Adjustment - Mediroyal DYFEX FHP MR328 Instructions

Pre Application
To select the right size, take the width measurement over the MCP-joints
then use the measurement chart (Pictures A).

Adjustment

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The DYFEX splint is made from a malleable aluminium frame and platform. This will
allow you to gradually adjust the splint depending on the progress of the patient.
Carefully evaluate the wrist, fingers and thumb. Adjust the frame by using your hands,
to reach a submaximal range. Start from the wrist, then adjusting the finger platform
and last the thumb. The wrist area can be quite stable. It might be easier to bend the
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splint over an edge. The thumb piece on the 328 MediRoyal DYFEX FHP can't be
placed into abduction. If you need abduction of the thumb, use the 329 MediRoyal
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DYFEX RHP instead (pictures B).
Application
Open the Velcro straps. Position the fingers, thumb and wrist into the splint. Start by
closing the straps around the wrist to secure the brace. Then attach the strap over the
fingers. The strap that runs from the ulnar side should be attached to the radial side
between the thumb and index finger. It's important to use this strap to provide more
support from the frame and to position the patient correctly over the MCP-bladder.
Make sure that the straps are not too tight as that might develop edema (Pictures C).
Adjustment of the air bladders
Once the patient fits into the frame, the bladders can be adjusted. The pump that has
been included has two tips. The clear one injects air and the black tip deflates. Insert
the clear ending into the lower valve, on the lower part of the outside of the splint. Let
the patient rest in the frame. Before pumping, check the position of the MCP-joints.
Inflate once and carefully follow the position of the MCP-joints. It usually requires only
one or two pump strokes to achieve a good support.
After the first initial pumping of the MCP-bladder, turn to the finger bladder. The valve
is placed on the ulnar side of the finger platform. Insert the clear tip of the pump.
Inflate with two full pump strokes to achieve finger extension and support of the PIP
and DIP arches. When you have reached a desired finger extension, move back to
the MCP-bladder. Insert the clear tip of the pump in the valve on the lower part of the
outside again. Top up the MCP-bladder with another pump stroke. It's important that the
dynamic extension of the fingers is supported correctly from the MCP-joints. Once the
MCP-bladder has been topped up, you might have to top up the finger bladder again.
When the finger bladder is full, the shape will be convex. This will assist the finger
position as well as supporting the PIP and DIP arches. If you want to reach a higher
degree of dynamic finger extension, deflate both bladders, adjust the finger platform
info further extension and start from above with inflating the bladders (Pictures D).
Further adjustments
The frame is quite stable and it's easier to bend it over a table edge. The finger platform
and thumb can be adjusted by hand. Avoid bending repetitive over the same place as
this might cause damages to the structure (Pictures E).
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