Stiff fingers can be very tricky to treat. Here is a simple but effective splint for patients with general stiffness of all finger joints.
You want to block any flexion of joints what already has good flexion eg, if there are no issues with the MCP joints, you want to block the MCP joints to the flextion force will be transferred to the IP joints. If the MCP joints are stiff as well, you will include them in the pull. Hope that makes sense.
You will need:
- A well fitting off the shelf wrist brace
- Cotton glove (sold at many pharmacies or even dollar shops
- Sports tape
- Elastic thread (sold by eg Ofit and at craft stores)
- Off cut of Orfit Classic or other sticky thermoplastic if you want to block the MCPs (Needs to be sticky to stick on to the brace)
- Safety pins (some cheap safety pins will bend so invest in some good quality ones)
For tools you need scissors, a heat gun if you want to add thermoplastic, and a hole punch.
1. Place glove on patients hand and tape each tip with the sports tape. This is to reinforce the fabric as this will be your anchor.
2. Pull the tips away from the patient's hand and hole punch through the tape and glove fabric.
3. Fold the elastic in half and feed the folded part through each hole. Feed the two cut ends through the loop and pull to tighten. The threads will now stay put.
4. Place wrist brace on top of the glove and add the first safety pin. The postion of this will depend on the flexion deficiency.
5. Place the second safely pin at the bottom of the brace. You now want to adjust the tension of the elastic thread according to deformity of each finger. This is a good knot that will not slide: Loop both end bits around your finger and feed through the hole - easy.
If you want to block the MCP joints you add a thermoplastic piece. I find dry heating eg Orfit classic works well as it sticks on to the brace well. It still needs to be worked in with your finger tips for a solid attachment. You may also want to pad the inside for extra comfort. Here is one made earlier, which is blocking the MCPs. This one might be good if you want to emphasise on the PIP joints.
If the fingers are very stiff you may want to consider making a small "cushion" for the fingers to rest on (not too big so it restricts the pull). Putting a bit of wadding inside some Tubifast is one idea....
It would be insteresting to hear what you think about this one and if anyone have used something similar. It is a cost effective and easy splint to make, and it seem to be well excepted by many patients. They key is not to pull too hard, but to be patient and go for a gradual increase of tension.