CHT CHT Splinting & Orthotic Fabrication 2 — Questions and Answers
Question 1: Following extensor tendon repair in zone VI, the standard early mobilization protocol positions the wrist at:
- 30° flexion
- Neutral (0°)
- 30–40° extension (Correct answer)
- 45° extension
Correct answer: 30–40° extension
After zone VI extensor repair, the wrist is positioned in 30–40° extension to reduce tension on the repair while early controlled motion is initiated.
Question 2: The purpose of serial static casting or splinting in PIP flexion contracture is to:
- Provide dynamic traction continuously
- Achieve incremental gains in extension through tissue creep (Correct answer)
- Rest the joint in a shortened position
- Strengthen surrounding musculature
Correct answer: Achieve incremental gains in extension through tissue creep
Serial static splinting applies a sustained low-load stretch that promotes plastic deformation (creep) of contracted soft tissue, progressively increasing PIP extension.
Question 3: For carpal tunnel syndrome, a neutral wrist splint worn at night is recommended because:
- It strengthens wrist extensors
- Wrist flexion during sleep increases carpal tunnel pressure (Correct answer)
- It improves grip strength
- It promotes median nerve regeneration
Correct answer: Wrist flexion during sleep increases carpal tunnel pressure
During sleep, unconscious wrist flexion dramatically increases carpal tunnel pressure and median nerve compression; a neutral splint prevents this positional aggravation.
Question 4: A dorsal blocking orthosis following flexor tendon repair is set with the wrist at approximately:
- Full extension
- 0–10° flexion
- 20–30° flexion (Correct answer)
- 45–60° flexion
Correct answer: 20–30° flexion
Standard dorsal blocking orthosis post-flexor tendon repair positions the wrist in 20–30° flexion and MCPs in 40–60° flexion to protect the repair while allowing controlled motion.
Question 5: When applying a circumferential orthosis, the therapist should ensure that the orthosis does not compress the:
- Radial artery only
- Superficial sensory nerves and bony prominences (Correct answer)
- Flexor tendons
- Palmar fascia
Correct answer: Superficial sensory nerves and bony prominences
Circumferential orthoses must be relieved over bony prominences and superficial nerves to prevent pressure ulcers and nerve compression injuries.
Question 6: The Kleinert protocol, used after flexor tendon repair, uses elastic traction to:
- Passively extend the fingers after active flexion
- Passively flex the fingers after active extension (Correct answer)
- Maintain static finger extension
- Block MCP hyperextension
Correct answer: Passively flex the fingers after active extension
In the Kleinert protocol, rubber band traction passively returns the fingers to flexion after the patient actively extends within the dorsal blocking splint, reducing repair tension while preventing adhesions.
CHT CHT Splinting & Orthotic Fabrication 2
Following extensor tendon repair in zone VI, the standard early mobilization protocol positions the wrist at: