Hi, my name is Lorann Putnam. I'm an occupational therapist. I specialize in hand therapy and I practice at Los Gatos Hand Therapy in Los Gatos, California. With a scaphoid fracture, when they cast the hand, typically the thumb is included because any loading onto the tip of the thumb radiates down into the scaphoid. Once the cast is removed, a hand therapist will fabricate a custom splint allowing the IP joint to be free so that you can get range of motion back sooner, however, still protecting the scaphoid but allowing you to move more. If there's no pain, then typically we'll make another one so that you can move the MP joint and have less stiffness. Because scaphoid fractures are immobilized for a very long time, you often end up with joint stiffness. If you can transition into a splint that allows more freedom of the thumb joint, that's not typically a problem, but the wrist usually ends up with some joint stiffness. So after this removable splint, then you would progress to a dynamic splint. There are various manufacturers and what you would do is it works both direction because you get stiffened wrist flexion and wrist extension. It slides on. And then you turn it and it will bend your wrist into flexion and hold you there. And there are degrees so that's measurable and you have an objective tool to progress your gains. And then when you turn it in the opposite direction, it will put you into wrist extension. And it takes you even beyond the normal range of motion.

2nd Edition, CASE 17

2nd Edition

Hand and Wrist

scaphoid fractures

hand therapy

dynamic splints

wrist flexion

range of motion