Sylvain CELERIER is a member of the French Society of Hand Therapists (GEMMSOR) working since January 2001 on the multi-disciplinary team at the European Hand Institute of Nancy - France ; PT registered, splintmaker, hand specialist in custom-made splints for hand injuries (traumatic, rheumatoïd, rheumatic...).

The role of this site is to show all of the different splints and how they are used in our clinic.

You can find many explanations such as :
- patient information
- help with splint prescriptions
- french legislation
- publications and bibliography
- national and international events
- slide presentation
- personal pictures...

A splint is a therapeutic agent like a medecine, which belongs to the rehabilitation and readaptation physical treatments category.
Preferably, the splints are custom-made for each patients, depending on personal and professionnel profiles.
It's a treatment for one or many lesions. Knowledge of the anatomy will allow appropriate treatment.
It's important to respect clinical signs like pain, inflammation or fragile skin.
It must respect many pathological rules, according to the objectives of the splint : pain reduction, joint stabilisation, tendon sutures protection, prevention of deformities, prevention of edema, immobilisation, correction, deficient moteur aid, motion range recuperation, compression, posture...

It's important to distinguish between static and dynamic splints.
Static splints are the base of dynamic splints which are made by adding a motor.
We use some compressive splints such as the finger splint and gloves.

Thumb fractures - Eurohand2011 - Oslo (Norway)

Thumb fractures : rehabilitation and splinting following intra-articular fracture of the trapezometacarpal joint

S CELERIER (PT), C. CAMPS, A. DURAND, M. ISEL, B. LALLEMAND, M. MERLE
European Hand Institute - Nancy (FRANCE)

Purpose: The thumb is articulated with its base by the trapezometacarpal joint (or carpometacarpal joint CMC). The trapezium (Tz) is a fixed bone, when the first metacarpal is mobile. The CMC joint ensures the stability and the mobility of the first finger. The thumb has an essential part in the hand function for the prehension.   Fractures of the thumb metacarpal occur most frequently at the base with an important functional impact. In 1882, BENNETT describes the fracture-luxation of the base of the first metacarpal (Bennett’s fracture). The 1st metacarpal moves by the action of the Abductor Pollicis Longus (APL) and the thenar muscles. It’s an intra-articular frequent fracture requiring adequate reduction. A secondary rehabilitation of good quality is undeniable.
Methods: Faithful to the “TTMP” doctrine (treatment of one time with early mobilization / Tout en un Temps avec Mobilization Précoce) describe in 1977 by FOUCHER, MERLE et MICHON, rehabilitation must encourage an early range of motion as soon as possible. The objectives are 1) the control of the edema 2) the prevention of the stiffness 3) and to maintain the tendons glides with the prevention of the tendon’s adherences. Those protocols combine inevitably specific rehabilitation and achievement of splints. Co-operation between patient and therapist is vital.
Results: Custom-made splints are appropriate for the treatment of intra-articular fractures. They respect a better immobilization position, the physiological curve of the patient, and an early range of motion. Rehabilitation must combine immediate self-mobilization and specific treatments by an experienced therapist.
Conclusion: Stiffness and osteoarthritis are the main consequences of these articular traumas, common cause of pain and poor hand function. These injuries are a challenge for a multi-disciplinary team. Economical incidence must be considered.

References :
Bennett EH. Fractures of the metacarpal bone of the thumb. British Medical Journal 1886 ; 2 : 12-13
Baker RP. Does postoperative hand elevation reduce swelling ? A randomized study. Journal of Hand Surgery (European volume) 2010, vol 35, n°3, 192-194
Corcella D. Les fractures récentes de la base du premier métacarpien. Cahier d’enseignement de la SFCM 2001 ; 13 : 35-47
Colditz JC. The biomechanics of the thumb carpometacarpal immobilization splint : Design and Fitting. Journal of Hand Therapy 2000 : 228-231
Merle M, Voche Ph. Fractures des métacarpiens et des phalanges. La main traumatique, 1. L’urgence 2010 : 78-104
Michon J, Foucher G, Merle M. Traumatismes complexes de la main. Traitement tout en un temps avec mobilisation précoce. Chirurgie 1977 ; 103 : 956-964.
Packer JW, Colditz JC. Bone injuries : Treatment and Rehabilitation. Hand clinics 1986 : 81-91
Tubiana R. La mobilisation précoce des fractures des métacarpiens et des phalanges. 
Annales de chirurgie de la main 1983 ; 2 : 293-297