and think about is the, always the spot here in the middle. So I will always work on this [00:13:00] spot to make sure it really, really fits someone very well before I take it and I mold it here.
Because if you can get this right, you can't really mess up, right? So I will make sure this is done really well. And then the other part is this one. What do I always say when it comes to orthosis is the middle parts. is the hardest part. So if you can make sure that's down, the ends are very easy to adjust, right?
So if this end here doesn't work well, I can essentially dip this in and still fix it. If this part was whatever, I can dip this in and fix it. If this is a little rigid, Like I could feel it. So I usually put my finger and I can feel it. This part needs to be smoothed out. Like this part is smooth now, but this part needs to be smoothed out.
So I can easily dip this little bit into water and just use the side of my thumb and smooth it out. All [00:14:00] right, so let's put it on. And I'll show you essentially the finished product, right? Um, here.
This is the finished product. So with the strap on, if you take a look, if you open the fingers right here, it's going to stop this from opening, right? It's going to fit right here between, um, right below, right just proximal to the distal palmar crease, goes in between, the thenar, um, in the thenar crease, right?
And then you're going to go ahead and make a fist. It's going to allow flexion and it's going to stop full extension. You don't have to be this low in terms of flexion. You can actually just be like more like this. Like 60 or whatever, but this is a position we ended up making. So whatever. It's good. It's still good Open there you go and then relax [00:15:00] And then open so it's just to hold the mps, but let the ips free Alright, so when it comes to anti claw orthosis, the question really is who would benefit from an anti claw orthosis, right?
So usually anti claw orthosis are really known for people who have an ul like an ulnar nerve issue, right? An ulnar nerve issue where they go MP goes into hyperextension and then IP just go into flexion and they usually have really good passive range of motion but they can't maintain. So they're gonna go into an anti claw, oh my goodness, anti claw, oh my god your hands are so small, anti claw orthosis so that it could help maintain MP flexion.
and, um, promote IP extension. So this is an anti claw orthosis. [00:16:00] So if you think about the purpose of an anti claw, which is to stop hyperextension of your MP and allow flexion, flexion of your MP, but also flexion and extension of your IPs, who else could benefit from this type of orthosis? Um, We are, uh, currently we have a small finger, a guy with a small finger injury that he has great passive range of motion, but he is, he keeps going into hyper extension is MP.
And therefore he keeps going into more and more flexion of his PIP and DIP. So he can, he gets great passive range of motion, he just actively can't get PIP. So what happens is in his attempt to get active, he goes into hyperextension. Once he goes into hyperextension of MP, Then it promotes flexion of the IP.
So there's a couple [00:17:00] of things that you could do. We could make a relative motion orthosis, right, which potentially could stop him from going into hyperextension. Or we can make an anti claw. And really, at the end of the day, it comes down to what's going to be most beneficial and most comfortable for him.
Something like this, or something that goes across. So the way we're going to do it is we're going to check. We decided that this because he has so so much motion that he actually can go into extension still and not get enough, not get enough, um, extension here. So that's why we're trying to use an anti claw orthosis, not just, not just to stop the MP from going into extension, but holding it down enough.
to get isolated PIP extension. So if you know the purpose of [00:18:00] an, of an anti claw orthosis, you know what it's supposed to do, you can figure out who you need to put it on and why they would benefit from this type of orthosis over any other orthosis. Right? So that's the Y2. And were there any other questions?
Okay, so we covered materials. You can use kind of almost any material, but materials that have a little bit more memory can help you over materials that don't have memory. You don't want anything really gummy because if you stretch it or you mess up, you can't really fix it. So anything with a little bit more memory.
Aquaplast, Orifit, um, even Taylor Splint has some memory so that's still a really good orthosis material to use. Um, and how do you get better leverage? Just get them to relax. Like I think when you're making the orthosis, getting someone to relax [00:19:00] gives you, gives you better. If you're too high? Yeah, if you're, if you're, if you're bar.
is too high. Like this doesn't fit my hand. Your bar is too high. It's not going to give you enough leverage. It needs to be right, essentially right below the distal palmar crease where it's going to sit. It's got to be right below. Otherwise it's going to be up here and it's going to dig into the MP and to the poly system, right?
So if you're struggling to work with people with nerve types of injuries, one of the best places where you can get some help is inside the mentorship program. The mentorship program runs every month. We do a new topic. And then while we're talking and teaching on that new topic, you can come on and get questions at any time to help you through your cases, such as if you're working with a nerve injury, any kind of, you know, Uh, splinting needs you have.
If you have any questions, [00:20:00] not only do we have a full library for you to go and look and learn through the different modules, you can come on live calls and ask me personal questions to help you think through your cases and to be able to progress your patients. Link's going to be below for you.
