Our OT has my son in a pan splint basically 24 hrs/day. When we recently met w/Dr Mackinnon, she questioned having him on a splint so often because he might lose his ability to close his hand. However our OT says in order to prevent his fingers from curling in, he needs to be on a pan splint day and night. His injury is only 2 mos old and his hand already appears flattened a bit. Chase is 7 yrs old and I'm not sure who to listen to. He currently wears a pan splint and shoulder immobilizer day and night. Does anyone have suggestions? Is this common protocol for a youngster w/TBPI? We're hoping to have surgery in the next 6 wks and get new direction then, but we're not currently under a "specialsts" care. Thanks for your feedback!
Lourdes
TBPI and hand splints
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Re: TBPI and hand splints
What is a "PAN" splint?
Im not even sure if they have a protocol for this injury really. Different therapists do different things depending on the need I guess.
After several months, James Dr. recommended we not let him wear the sling so much. It couldve caused elbow problems in the future. His OT suggested a shoulder brace for his subluxation and he wears it everyday except for sleeping. Its been hard to find one to fit him properly though. He says it takes some of the pressure off. The heaviness of his arm. At night, he has always worn a splint to hold his fingers straight. Even with all the ROM we do, if we dont do it religiously several times a day, they still seem to curl and his palm has REALLY flattened out bad. This concerned the OT so we are now looking into a splint that he can wear day and night for his hand to try to help this. Its made of neoprene material and only fits to his wrist. That way he can stop using the one he uses at night. It fits all the way up to his elbow and theres no need for that really. They gave that to him when he first had his accident almost 2 years ago.
Since James dont wear his sling anymore and started using the shoulder brace with his arm hanging down, we have noticed his fingers are swelling pretty bad, so hes using the sling off and on when hes doing something really active to keep his arm from slinging around, and if hes in the house not doing much, he keeps it off and trys to keep his hand up some to help reduce the swelling. So its been a guessing game with whatever we do really. Sounds like they are trying to do all they can for Chase. I wish we wouldve done the hand splint sooner though. Maybe his palm wouldnt have looked as bad as it does now. Hope that helps you.
Im not even sure if they have a protocol for this injury really. Different therapists do different things depending on the need I guess.
After several months, James Dr. recommended we not let him wear the sling so much. It couldve caused elbow problems in the future. His OT suggested a shoulder brace for his subluxation and he wears it everyday except for sleeping. Its been hard to find one to fit him properly though. He says it takes some of the pressure off. The heaviness of his arm. At night, he has always worn a splint to hold his fingers straight. Even with all the ROM we do, if we dont do it religiously several times a day, they still seem to curl and his palm has REALLY flattened out bad. This concerned the OT so we are now looking into a splint that he can wear day and night for his hand to try to help this. Its made of neoprene material and only fits to his wrist. That way he can stop using the one he uses at night. It fits all the way up to his elbow and theres no need for that really. They gave that to him when he first had his accident almost 2 years ago.
Since James dont wear his sling anymore and started using the shoulder brace with his arm hanging down, we have noticed his fingers are swelling pretty bad, so hes using the sling off and on when hes doing something really active to keep his arm from slinging around, and if hes in the house not doing much, he keeps it off and trys to keep his hand up some to help reduce the swelling. So its been a guessing game with whatever we do really. Sounds like they are trying to do all they can for Chase. I wish we wouldve done the hand splint sooner though. Maybe his palm wouldnt have looked as bad as it does now. Hope that helps you.
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Re: TBPI and hand splints
Hi, Lourdes
I have a Complete right brachial plexus injury that i suffered three years ago. I would go with what the surgeon says as far as when your son wears the splint or not. Your OT is right the hand will curl over if the fingers are not kept limber. Although i do not think that there is a need to keep it in there all the time. I have a splint to but i only have it on when i am in bed and when i go out. I asked my physio (who happens to be my dad) about this and he said that having a splint on 24hrs a day is not necessary as long as his fingers stay limber. My fingers still have full range of motion and i only have the splint on 12hrs a day at most. What position is the shoulder immobilized in? and is the shoulder being stretched at all? anyways hope this helps a little bit.
Andrew
I have a Complete right brachial plexus injury that i suffered three years ago. I would go with what the surgeon says as far as when your son wears the splint or not. Your OT is right the hand will curl over if the fingers are not kept limber. Although i do not think that there is a need to keep it in there all the time. I have a splint to but i only have it on when i am in bed and when i go out. I asked my physio (who happens to be my dad) about this and he said that having a splint on 24hrs a day is not necessary as long as his fingers stay limber. My fingers still have full range of motion and i only have the splint on 12hrs a day at most. What position is the shoulder immobilized in? and is the shoulder being stretched at all? anyways hope this helps a little bit.
Andrew
Re: TBPI and hand splints
Thanks for your responses (Priscilla and Andrew). I feel better about having him in the splint - I wasn't sure if it was "normal" to use one as often as Chase is. He wear's a pretty hard one at night and during the day, he wears a perforated one (because he sweats so much) and it's very flexible. As I mentioned, he also wears a shoulder immobilizer (mainly to bed - which I wonder about too) and a Joslin sling during the day (it's just less bulky). Our OT made the immobilizer - it's a band around his chest (w/velcro), and a strap around his arm and around his forearm as it rests against his abdominal area...make sense? Anyways, he is showing signs of a small subluxation in his shoulder, but I'd much prefer to see him in a shoulder support rather than a sling. Of course, I have thought about James' swollen fingers too and that doesn't sound good either. I suppose it's like everything else...individual. Thanks again - I hope you're all doing well!
Lourdes
Lourdes
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Re: TBPI and hand splints
Caralyn was never in a splint after her injury and they didn't want her in a sling either. They wanted to keep her arm moving and they said if we kept her in a sling it would tighten up and we might never get use out of the muscles in her upper arm. She only wears a sling now when she is at school and that is just to keep her from knocking it into people. She exercises her hand, fingers and arm every day to keep things from tightening up. We are looking at putting her in a splint for night time only for her wrist and fingers. I hope this helps.
Rene
Rene
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Re: TBPI and hand splints
Caralyn was never in a splint after her injury and they didn't want her in a sling either. They wanted to keep her arm moving and they said if we kept her in a sling it would tighten up and we might never get use out of the muscles in her upper arm. She only wears a sling now when she is at school and that is just to keep her from knocking it into people. She exercises her hand, fingers and arm every day to keep things from tightening up. We are looking at putting her in a splint for night time only for her wrist and fingers. I hope this helps.
Rene
Rene