Splints and casts
It is common to have a splint or cast recommended as part of your treatment for a hand condition or injury. Splints and casts are used to immobilise the hand. Immobilisation reduces pain, prevents movement, encourages rest and elevation, allows injured structures to heal in the correct position and promotes resolution of inflammation.
How many hours a day and for how long do I have to wear the splint or cast?
This varies widely according to your injury and stage of recovery so please ask your doctor this question. You may need to keep your hand immobilised for 24 hours a day (during the early stages of recover), or only wear the splint for contact sports (during the later stages of recovery).
The number of weeks that you have to wear the splint or cast is based on the type of injury. It may be:
- 4 weeks for an extensor tendon injury
- 6 weeks for a fracture (broken bone)
- 6-10 weeks for a flexor tendon injury
- 8 weeks for a mallet finger injury
- As a permanent aid for arthritis (where the aim is to manage your symptoms, avoiding surgery until conservative treatment no longer provides adequate relief)
- Until symptoms have resolved or until surgical management is deemed necessary for carpal tunnel syndrome and de Quervain’s tendinitis
What is the difference between a splint and a cast?
A cast goes around the entire circumference of the hand and wrist. It can only be removed by cutting it off. Casts are usually very stable. They do not allow movement of the joints that are included within the cast. They can be made of plaster or fiberglass. Fibreglass is lighter, plaster is heavier. Casts are most commonly used for broken bones, especially in children.
A splint is usually constructed out of hard plastic that is molded to the shape of your hand. It usually only goes part of the way around the circumference of your finger, hand or wrist. It is commonly held in place with Velcro straps.
Splints are used for many hand conditions. This includes injuries as well as conditions such as carpal tunnel syndrome (top left; photo credit), de Quervain's tenosynovitis (bottom left; photo credit) and Dupuytren’s disease. The appropriate use of the splint varies for every condition. Please listen carefully to your surgeon and therapist’s advice on how to use your splint.
If you are instructed to do so by your hand surgeon and/or hand therapist, a splint can be removed for specific activities. Most commonly these activities are the finger and hand exercises that are prescribed by your surgeon and therapist. Depending on your hand condition and stage of recovery you may also be permitted to take the splint off for low impact activities such as eating, typing, toileting, reading, showering.
Please note! If you have a mallet finger injury or an extensor tendon injury you MUST not remove your splint at any time without the express permission of your hand therapist. It is not appropriate to move these injuries until full healing has occurred.
Video of splint construction
The video below shows how a hand therapist constructs a splint that conforms exactly to your hand.
Can I have a waterproof cast?
If your doctor considers it safe for you to have one - please ask your doctor if a waterproof cast is suitable for you.
The difference between a waterproof cast and a non-waterproof cast is in the inner lining material. Waterproof casts are available from some private plaster technicians. They cost a little more than a standard cast. The benefit of a waterproof cast is that you can safely get the cast wet while swimming or showering.
Your doctor will not recommend a waterproof cast if it is not safe to get your hand wet. If you have open wounds, problematic wounds or protruding wires it is not safe to get these wet. If your skin is intact it is probable that your doctor will give you clearance for a waterproof cast.
Cast Do's and Don'ts
- Keep your cast clean
- Check the condition of your skin around the cast area, looking for any areas of irritation or injury
- Seek assistance if there are problems with the fit of the cast (too loose or too tight), or if the cast deteriorates (cracks, breaks or develops soft spots) or if the cast becomes badly soiled
- Seek assistance if you have swelling or pain, if you develop blistering or skin irritation, if there is an unusual odour coming from the cast, if you have unexpected numbness or persistent tingling of your fingers
- Insert objects inside the cast
- Put oils or powders inside the cast
- Pull out or rearrange the cast liner
- Break off or trim the edges of your cast
- Lever against the cast or engage in activities that may damage the cast