61-158

Full wrist static splints (left panel) are required when flexor spasticity predominates the hand posture with no active extension recorded. Shortened spastic muscles are elongated to reduce dynamic contractures at joints. Lever arm principles are used by applying forces at the end of lever arms and counter forces through straps.

Specific positioning of the hand supports the distal transverse arch of the hand to preserve mobility at the metacarpal heads while thumb position preserves the C-shaped web spaces. Serial casting may be employed to gain the tissue length and mechanical alignment prior to static splinting. Dynamic splints impose movement and force to assist the child in completing tasks.

These splints are used with the child who demonstrates weak but active control of extensors and flexors. The spiral splint in the right panel provides active wrist extension for the child in reaching.

The splint allows the child to actively flex the wrist causing the splint to unspiral. As the child relaxes, the splint returns to the initial position of wrist extension