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Hand and Upper Limb Service

These clinics aim to provide a specialised service, in which the Occupational Therapist chooses, creates and monitors (as appropriate) an upper limb splint. The aim is to increase or maintain a child/young person’s functional skills. Splints may also be prescribed to reduce deformity or assist in the child/young person’s activities of daily living.

Objectives

  1. To provide either a static thermoplastic splint or pre-fabricated neoprene semi-dynamic splint to prevent development of future deformities by correct positioning and decreasing the risk of contractures.
  2. To enhance functional ability of a child’s upper limbs by correct positioning.
  3. To support, educate, advise and monitor families, carers and educational staff using the splint.
  4. To offer the family a referral to other professionals when further hand investigations may be required.

Indications For Splinting

  • Mild to moderate limitation in upper limb function

– Associated reactions influencing bilateral hand use (use of both hands together)
– Instability of joints
– Post surgery
– Post Botox

  • Moderate to severe limitation in upper limb function

– Associated reactions influencing bilateral hand use (use of both hands together)
– Instability of joints
– Post surgery
– Post Botox
– Contracture management

  • Severe limitation in upper limb function

– Contracture management
– Skin integrity
– Reduction of pain
– Post surgery
– Post Botox

  • Brachial plexus disorders e.g. Erb’s palsy
  • Peripheral nerve injuries
  • Post surgery
  • Post Botox
  • Other medical conditions impacting on upper limb function or where the child is at risk of deformity