Hand Splints in the NICU

Babies in the Neonatal Intensive Care Unit (NICU) commonly have hand deformities and hand dysfunction. Since occupational therapists help with daily activities like eating and other fine motor skill tasks, it is important for OTs to try and fix these hand deformities quickly and accurately, so that the baby can perform daily activities of life now and in the future.

Hand deformities and hand dysfunction, being common in the NICU, can be caused due to many things. The authors stated that, "problems are due to increased tone resulting from central nervous system damage associated with CNS developmental anomaly, hemorrhage, hypoxia, infectious processes, tumors, or trauma" (Anderson & Anderson, 1988, p. 222). Rare yet possible, hand dysfunction isn't usually caused by the ingestion of a drug or other toxin during pregnancy.

Due to NICU babies' instability and time constraints, OTs usually opt for the intervention of hand splinting, to try and correct the deformity and dysfunction of a hand. Splints can provide protection, support, and immobilization. Orthotic splinting can hold a joint in a function position through a series of changing molds in order to force a joint into better alignment over time (Anderson & Anderson, 1988, p. 225).

Safety is very important when splinting, especially on infants, since they can't directly tell you what hurts. Premature and ill infant are more at risk for skin ulcers due to diminished fat pads on their hands. Therefore, it is important to watch carefully for irritation from the splint. The straps, if pulled too tightly, may also cause edema. The straps should be loose and wide so that the pressure is spread over a great area. The glue used to adhere the straps should also not come in contact with the baby in order to prevent contact dermatitis. Finally, a sock usually is put over an infant's splint in order to prevent injuries or removal by infant (Anderson & Anderson, 1988, p. 225).

Thanks for reading,

Kayla

Works Cited:

Anderson, L. J., & Anderson, J. M. (1988, April). Hand Splinting for Infants in the Intensive Care and Special Care Nurseries. The American Journal of Occupational Therapy, 42(4), 222-226. Retrieved November 4, 2016.