Splinting Carpal Tunnel Syndrome at night is an effective way of trying to reduce symptoms. Here is a tutorial on how to make a night splint, using Orfit Classic, as we use the fact that it is sticky when warmed up. This makes it stick to the stoking which helps conforming the splint nicely around the client's contours while moulding it.
You will need:
- 1.6 or 2mm Orfit Classic
- Pattern (download here and adjust according to hand size)
- Water bath and heat gun
- Stocking - I used green Tubifast
- Velcro - self adhesive hook (3cm) and loop 3cm + 5cm)
First, trace the pattern on to the thermoplastic and cut it out. Heat the thermoplastic up in waterbath. Ensure it doens't fold on to itself as it will stick!
While the thermoplastic is heating up, prepare the client. Place a tight stocking on the hand. A loose stocking will cause creases and will not allow the plastic to mould around the contours of the hand.
Bring the thermoplastic onto a tea towel and dry it gently. Fold the edge on top and on thethumb side. Leave the ulnar side for now. Put the thermoplastic back in the bath briefly to ensure the themoplastic is heated through. Bring it back up, dry it and place on the client's hand.
Ensure that the wrist is being kept in a neutral postion, holding is still while moulding. Mould the arches of the hand and once the thermoplastic is starting to set some, rotate the arm at the same time as you are rotating the stocking, so the hand and splint move towards pronation simultaniously.
Cut off any access plastic and heat the ulnar side of the splint and fold that edge.
Flare the proximal edge to avoid any cutting in to the forearm. Once you are happy with the fit, attach the self adhesive velcro. To make it stick on better, heat it briefly using the heatgun, spot heating the plastic and the glue. Work in the velcro with your fingers. Add loop velcro next. Wide strap over the wrist, as this is where most of the pressure will be.
If the client would like to wear a stocking underneath when wearing the splint, ensure it is a loose fitting one (and not the one you used to mould the splint), so it doesn't compromise circulation. Also ensure that the straps are not applied too tightly, as the hand may swell at night.