New Roll-On Splint for Stiff Finger Tip
The fingers bend and straighten because of three separate joints. The middle joint called the proximal interphalangeal joint (PIP) is the focus of this case study. A previous ATV accident left this 49-year-old with a very stiff PIP. The problem described was stiffness of the PIP causing pain and preventing finger pinch, grip, and overall function.

The solution was a new roll-on splint for the PIP. The splint is designed to stretch the joint by applying a dynamic, low-load over a long period of time. And the results? Excellent recovery after daily wearing for six hours over a period of three months.

The hand therapists treating this individual describe many advantages in using this new splint with only a few potential downfalls. Some of the benefits included:

  • Easy to get on and off the finger: flexible material allows the patient to just roll it on and off the finger.
  • Easy to keep the finger clean and avoid any skin breakdown with long-term use.
  • Spreads the load evenly over the finger.
  • Designed to cover just the middle (PIP) finger joint, leaving the other two joints free to move. In other words, the splint does not interfere with daytime use of the hand and fingers during daily activities.
  • Useful for older adults who need the use of their hands and arms to push up out of a chair or walk with assistive devices such as a cane or walker.
  • Has an opening at the end to allow for visual inspection of the tip of the finger (this makes it possible to see if circulation to the end of the finger is okay; something a regular splint or cast would not allow).
  • Light-weight and not bulky so it doesn't catch on clothing or weigh the finger down causing fatigue.
  • Available in 5 different sizes for variations in finger size from patient-to-patient; most patients need at least two different sizes to adjust for daily fluctuations in swelling and stiffness.
  • Considered a dynamic splint because it allows the person to bend the finger against the splint while getting help extending (straightening) the finger.

    And as the results showed, these many features of this little finger splint made it possible for the patient to wear it faithfully. The result was a significant and measurable increase in motion and strength with a decrease in pain, swelling, and stiffness.

    Were there any disadvantages to the roll-on PIP splint? A few -- but very few -- and easy to work around. First, the splint is made of silicone material, which is known to cause allergic reactions in some people. That was not the case for this patient. And second, it was too uncomfortable to wear at night so wear-time was limited to daytime hours when the person might need the finger more for daily activities.

    The hand therapists who worked with this patient were very favorably impressed with the roll-on splint. They suggest it is a simple yet effective treatment for challenging cases of proximal interphalangeal (PIP) joint stiffness. Of course, with only one patient involved in the study, there is a need for more research with a broader range of patients. Other studies comparing results of this roll-on splint with other finger splints used for the same problem would also be helpful. Concern about possible allergic reaction will require careful monitoring with this particular splint.
    Ronit Wollstein, MD, et al. A Novel Splint for Proximal Interphalangeal Joint Contractures: A Case Report. In Archives of Physical Medicine and Rehabilitation. October 2012. Vol. 93. No. 10. Pp. 1856-1859.