Static Progressive Addition to the DIP Blocking Splint

A few days later I decided to modify my pt's DIP blocking splint because he was getting frustrated having to switch different splints all the time. His initial static progressive splint was a forearm based splint which was often bulky and a pain to drag around. The main idea was to develop a 2 in 1 splint, with both a static progressive component and a active blocking exercise option. He wears the pulleys for up to 20 min 4x a day and follows with blocking exercises.

DIP Blocking Exercise Splint

Doing blocking exercises for any joint can be a real pain because it takes quite a lot of strength from the other hand to stabilize/immobilize the joint that is being "blocked". I always thought it would be great if a person could use some sort of device to assist with this otherwise time consuming task.

My pt had a PIP (proximal interphalangeal joint) contracture of both his ring and small fingers which made it increasingly difficult to perform DIP (distal interphalangeal joint) blocking exercises. The FDP (Flexor Digitorum Profundus) could not be isolated because the FDS (Flexor Digitorum Superficialis) always took over.

Below is a splint that was initially created for him by another therapist. The main problem was that there wasn't enough support dorsally because the splint would keep sliding up and down which still required quite a bit of effort from the other hand to stabilize. We attempted to put a dense foam to apply additional pressure but it just wasn't enough.


After trying a few other adjustments we decided to create a whole different splint for him. This took more of a gutter approach with support both volarly and dorsally. This provided a snug fit which reduced the amount of space allowed for sliding up and down. I had to open up the radial side of the ring finger because my pt was having quite a bit of pain sliding his fingers in and out of the splint. Fortunately he has been able to use this splint to perform isolated blocking of both his ring and small finger DIP joints.

The Wrist Cock Up Splint

Honestly, the wrist cock up splint is the most basic splint to know how to make. I've made more of these than any other splint.



This particular one was made for a pt with a metacarpal fracture of the 5th finger after her pins were pulled.

CPMC Hand Therapy Clinic

I'm starting this blog super late but I'm going to do my best to document the work that I've done at Davies Hand Therapy Clinic during my 3rd Level II internship. Splinting has been one of the most enjoyable aspects of this internship so far.. Please follow as I problem solve my way through my many adventures of splinting!