What is the recommended position for splinting the hand after an injury to prevent ligamentous shortening?

• A. Wrist flexed, MCP extended, IP joints flexed
• B. Wrist extended, MCP partially flexed, IP joint extended
• C. Wrist neutral, MCP flexed, IP joints extended
• D. Wrist flexed, MCP partially flexed, IP joint extended

Answer: (B)

The recommended position for splinting the hand after an injury to prevent ligamentous shortening is with the wrist extended, the metacarpophalangeal (MCP) joints in a partially flexed position, and the interphalangeal (IP) joints extended. This positioning is essential for several reasons.

Wrist extension is crucial because it places the wrist in a stable position that allows for optimal alignment of the tendons and ligaments, thereby reducing the risk of contractures. The MCP joints being partially flexed helps to maintain some amount of function in the hand while also preventing stretching of the collateral ligaments that could occur if the MCP joints were fully extended. Keeping the IP joints extended also ensures that the flexor tendons are not overly shortened and maintains a functional length.

In summary, this position provides a balanced approach to immobilization, preventing both ligamentous shortening and maintaining joint function, which is critical in the healing process after a hand injury.