Wrist in slight extension.
Gutter splint mcp.
Mcp joints in 70 90 degrees flexion.
Pip joints in 5 10 degrees flexion.
The radial gutter splint provides both volar and dorsal splint immobilization of these metacarpal injuries.
Leave the thumb index and middle fingers freely mobile.
The goal of splinting for boutonniere deformity is to maintain pip joint extension while keeping the mcp and dip joints free for about 6 to 8 weeks.
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.
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.
Splint from the proximal forearm to slightly beyond the fourth and fifth finger dip joints.
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.
Insert a dry gauze or cotton material between the 2nd and 3rd fingers.
Forearm based ulnar gutter versus hand based thermoplastic splint for pediatric metacarpal neck fractures.
Dip joints in 5 10 degrees flexion.
Bisect the splint longitudinally from the fingertips to the wrist.