CHT CHT Splinting & Orthotic Fabrication 1 — Questions and Answers
Question 1: A resting hand orthosis for a patient with rheumatoid arthritis should position the wrist at:
- Full extension
- 0–15° extension (Correct answer)
- 30–45° extension
- 20° flexion
Correct answer: 0–15° extension
A resting orthosis for rheumatoid arthritis positions the wrist at 0–15° extension, MCPs in slight flexion (~15–20°), and IPs near full extension to rest inflamed joints in a functional, non-deforming position.
Question 2: The safe position (intrinsic-plus position) for immobilizing a hand to prevent contracture is:
- Wrist neutral, MCPs extended, IPs flexed
- Wrist extended, MCPs flexed 70–90°, IPs extended (Correct answer)
- Wrist flexed, MCPs neutral, IPs flexed
- Wrist extended, MCPs and IPs all flexed
Correct answer: Wrist extended, MCPs flexed 70–90°, IPs extended
The safe (intrinsic-plus) position places the wrist in extension, MCPs in 70–90° flexion, and IPs in full extension to maintain ligament length and prevent contracture.
Question 3: A dynamic extension splint with outrigger is most commonly used for which condition?
- Boutonniere deformity (Correct answer)
- Extensor tendon zone 6 repair
- Flexor tendon zone 2 repair
- Trigger finger
Correct answer: Boutonniere deformity
Dynamic PIP extension orthoses are a primary conservative treatment for boutonniere deformity, applying a constant low-load stretch to the PIP joint into extension.
Question 4: When fabricating a thermoplastic orthosis, the recommended water temperature to soften most low-temperature thermoplastic materials (LTT) is:
- 50–55°C (122–131°F) (Correct answer)
- 60–70°C (140–158°F)
- 80–90°C (176–194°F)
- 100°C (212°F)
Correct answer: 50–55°C (122–131°F)
Most low-temperature thermoplastics become pliable at 60–70°C; however, many clinical guidelines cite heating the water to around 60°C with material softening at approximately 60–65°C for safe skin application.
Question 5: A figure-of-eight orthosis is primarily used to treat which digit deformity?
- Mallet finger
- Swan neck deformity (Correct answer)
- Trigger finger
- Boutonniere deformity
Correct answer: Swan neck deformity
The figure-of-eight (or ring) orthosis blocks PIP hyperextension while allowing full PIP flexion, directly addressing the PIP hyperextension component of swan neck deformity.
Question 6: Which orthosis design is used to maintain thumb web space in cases of first web space contracture?
- Thumb spica splint
- C-bar or opponens orthosis (Correct answer)
- Wrist cock-up splint
- Buddy strap
Correct answer: C-bar or opponens orthosis
A C-bar or opponens orthosis maintains the first web space by positioning the thumb in abduction and opposition, preventing or addressing contracture of the web space.
CHT CHT Splinting & Orthotic Fabrication 1
A resting hand orthosis for a patient with rheumatoid arthritis should position the wrist at: