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

Splint-in-the-Spotlight

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:  Volar 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.

volar wrist cock-up orthosis

 

Pathologies

Many pathologies of the wrist are treated with a custom fabricated volar based wrist cock-up orthosis. The most common pathologies of the wrist that benefit from this orthosis include:

  • Fractures
  • Nerve compressions (Carpal tunnel syndrome)
  • Wrist sprains
  • Tendonitis
  • Ganglion cysts
  • Arthritis
  • Post-surgical conditions

Positioning of the wrist varies according to the diagnosis; however, the wrist is usually maintained in either neutral or slight extension. This allows the patient to comfortably perform functional activities with the wrist fully supported and properly positioned.

Product Recommendations

The volar wrist cock-up orthosis should be fabricated from a thermoplastic material that has a high degree of conformability to ensure a close fit.  Orfit Industries offers the following thermoplastic materials with high drape and excellent conformability, perfect for a well-fitting and comfortable volar wrist cock-up splint. They are available with perforations or in solid sheets.

These materials do best when the patient’s extremity is placed in a gravity- eliminated position and the material is allowed to fall over the patient’s wrist and forearm, and conform to the underlying anatomy.

Some therapists may prefer the use of elastic materials for this orthosis, 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.

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 volar based wrist cock- up orthosis include a protected palmar surface and easy to don style.  The orthosis does allow for functional activities using the fingers and thumb while firmly supporting the wrist.  The wrist placed strap must be wide enough to hold the wrist firmly inside the splint.

Here is a video which demonstrates the fabrication of a volar wrist cock-up orthosis.

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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