Splint in the Spotlight – the Dorsal Wrist Cock-up Orthosis

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Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Dorsal Based Wrist Cock-Up Orthosis

Objectives of the Splint: Immobilization of the wrist joint for restriction of motion, pain relief, joint alignment, functional support, and/ or positioning for healing.

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Pathologies

Many of the same wrist pathologies treated with a custom fabricated volar based wrist cock-up orthosis can be treated with a dorsal based orthosis as well. The most common pathologies of the wrist that benefit from this orthosis include:

  • Fractures
  • Nerve compressions (Carpal tunnel syndrome)
  • Wrist sprains
  • Post-surgical conditions
  • Spasticity
  • Cerebral palsy

Some distinct advantages of the dorsal design are that it leaves the volar palm free for sensory input, and it acts as a strong lever to help lift a spastic flexed wrist into a more functional and beneficial position. The dorsal design allows for functional activities to be performed easily without interference of the orthosis.

Product Recommendations

The dorsal wrist cock up orthosis should be fabricated from a thermoplastic material that has a moderate to high degree of conformability to ensure a close fit, yet is strong enough to support the desired wrist position. Orfit Industries offers the following thermoplastic materials with high conformability which ensures that they fit comfortably on the dorsal forearm and allow for molding around bony prominences. They are available with perforations or in solid sheets.

The following Orfit Industries thermoplastic materials offer moderate conformability and moderate rigidity when stronger support is necessary, as with a client with increased tone or a wrist flexion contracture. These materials are also available with perforations or in solid sheets.

Some therapists may prefer the use of elastic materials for this orthotic design, and Orfit Industries offers several products with excellent elastic stretch and full memory. The memory allows the orthosis to be remade easily as the material will revert to its original size and shape when reactivated in hot water. This remolding might be necessary due to decreasing edema in the patient’s arm or improved wrist positioning as healing occurs. The following elastic products are recommended and are available with perforations or in solid sheets.

In addition, Orfit Industries offers a precut dorsal wrist orthosis in 4 sizes, making this design extremely easy to fabricate. Instructions for fabrication can be found in our Educational Corner.

Orthoses for the wrist are typically fabricated from 3.2mm (1/8”) thick materials. This thickness offers enough rigidity and support for most adult patients. However, for small children and smaller adults, a material of 2.0mm, or 2.4mm (1/12” or 3/32”) thickness may also provide adequate support.

Benefits of a dorsally based wrist cock- up orthosis include an obstructed palmar surface and easy to don style. The orthosis does allow for functional activities using the fingers and thumb while firmly supporting the wrist.

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Questions?

If you have a question or comment, please post it in the Orfit Splinting & Rehabilitation Group on Facebook, or send an email to welcome@orfit.com.

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