Thermoplastic splinting is a treatment modality commonly used to immobilise structures, protect from further injury and minimise pain. Custom thermoplastic splints are made in session, moulded to fit your hand to provide better stability and comfort. Such splints are also removeable and waterproof, which can suit any lifestyle.
Every injury needs to be treated differently and the same goes with splinting. Each injury needs to be immobilised in a different position to maximise function and healing. Custom splints can be moulded differently to fit the injury however this cannot be done with over-the-counter braces, which have very limited options available. For example, when a patient presents with basal thumb osteoarthritis- it is important for the splint to position the thumb in a certain angle to ensure bony and ligamentous alignment, which can easily be done with custom splinting but not prefabricated braces.
Many studies have also shown benefits of splinting for other conditions such as carpal tunnels syndrome, arthritis, tendinopathies and other overuse or sporting related injuries. Thermoplastic splinting is a beneficial treatment modality which reduces pain, increases grip and pinch strength as well as improving overall hand function (Bani et al., 2013).
A study focusing specifically on the differences between custom and prefabricated splints for finger injuries revealed that custom splints are more beneficial as they are better adapted to your hand and provide a greater degree of immobility to facilitate healing. In addition, prefabricated braces have a greater degree of movement which ends up being counterintuitive and reduces their efficacy. (Güven and Suner-Keklik, 2022).
Some injuries such as fractures require a greater degree of rigidity and stability to ensure proper healing and alignment of the fracture which can be easily achieved with a thermoplastic splint, whereas prefabricated braces pose a much greater risk of displacement. Studies have shown benefits of custom splinting especially for fractures- as they provide better fracture stability resulting in a higher rates of fracture union compared to prefabricated. In addition, prefabricated splints have shown to have a higher risk of non-union (Swellengrebel et al, 2023)
While there are many benefits of choosing custom splinting over prefabricated braces- the key differences have been highlighted below.
| Thermoplastic Splint | Over the counter Splints |
| Made from polymer resin rigid material to provide better stability | Made from soft material with metal boning allowing greater degree of movement |
| Moulded to your hand in session to ensure good fit and comfort | Available in chemists – one size fits all |
| Can be altered as needed every session for comfort and to account for changes in swelling | cannot be altered |
| Durable thermoplastic material | Soft cloth material |
| Waterproof | Not waterproof |
| Only immobilises affected joints/area | One size fits all hence cannot be fitted specifically to your injury |
| Easier to clean and durable material | Cloth can wear and get stretched out |
References:
Bani, M.A., Arazpour, M., Kashani, R.V., Mousavi, M.E., Maleki, M. and Hutchins, S.W. (2013). The effect of custom-made splints in patients with the first carpometacarpal joint osteoarthritis. Prosthetics & Orthotics International, 37(2), pp.139–144. doi:https://doi.org/10.1177/0309364612454047.
Güven, E. and Suner-Keklik, S. (2022). Custom-made finger splint versus prefabricated finger splint: finger flexion stabilization. Revista da Associação Médica Brasileira, 68(7), pp.935–938. doi:https://doi.org/10.1590/1806-9282.20220093.
Swellengrebel, H.J.C., Saper, D., Yi, P., Weening, A.A., Ring, D. and Jawa, A. (2018). Nonoperative Treatment of Closed Extra-Articular Distal Humeral Shaft Fractures in Adults: A Comparison of Functional Bracing and Above-Elbow Casting. The American Journal of Orthopedics, 47(5). doi:https://doi.org/10.12788/ajo.2018.0031.
