Hi all,

I am seeing an 18 month boy with hemiplegia. His (R) arm is showing very limited
functional movement, with increased tone being an issue particularly in his
hand. His thumb is his main problemIt is tightly abducted particularly when he
is active. His fingers show some active extension. I am concerned about
subluxation at MCP joint and am also wanting to allow for functional use of his
hand (ie. holding on to a push car for walking). I have tried a neoprene splint
which didn't seem to provide enough support to abduct the thumb. I have also
tried strapping tape, but was concerned about skin folding under the tape when
adequate stretch was achieved. I would love some advice. His Mum does regular
stretching. Is there anything else I can do?

Melissa
Community Health Paediatic Team
Darwin