Duration of Splinting for Swan Neck Deformity
A figure-of-eight finger splint should be worn for 12 weeks for swan neck deformity, allowing full PIP flexion while limiting extension to 20-30° of flexion. 1
Splinting Protocol for Swan Neck Deformity
Initial Splinting Phase
- Apply a custom-made figure-of-eight finger splint immediately after diagnosis or post-surgical correction
- The splint must be configured to:
- Allow full proximal interphalangeal (PIP) joint flexion
- Limit extension beyond 20-30° of flexion
- Maintain this position consistently during the healing period
Duration of Splinting
- Primary splinting period: 12 weeks 1
- For surgically treated cases with temporary transfixation of the PIP joint:
- Remove wire after 4-6 weeks
- Begin mobilization exercises
- Continue splinting for the remainder of the 12-week period
- Passive extension beyond 20-30° of flexion should only begin after the full 12-week period
Splinting Considerations
Type of Splint
- Custom-made orthoses are preferred over prefabricated ones for better compliance and outcomes 2
- The splint should be a rigid rest orthosis designed specifically for swan neck deformity
- For optimal results, splints should be made by trained occupational therapists who can properly adjust them for each patient 3
Monitoring and Adjustments
- Regular assessment during the splinting period is essential
- Patients should be encouraged to contact their healthcare provider if:
- The splint needs adjustment
- Pain increases while wearing the splint
- Adverse effects such as skin erosion occur 3
- Follow-up clinical and functional assessments should be performed at regular intervals, with a comprehensive evaluation at 12 months post-treatment 3
Post-Splinting Management
Gradual Return to Function
- After the 12-week splinting period, gradually increase range of motion
- Begin passive extension exercises beyond the previously limited 20-30° of flexion
- Monitor for any recurrence of deformity
Long-term Follow-up
- Regular clinical and functional assessments should continue until stability is confirmed
- If the deformity worsens after splinting, reassessment and potential surgical intervention may be necessary
Common Pitfalls and Considerations
- Insufficient splinting duration: Premature discontinuation of splinting before 12 weeks may lead to recurrence of the deformity
- Improper splint positioning: The splint must maintain the correct position to prevent hyperextension while allowing flexion
- Inadequate monitoring: Regular follow-up is essential to ensure proper healing and to make adjustments as needed
- Patient non-compliance: Emphasize the importance of consistent splint use for the full duration to achieve optimal outcomes
By following this 12-week splinting protocol with proper positioning and regular monitoring, patients with swan neck deformity have the best chance for successful management and prevention of recurrence.