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Splinting Materials in a Hand Therapy Clinic
456 Plays6 months ago
Josh and Miranda talk about their favorite splint materials to use in the Hand Therapy Clinic
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Transcript
Introduction to Hand Therapy Academy
00:00:06
Speaker
Hi, I'm Josh McDonald. And I'm Miranda Materia, and we are Ham Therapy Academy.
Common Questions About Splinting Materials
00:00:11
Speaker
Let's talk about splinting materials. We get asked a ton of times, all the time, when we put up any kind of splint on an Instagram post or something, we get asked what splinting material you're using. What's the edging? What's the strapping? We get all those questions, and we're totally fine answering them, but let's just kind of go over it so we all get an idea.
Miranda's Preferred Splinting Materials
00:00:28
Speaker
So Miranda, what are your two go-to materials for thick material and thinner material?
00:00:34
Speaker
Yeah, so one is the North Coast Prism. It's the, I think it's 1.12. So it's in between, I think, what you use, which I think you use 1.16 and 1.8. So I like this 1.12. And mostly because it's a little bit more expensive, but it has like a nice sheen on it. I feel like it makes a nice finished product. So that's what I use for thinner. And then for thicker, I use the 1.8 Aquaplast or the Encore
00:01:02
Speaker
which I think is somewhat the encore perforated from North Coast as well. So those are my two main ones. And then at my neuro clinic, that's a whole different beast that we can get into if we have time. What about you?
Josh's Preferred Splinting Materials
00:01:14
Speaker
So, um, I'm using aquaplasty 16th inch and aquaplasty eighth inch. The eighth inch I have in the 19% perforation.
00:01:25
Speaker
and the thinner material I have in the 13% perforation. There's names for those, ones Opta, 13 and 19%. I can't remember which name goes with which, but the thicker material I have with bigger holes, the thinner material, smaller holes, just because it starts to get, like if you're making a little finger splint and you're trying to cut and it's got ginormous perforations, you get these big jaggedy scallops on there. So I want those holes much smaller to take some of the weight out and to get a little bit of breathability.
00:01:54
Speaker
So and then when you cut that and they have the jagged edge, are you like heating it up and smoothing it out? Are you putting an edge on it? What are you doing with those edges on that perforated material?
Challenges with Exos Edging
00:02:05
Speaker
So for the bigger perforated material or even a bigger splint that's not the thicker material, I'll put the Exos Edging EXOS. It goes with the Exos splints that you like bake in the little dome oven that are more like a prefab off the shelf with a little bit of custom. But we've got the edging. It comes 24 inches long and one inch wide.
00:02:23
Speaker
and we cut it lengthwise so we get two strips out of each one. We've learned not to cut it ahead of time because when you cut in the thin strips all the backing comes off in the drawer and then just get a hot mess of everything stuck to itself like a rat's nest so we use the edging.
Importance of Finishing Splints
00:02:37
Speaker
If it's a little finger splint that edging starts to take up bulk
00:02:41
Speaker
And as long as I don't have jagged holes in like web spaces and stuff, I can just like trim and contour around it. But I feel like heating the perforations makes everything contract, the low spots and the high spots. So I can't smooth it out. Everything just lowers instead of evening. Yeah, that's definitely a problem that I have too. Like everyone tried like folding. I don't know. I just think edging works so much better. And then if that wears out, you tell them to come back, you know, in three months and you can put a new edge on it for them.
00:03:10
Speaker
Yeah, and most of our patients with these orthopedic splints aren't needing them for all that long. So we'll make little patchwork changes here and there, but even if it's a 12-week splint for like a Munster or like certainly the six-week disarrange fracture splints, these things last that long. If I'm doing a splint for a kid that needs it long-term because of a developmental diagnosis or like a rheumatoid neuro, then I'm going to consider different materials if it has to be a very long-term splint, but the exocyging is good for six to 12 weeks for sure.
00:03:38
Speaker
Yeah. And it works great. I think it makes it look really finished too, right? Because, you know, insurance is paying a lot of money for these blends. So we don't want to send them out. That's something that doesn't look like a nice finished product. I always say that too. Like you don't want to send them out somebody that looks like a $10 splint. Yeah. It has value and looks nice.
00:03:56
Speaker
And when we're teaching students and new hires and all that, it needs to do its job as a splint, but you want it to look nice. Like you want to have a professional product you can be proud of when you're sending it out there without wrinkles. And these materials don't really impart thumb prints, so you don't want a bunch of fingerprints, but you just don't want wrinkles and bumps and lumps and things.
Strapping Materials and Preferences
00:04:14
Speaker
Now, what about strapping? What are you choosing for your strapping material with these patients?
00:04:19
Speaker
We go with a company called SME superior medical equipment and they do a great job of price matching people price matching all the other companies and so we just get all of our two inch and one inch non sticky back loop velcro from them for my
00:04:35
Speaker
the vast majority of my splints were doing black on black. In my smaller clinic where I don't have much space, that's all I offer. In the other clinic I have colors, but I'm slowly dwindling those down. I've got someone that I inherited splinting straps from ordered yellow, orange, and red for days, and I have barely touched the supply of yellow, orange, and red. But
00:04:56
Speaker
Some people like to find the colors for their favorite sports team or whatever but I use one inch and two inch and if I need something in between I cut one of them down and that works great so I'm not having to keep in stock one and a half and all these other splinting options or strapping options. And then do you use any elastic strapping?
00:05:14
Speaker
I do have both three quarter inch wide and one inch wide. The elastic that's like, it's kind of like the loop on one side and the elastic on the other. It's got a little fuzzy side to it. Um, that I usually like the most often circumstance for that is a low profile radial palsy splint. Um, cause I like to have that loop through the fingers and over the back of the splint through the back of the splint. Um, or if I'm doing like a PIP flexion device, like a dynamic device that you safety pin together, something
Neuro vs Ortho Splinting Needs
00:05:41
Speaker
like that.
00:05:41
Speaker
Um, so I've got that on hand too. I've got a bunch of other like miscellaneous things that it's handy to have if I'm doing a pediatric splint or, but my simple clinic, basic, basic one inch, two inch basic stuff. Yeah. I think we're the same when our first clinics, I feel like have everything right. Cause we've been in them for so long with the newer ones are a little more streamlined and stuff, you know, and if you need something special, you can go over to the other ones and grab it, but.
00:06:10
Speaker
Yeah. Yeah. I found during COVID when it got a little hard to find things, we were well-stocked. The goodness is going into it. We were well-stocked, but then things got more expensive. And I learned that ordering all the fun colors, those were two to three times more expensive than the charcoal. So, and I would say 80 plus percent of my people pick charcoal anyway. So if they don't know there's another color to pick and they get fun strap colors, great. Yeah.
00:06:35
Speaker
Yeah, every once in a while if I have a pediatric patient or something, I'll try to get something special for them or order something. You don't have to make it a little bit more fun, but for the most part, I try to keep it simple and reduce costs and also the amount of time you spend ordering all these different things, right? It just needs to be too much. And the capital it takes to have all that on hand. Like if I order a sheet of pink one-eighth inch, by the time I get to using the last piece of that pink, it's been around long enough, it may not
00:07:02
Speaker
mold well and it gets drapey, pink especially, there's nothing about pink, but yeah, if it's been around long enough, it snaps instead of flexing, it becomes funky on us. Yeah, the property, it's like they have an expiration date on them. Yeah, yeah, definitely. And we like, whether it's the prism that she's using from North Coast or the aquaplast tea, we like its drapeability. And we've done a blog post on that, you can find if you just do splinting materials search on our blog post, we've done like how to choose different materials.
00:07:29
Speaker
We like that it's drapeable and conformable. So we can do the stretch and tag. There are other materials that don't stretch and tag that I will use in other times. Like I'll use Taylor splint for my pediatric and neuro splinting just because they have a little bit more rigidity and they're sturdier under spasticity or repeated load, that kind of thing. Right. And I even feel like sometimes the strapping you choose for neuro is different, right? Like I have a lot of neoprene wide straps. So if you're fighting spasticity, it has a little bit of give in it.
00:07:57
Speaker
I just, I think for a neuro, you almost have to have just basically the separate toolbox of tools you use. Yeah. Yeah. Lots of different options. Lots of different like problem solving with neuro splinting. You're, you're solving more problems than with the ortho, you know, they're in it for six weeks. It's, it's not fluctuating tone. It's kind of more of a straightforward thing.
Padding Materials in Clinics
00:08:19
Speaker
So as far as like padding, do you have at your, let's talk about your basic simple clinic. What did you choose to get for padding there? Um, it's like this really thin and I, that I don't know the name of it, but it's almost like one step above both skin. It's like this really thin padding that I use to put over like the older styloid and
00:08:42
Speaker
you know, maybe if I have like a strap that's going through the wild space, I'll wrap the strap with that foam, but that's pretty much it. Oh, and I do have the blue, the sticky back foam. What's the thicker one? Like the memory foam. Yeah, I have the memory foam one, and that's always a must. I love putting that on the straps and this one. So, but that's pretty much it. What about
Managing Materials and Costs
00:09:02
Speaker
you? What padding are you using?
00:09:03
Speaker
Yeah, those two are my basics. It's that thin like 16th, maybe three 30 seconds inch. It's like a light tan foam sticky back. Same thing, we put it on straps in the web space and then the memory foam. I have in the other clinic a lot of different types of foams. Honestly, some of them were misorders.
00:09:23
Speaker
Or or it's like well let's try this this time instead and it stuck to the splint too much or you know honestly I just kind of land on like oh this works great why order something different at this point right yeah yeah that's definitely true and sometimes you get like a staff member they want to try and you're like all right let's give it a try and then
00:09:43
Speaker
Yeah. Yeah. Especially running our own clinics. You know, when, when we were at bigger organizations, bigger hospitals, you don't have that sense of how much this stuff costs and how quickly you go through it. But when you own your own clinic, you get awfully good about sustainability and not wasting materials and you're using little scraps and you're hanging onto stuff. I'm not hanging onto every little bit of scraps, splinting straps, but I'm not getting rid of splinting material. If I could make a finger splint out of it. Yeah, that's right.
00:10:12
Speaker
Yeah, yeah. And I'm not gonna keep a giant list of all this material that I just have to reorder and expires and it sits on the shelf for a long time. Yeah, it definitely changes things. Yeah.
Contact Information for Splinting Questions
00:10:23
Speaker
Well, if you have favorite things or if you have questions for us about splinting materials and strapping and padding and all of that, feel free to reach out. You can email us info at handtherapyacademy.com or reach us on our direct messages or on social media at the Handel Hand Therapy Academy.