The Best Splinting Guide for Occupational Therapists

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I’ve heard from so many occupational therapists and OT students over time about how hard it is to find a reputable splinting guide. Creating splints (now also known as orthotics) is a challenge when you’re consulted to make one on the fly that you may have only done once or twice in OT school.

So, I consulted with my hand therapist colleagues to get their expert opinion on what has helped them the most in their practice. Most agreed on what they think is the best splinting guide for any occupational therapists needing to make hand splints/orthotics.

I started using this guide after their recommendations and was so glad to have it when working in acute care with the occasional splint order.

Here is my honest review and summary of one of the best splinting guides available to OTs. The book is:

Orthotic Intervention for the Hand and Upper Extremity: Splinting Principles and Process

The top recommended splinting resource from my hand therapist friends is titled Orthotic Intervention for the Hand and Upper Extremity. It’s written by certified hand therapists MaryLynn A. Jacobs, MS OTR/L CHT and Noelle M. Austin, MS PT CHT.

This book is the most comprehensive resource for fabricating splints and other orthotics, and it also provides important information on most upper extremity diagnoses. This helps you to make an informed decision on the best solution for your patient’s needs.

The book covers extensive splint fabrication techniques and interventions with precautions and contraindications – a must for new practitioners! Popular taping methods are also covered.

Another great aspect of this splinting and orthotic guide is that the authors also include “Clinical Pearls” and “Pattern Pearls.”

These are really helpful tips and help you gain further insight into your fabrication methods along with tips to help you save time. Case studies and evidence-based examples are also included to help stimulate your clinical reasoning.

Here is a sample of chapter topics from the table of contents:

• Concepts of orthotic fabrication
• Anatomical Principles
• Mechanical Principles
• Equipment and Materials
• Fabrication Process
• Immobilization Orthoses
• Mobilization Orthoses
• Restriction Orthoses
• Nonarticular Orthoses
• Prefabricated Orthoses
• Casting
• And several more chapters related to diagnosis and injury

This guide is really user-friendly when you need to find a splint quickly. It is spiral-bound, making it easier to flip through and lay out open on your table while you’re making your splint or other orthotic. The book lists all splints by name and by diagnosis in the index so you don’t have to spend time combing through endless, not-so-helpful search results online.

If you are only able to purchase one splinting guide for your toolbox, we think this should be the one. It has everything a new hand therapist needs for fabricating splints and orthotics, while also including important diagnosis information.

Of note, there is now a third edition, available here, that is printed in a larger format and with added chapters on Relative Motion Orthoses, Prosthetics, Orficast, Delta-Cast, and Tendon and Nerve Transfers with additional information from hand surgeons and other clinical experts in the field.

We have gotten feedback that both editions are great options depending on your budget and preference.

Recommended Add-On: Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity

While this textbook isn’t an actual splinting guide (although there is an orthotics chapter), it’s a great second resource for hand therapists to also have in their OT toolbox, once you have your Orthotic Intervention for the Hand and Upper Extremity guide.

Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity by Cynthia Cooper, MFA MA OTR/L CHT, covers everything a hand therapist or student needs in terms of important hand information needed when working with the upper extremity. It’s also great for occupational therapists working in other fields, like acute care and rehab.

This book includes hand anatomy, the evaluation process, and diagnosis-specific information. Expert tips, treatment guidelines, and case studies are also included to help you think critically about each client’s individual needs.

The authors also use helpful images and clinical pearls throughout the book to help you combine theory with real-world clinical practice. Case examples are also included to help you use your clinical reasoning and a ‘humanistic approach’ when treating your clients.

Like the Orthotic Intervention for the Hand and Upper Extremity textbook, this book also helps you find needed diagnosis-specific information quickly by placing it in the final section of the book.

Here are just a few other helpful features included in this book:

• Fundamentals of hand therapy concepts and treatment techniques
• Questions to discuss with the physician
• Healing timelines
• Evaluation tips
• Precautions and concerns
• Tips from the field
• What to say to clients

More Splinting Resources 

We know splinting can be a challenge!

For a quick read, check out our article Yes, You Can Splint With Confidence! Neuro Splinting Tips for the ‘Non-Splinter’ for neuro patients that will benefit from splinting.

There is also so much great splinting content created by OTs on YouTube to peruse. Here are just a few to get started:

Splints: Basic Principles (OT Over Easy)

Orthosis Training for Occupational Therapists (Full series from Hand Therapy Secrets)

Occupational Therapy Splint Fabrication (Basics from Physio Keeps You Moving)

Once you’re regularly splinting, you can provide this printable splint hand-out to your patients. You can also write your specific splinting instructions on it:

Occupational Therapy Splint Instructions (Aurora Health Care)

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With these resources in your toolbox, I hope that you will find splinting a little bit more manageable and less intimidating. I’d love to hear if you have any other favorite splinting guides and resources that have helped you!

This post was originally published on September 24, 2018 and updated on February 22, 2023.