Blocking splints to assist finger exercise.

T o treat traumatically injured tivene,s of the exercises, blocking hands effectivelv, it is often splint.) can be constructed for one necessary to isola te exercise or stretch (Figure 3) or more fingers (Figure to individual-affected joints by 4). blocking out joint excursion in the In addition to facilitating active unaffected joints. Isolated exercise exerci:;e for individual joints, the and stretch are particularly imporblocking splint can be used, or tant for patients with long-term adapted, for several other purposes. stiffness or tendon adherence. Such First, because it frees the opposite exercise has traditionall y been facilhand, the splint can be used when a itated by manual blocking or by use patient performs a combination of of regular or adapted Bunnell blocks active and passive exercises. Such (1). However, both manual blockexerci!;e tends to increase exercise ing and Bunnell blocks require the efficiency and promote more rapid opposite hand to do the blocking gains in motion as well as maxi(Figure 1) or to hold the Bunnell mum tendon glide. This exercise block (Figure 2). In addition, manbegim with the opposite hand pasual blocking can be fatiguing and si vel y llexing the joint for 5 seconds, stressful to a normal opposite hand, follO'·\ ed by an active muscle conor difficul t for and harmful to a distraction that attempts to hold abled opposite hand. To avoid these the joint in the same position for an problems and to increase the e[[ecadditional 5 seconds. A second adapt<:ltion involves constructing the blxking splint with a dorsal Carroll B. EngLish, M.A., OTR, Is outrigger and finger cuff to give resHand Therapist, office of Richard istance to flexors and provide musL. Petwldt, M.D., San Jose, cle re-education (Figure 5). If deCaLifornia. sired, a volar outrigger with cuff ma y t e added to provide passive Rosemary A. Rehm, OTR, is flexion and to strengthen the extenHand Therapist, office of Richard sors (Figure 6). In both of these L. PetwLdt, M.D., San Jose, adaptations, traction should be light CaLifornia. enough so that the patient can pull throu§;h the full available range of Rl:chard L. PetzoLdt, iVI.D., Is active motion. The third adaptaOrthopaedic Hand Surgeon, prition is u sed for a pa tient who wears vate practice, San Jose, CaLifornia. a positioning splint all day. The Richard L. Petzoldt