Posted by: zdy1 | 21 April, 2010

Alternative hand splints!

The availability of resources at our hospital is a challenge. There are many reasons why this may be and there are no simple solutions. It is extremely frustrating for the staff (although they are often remarkable in the way they cope with it) and patient care is obviously compromised.

One way of managing this is requesting patients to purchase necessary items, however this is not always possible as patients and their families often have very limited funds. This method also requires patients to see the value in the treatment. When that is applied to items needed for Physiotherapy/Occupational Therapy that can mean there is no possible way to provide them. (People here often prefer injections/creams to other methods of treatment). For example a patient with a Severe Head Injury who is at risk of developing hand contractures who would benefit from a hand resting splint.

My friend Grace, who is an occupational therapist, visited for a few weeks recently and this was a great opportunity to discuss (along with our OT/Physio colleagues at the hospital) and trial alternative options.

I was really impressed with her ingenuity and know she’ll hate me for posting pictures of her but here we are any way (until she asks me to remove them!):

First attempt was a splint made out of Banana plant – a piece of stalk for the hand and bark for the arm bit:

This worked great as a temporary splint but it was difficult to maintain a fixed position and obviously concerns about skin care.

The second attempt involved trying to make a salt dough mould to then make a paper mache splint on, unfortunately the dough changed shape in the oven!!

The final attempt involved making a paper mache splint using a human model. A long process but it worked well.

The paper mache was initially made using maize flour – just the slight problem that this is also what is used as dog food here, so there was one episode of needing to extract it from a dog mouth!! In the end Grace discovered that millet/Cassava flour worked the best. (Ivan, the OT at the hospital, suggests that just cassava flour is good, but we didn’t have any of that to try).It took a few days of moulding/remoulding/reinforcing and then varnishing but the end product was great. (Grace will express concerns about some aspects of it but I still thought it was fab!!)
Here it is on the patient:

Sadly the patient was discharged home shortly after this (unexpected discharges is a big thing that the rehab team have to contend with here) and so we don’t know the outcome but the family members seemed really on board with the idea and certainly the time taken over it will hopefully have reinforced to them the importance of hand care.

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