Splinting the rheumatoid hand.

Splinting of the rheumatoid hand is a complex topic. Understanding is assisted by the use of precise terminology and so is accurate prescription. Dynamic and static orthoses can be prescribed for any part of the upper limb to assist function or provide resistance exercise. Orthoses can be valuable in planning surgery and assisting return of function postoperatively. The importance of training in prescription, manufacture, fitting and wearing of orthoses is stressed and careful discussion with the patient is vital. Thermoplastic materials have provided a new spectrum of designs. Spring wire attachments developed at Chessington (Wynn Parry et al, 1970), Odstock (Glanville, 1962) and The London Hospital (Ellis, 1981) have introduced further possibilities. Designs should be functional and must be acceptable to the patient.