Do dynamic splints reduce wrist stiffness following fracture?

The dynamic splint is custom-made for the subject with thermoplastic. There is an axis about the wrist joint, and a force is applied into wrist extension with rubber band traction. The fingers and thumb will be free to move, and the subjects will be encouraged to use their hands for activities of daily living with the splint on wherever possible. Subjects will be instructed to wear the splint for more than 6 hours per day, (with total time of wear recorded) for 8 weeks. The subjects in the intervention group will also receive exercise and advice, as per the control group. The exercises will involve active range of motion and stretches into wrist extension, flexion, radial deviation, and ulnar deviation, as well as forearm pronation and supination. Subjects will be asked to perform the exercises three times per day, with ten repetitions per type of exercise for 8 weeks. The advice will be verbally given. Guidelines for advice to the patient will include using the involved upper limb for activities of daily living as much as possible, together with advice and reassurance relating to situations which may involve discomfort resulting from the exercises or activities of daily living. The type of advice and manner of delivery best reflects current clinical practice. In this way, the effectiveness of a dynamic splint over and above exercise and advice can be determined.