Leather, The Forgotten Strapping Material,
Clinical Pearl No. 4 – February 2009

HandLab Clinical Pearls

April 2009                               No. 4

 LEATHER, THE FORGOTTEN STRAPPING MATERIAL

 

Although hook and loop closure is readily available and serves as a quick, efficient, and convenient strapping material for splints, the use of leather straps for selected circumstances can be a great advantage, increasing tolerance to the concentrated pressure of a strap. Leather is the only natural or manmade material which will conform perfectly to the underlying contour, making it the most desirable strapping material to comfortably distribute pressure. To use leather, one must have the ability to sew hook/loop closure to one end of the leather strap and to attach the other end of the leather strap to the thermoplastic base using rapid rivets.

The circumstances that merit consideration of leather strapping are:
1. Straps on splints for chronic problems; these straps are often in place for long periods of time, requiring even distribution of pressure.
2. Straps that cross delicate skin, tenuous scar, or hold against the strong pull of spasticity.143.10.03-testforweb

Leather straps are used with other strapping materials in a splint for long term wear following excision of a malignancy and full thickness graft on the palmar aspect of the ring and little fingers.

3. Straps for splints on babies and children; the contouring of the leather allows a better grasp on the skin when the shape of the underlying bony contour is not well defined.

4. Straps that must cross deformed joints or bone; examples are rheumatoid joints with deformity or preexisting pressure areas over a bony prominence. Hint: Unfinished leather will absorb body oil readily and can easily be molded by wetting the leather and letting it dry while the strap is in place.33.01.15-for-web

Leather straps are used to secure a young child’s hand in a splint to reduce the PIP joint flexion contracture resulting from camptodactyly.135.11.120testforweb

A leather strap is placed over the dorsum of the proximal phalanx where a previous splint has created a pressure area. Note the edge of the strap has been clipped to relieve edge pressure.

Download Clinical Pearl No. 4, Leather, The Forgotten Strapping Material, February 2009

 

ADDITIONAL SUGGESTED READING

Clinical Pearl No. 30 – Should all Orthoses be 2/3 the Length of the Forearm?

Clinical Pearl No. 26 – Use of a Relative Motion Orthosis for Regaining PIP Joint Flexion or Extension

Clinical Pearl No. 14 – How Long Should I Serial Cast a Finger?

Clinical Pearl No. 13 – Why I Dislike Ulnar/Radial Gutter Splints!!

Clinical Pearl No. 12 – Why I Avoid Passive Flexion of the DIP Joint

Clinical Pearl No. 7 – Attaching Interface Mold to Splint Surface

Clinical Pearl No. 5 – “Splint” Suggestion for the Hypermobile Wrist

Clinical Pearl No. 3 – Making the Most of Mallet Finger Splinting

Clinical Pearl No. 2 – Pre-Operative Serial Casting for Dupuytren’s Contracture Involving the PIP Joint

Book Chapter – Principals of Splinting and Splint Prescription, Surgery of the Hand and Upper Extremity – 1996

Journal Article – Splinting for Radial Nerve Palsy, Journal of Hand Therapy – 1987

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Disclaimer: HandLab Clinical Pearls are intended to be an informal sharing of practical clinical ideas; not formal evidence-based conclusions of fact.