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Dip joints in 5 10 degrees flexion.

Gutter splint mcp. Forearm based ulnar gutter versus hand based thermoplastic splint for pediatric metacarpal neck fractures. Insert a dry gauze or cotton material between the 2nd and 3rd fingers. Cut out a 3 or 4 inch splint material to the length necessary to immobilize the wrist and mcp joint. Radial gutter splint cast second and third proximal middle phalangeal shaft fractures and select metacarpal fractures proper positioning of mcp joints at 70 to 90 degrees of flexion pip and dip.

Bisect the splint longitudinally from the fingertips to the wrist. Splinting mcp s in flexion and ip s extended intrinsic plus positioning safe position forearm based or hand based gutter splint position of mcp joints collateral ligament stablility. The radial gutter splint provides both volar and dorsal splint immobilization of these metacarpal injuries. Leave the thumb index and middle fingers freely mobile.

Use of a hand based thermoplastic splint for treatment of isolated fifth metacarpal neck fractures in pediatric patients has not previously been studied in a randomized blinded trial the authors conducted a blinded 1 1 allocation two arm parallel group. If there is a pip flexion contracture a prefabricated dynamic three point extension splint might be used or a static splint can be adjusted serially with the goal of achieving full passive pip. A blinded randomized trial. Pip joints in 5 10 degrees flexion.

Mcp joints in 70 90 degrees flexion.

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