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Splint Design: Ulnar drift splint
Objective of the splint:
This splint design can be used to improve the alignment of strongly deviated fingers, which is in many cases caused by rheumatoid arthritis. An ulnar drift deformity is characterized by ulnar deviation and volar subluxation of the metacarpal phalangeal (MCP) joints. In rheumatoid arthritis, chronic inflammation of the MCP joints and many other contributing factors cause damage to the joint capsule and surrounding ligaments resulting in this deformity. This deformity has functional and esthetical implications and is often accompanied by wrist deviation and other extremity deformities as well. As the ulnar shift must be corrected, it is highly recommendable to use a lever system (see figure below).
In addition, it is also advisable to pull rather than push in order to obtain a comfortable correction, which explains the position of radial bar at the level of the MCP and first phalanx. Therefore it is very important that this part of the splint is moulded correctly (correct position and covering enough surface) and that extra padding (Luxofoam) is provided to prevent overpressure. The piece/bar which covers a small part of the palmar surface must also be shaped and moulded in such a way that it conforms to the anatomy of the distal border of both the thenar and hypothenar musculature. These crucial points contribute to overall patient comfort. Continue reading