For this week’s episode of Splinting Thursdays, we would like to show you how to create an anti swan neck orthosis from Orfit Strips.
The swan neck deformity describes the finger with a hyperextended Proximal- interphalangeal (PIP) joint and a flexed Distal -Interphalangeal (DIP) joint. A common condition that might cause PIP joint hyperextension and produce a swan neck deformity of the finger is Rheumatoid arthritis (RA). Chronic inflammation of the PIP joint puts a stretch on the volar plate, a ligament that normally keeps the PIP joint from hyperextending. As the volar plate becomes weakened and stretched, the PIP joint begins to hyperextend. The extensor mechanism of tendons and ligaments then becomes off balance, pulling the DIP joint into flexion and causing the swan neck deformity to occur.
Other conditions that weaken the volar plate can also produce a swan neck deformity. The small (intrinsic) muscles of the hand and fingers can tighten up from hand trauma, RA, and various nerve disorders, such as cerebral palsy, Parkinson’s disease, or stroke. Weakness in the volar plate can also occur from a finger injury that forces the PIP joint into hyperextension, stretching or rupturing the volar plate.
The anti-swan orthosis offers a simple method of blocking hyperextension of the PIP joint while allowing for full flexion and maximal function.
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