Biomechanical Engineering

When I write my blog entries, I try to be as unbiased and accurate as possible.  Sometimes events make me look good, sometimes bad, but it's never about beating myself up, and it's never about bragging.  Except today.  I'm feeling really good about this particular event, so I'm gonna brag.  Just a little.

First the background.  This part of the continuing saga of the injured left little finger, begun in previous entries.  I have been trying to make progress on diagnosis and treatment, but it has been difficult and slow.  Who knew the little finger could present such a big challenge?  In spite of the fact that it never was broken, it has been splinted virtually nonstop for over two months.  In that time I have used three different types of splint: 1) the traditional "tie or tape it to something stiff" variety; 2) the thermal-molded plastic or fabric variety; and 3) the sprin-mechanism variety.  The goal at this point is not to keep it straight, but to make it straight.  In other words, the finger is bent, but that bend prevents the surgeon from doing anything with it.  He says he even diagnose it until it is straight.  So for the last month-p;us I have been working with a couple of occupational therapists (OT) to make it straight, or as close as we can get.  When we started, they measured the angle at which it was stuck and found it too be 48 degrees, if I recall correctly. Today it was 30 degrees.  Our goal is 10, so we have a ways to go yet, but the surgeon expressed surprise and optimism that we have come so far so fast.

It might seem fast to him, but not to me.  In fact, I want to speed things up.  I'm missing opportunities to go to Spartan races; my regular workouts are more difficult; everything from washing my hands and face to putting on gloves is awkwad at best . . . I just want to get back to normal, and the sooner the better.  So back to the splints.  The first variety is not useful in this situation.  Of the other two, I prefer the thermal-molded fabric.  In essence, you boil it, let it cool enough to not hurt but still be hot to the touch, then wrap it around the finger.  As it cools to room temperature, it hardens until it feels roughly like a traditional plaster cast.

Here's where it gets interesting.  When you wrap something around a bent finger, the finger is still bent.  The best you can hope for is to lock in the gains you have made; there is little improvement from just wearing the splint.  The third variety of splint--what the surgeon called an LMB splint--is designed to actively make progress toward getting that finger straight.  However, it is difficult to put on, it is awkward and painful to wear, and I flat don't like it.  I wore it, but the whole time I was trying to think of a way to make that fabric splint more effective.  Each trip to the OT, we would remove it, re-mold it, and track our progress.  The emphasis was on making it tight, to keep the finger at its latest version of peak straightness.

My mental breakthrough came two days ago, when it occurred to me that "tight"is good, but "straight" is better.  It is the goal, after all.  So how can we stop chasing "tight" and instead chase "straight" with the fabric splint?  The answer is simple:  make it straight and then force the finger into it.  Doing so could perhaps be accomplished with a dowel that is roughly the same thiickness as the finger.  You could do it better by taking a mold of the finger and then somehow straightening it the desired amount.  Two ays ago, OT #1 said "great idea, I'll bring it up at our staff meeting this afternoon".  Today I asked OT #2 about it . . . he had never heard of it.  So, I went through the whole thing again, aand again I was told that the idea was good--but then it was business as usual.

After a while I brought it up again and got the OT to start looking aound for something along the lines of a dowel or similar object.  I spotted a Sharpie and some other markers, and one of them looked lke a decent match to my little finger.  He re-molded the splint and shaped it on the marker, and then we stuffed my finger into it.  Success!  This is the straightest we have been able to make this particular splint.  It's nothing fancy--on the contrary, it is quite simple--but it was a fun engineering exercise to go through, and it is an improvement over the standard tool/method.