okay so first we need to define the [Music] hand because we're making the wrist splint so you want to see the wrist crease right here make a mark the other side and then we want to free all five digits so find the CMC trck it down make a mark and then this is the whip space right here and then check the uh transverse Arch right here the other side the transverse Arch right here okay that's it and then so this is the hand so again link the wrist quiz link um the Palmer quiz right here so these are a finger movement then we don't need it and we want to immobilize the wrist right and then free the thumb so what we want to do is to make a uh to divide this in half this is CNC let me put it CMC joint right here so you want to free this so first of all you want to extend it um and then extend it 1 inch the whole thing okay 1 inch and then link this link this it will make it larger in case you need more and you can cut it and then I would make it longer right here so now the thumb can be tricky we want to free the thumb right so let me draw a bar right here you want to make a make the thumb and you want to free the thumb so you want to make it below the CMC but not over the wrist and you can choose to draw this this circle like all the way up to here but not cross it I um if you're afraid you can make it smaller and you can roll it up I will show you when I make this splint so this is what we need for the wrist so then you need to cut it so this will be the wrist splant so once I finish I want to make sure that it fit right so put this under um the quas right here because you want to free the finger movement right so you want to put it underneath here what you need to make sure is if the um the profile can kind of cover half of the form uh in this sense uh I may need a little bit more here but it looks okay so that's going to half I need more here but here is okay so I need more here because my model is kind of strong in his hand so now the next step you want to put it to your uh spring material um the material that I have is shorter than the model it's fine because as long as the wrist is covered you're good um and you can stretch it and I may show you again uh use crayon not a Sharpie and uh I can only find Sharpie right here so I'm going to use Sharpie she okay so now you need to cut cut it you have two choices you can cut it like right now it's hard and you cut it and uh I guarantee you you hurt your hand U but that's your choice I'm not going to do it um the other way is you heat it um so this material is called um Aqua plus when it's heated it'll turn transparent so you know it's completely soft and if you want to just cut it uh cut this out I wouldn't wait until it become you know totally transparent uh when it's half and then uh it's soft enough for you to cut so I'm going to show you how to do this I'm going to try this a little bit okay okay so you want to know you want to heat uh this is my frying pan you can see and then I just put water in there and um if you worry that uh the material kind of May ruin your pan you can put this down we can put it as a lubon okay so so you're protecting your PIN okay so uh you won't ruin your pan when making this split yeah okay so um the reason that I put it down on the luric inside because I I need a uh the rubric um so that uh the material won't stick to your pan okay so this is important okay so now you want to worry how hot should your water be okay that's why I have this little piece and then you can test it out you can see it start to turn uh transparent in that in those hole so that means the the temperature is okay so turn off um the heat you see it becomes transparent and it's not sticking to the pan you see here all right so now let me show you oh where is it let me show you how to test uh this material okay you want to Dy it out you see here you can elongate this so This is called flexibility of the material okay and when it's you see here so um typically um they have memory they will come back to the original shape but because I have def deformed the whole material so it's impossible that the the material go back but you see when I put it back to the water it goes back so if you're making a splint and you're like okay um you don't like it you can always um put it back to the water and then you can make it again okay and you may ask how many times do you how many chances do you have to to make this I was say uh no more than uh three okay so try to try to limit that you see each time it you know this is uh it becomes uh longer but because uh the material uh the structure of the material has been um deformed by me so the water uh temperature is good uh and then you try this out you see it's not sticking to the pan or to your to your hand then this temperature is okay okay so so see now I put the piece into the pan and it it become half uh white half transparent so this is good for cutting so I put it on the towel to dry it and then I can cut it you see here it's totally white it become hard to cut then you can reheat it this is a chance that I show you if you don't have enough material to cover the limb you will lose the leverage um for protection or uh the force that you need so this is the pattern then you will put uh it into the water and then when it becomes uh entirely transparent and then you're going to apply it to the um the client's hand so now let let me walk you through on how to position um the client's hand okay so um I would I put one towel um in the bottom so I can dry the splint material and another towel right here just to help me position the wrist relax relax it's just to help me uh position the wrist so the gravity will bring the wrist down which is in um wrist extension that's uh what we need you can move the towel relax relax you can move the towel you can see uh um the hand kind of go into more flat or neutral so you wanted that okay so this is the position that you need and then you have you make sure that your client's hand is uh comfortable and then we can start um the splinting process okay okay so now I'm cooking the splint material see it becomes um transparent gradually okay make sure that uh you don't overheat the water because it's going to be too hot for you to to take the material out okay and make sure you did uh you do put the um the lubricant or uh the down the dish how to say the detergent in there otherwise you ruin the material and your pan okay so now it gets all transparent you see here you still see that color of the Sharpie that's why I said don't use Sharpie because that going to make it uh unpleasant to look so I take it out it's hot and put it on the towel carry it like this and that's uh apply to the hand when you apply to the hand make sure that um it's not too hot is it hot no okay okay so you want to mold the hand make sure it's under I mean under the quiz right here and then put it and then make sure it's flat to the limb okay so now because our focus is wrist right so you want to make sure the wrist is all is all flat you see here here's a little bit higher I can I can trim it afterwards okay so now the thumb is not free I need a free the thumb right so you can roll this out like this so that thumb is free and when you roll this out it it gets stronger so um the splint is much stronger in this way um some people uh don't like this uh rolling out technique because it just make it not flat or one piece um I I said some people I mean me um but a lot of people like this so I'm I'm showing you how to do this you see here every Point can be a pressure point so you want to make sure that you avoid um creating uh pressure point to the skin or you will you will ruin the Skin Integrity so now it gets whiter and whiter right that means it's uh it's getting harder and when it's done you can take it out I typically don't wait uh for it to to you know entirely um hard but as a new therapist I will encourage you to do so uh reason I said no I don't want to wait is if I need to trim something I can trim it while it's I'm still soft soft so I can trim it like right now you got to be careful because it's not entirely hard so your Force May ruin the shape so you want to make sure that you [Music] don't so I smooth it so here you see that spiky right here so you want to trim it so you don't create some pressure point to the hand okay so this is smooth and you may want to trim all these but um for now I'm going to leave it okay so it's it's harder and it's white this way I typically don't like um The Edge like this okay so I'm going to trim it all right so this is the wrist splint see here so the hand when the hand is in this splint it's in slight uh extension right and you see here by the side you may cut into the SK uh the skin that's not good so you can kind of use your hand to kind of widen the shape and it cover approximately like half of the limb which uh which means I'm doing a good job on this again I'm going to trim it so it doesn't cut it all right okay so I uh I put the velcro on um I I left um here because I need to show you how to how to do this you see uh my hand model um is forms um uh quite strong okay so you see uh it's narrower uh uh when it close to the wrist and then gets bigger uh when it's up to the Elbow so you want to make sure that you don't create any sheer force what I meant is it has to be flat like this okay so when you go okay turn this way you see kind of go in know in a diagonal um Direction so what I mean is I will put the velcro in a diagonal position like this and you can it this way see right here here so I can cut it okay so that's this um and then the wrist and then one more for the pum okay so now I B I'm basically done so you want to check if your design is good so what how you how do you check it next so you put your hand in the middle because this see this as a lever system the first class lever can the pivot point is in in the middle um this acting like a force to counter the weight of the hand okay so when you put your hand right here it's kind of balanced you're good often times if uh the spoon is not long enough say right here the uh when you put your hand in the PIV point the the sping will look like this so that's how you know that oh you may need to re uho or redesign your splint okay so now you need to teach your client how to put this on okay again this is uh a wrist splint okay so the most important part is to immobilize the wrist so when uh the client put this on make sure that this you don't cover this line so it's in good shape and then the first strap to do is the wrist so that it's it's secure okay and the this or that is it doesn't matter okay so this is how you uh educate your client how to put on um the splint okay we're done