If you’ve injured your hand, wrist, or forearm – whether on the job or at home – you may need a splint to protect your injury and help it heal. But not all splints are created equal. Depending on your condition, your provider may recommend either a custom hand splint or a prefabricated one.
Understanding the difference between these types of splints can help you feel more confident about your care plan and recovery.
What’s the Difference Between a Custom Splint and a Prefabricated Splint?
Custom-made splints are designed by a licensed occupational therapist (OT) and molded specifically to fit your anatomy. They’re made from heated thermoplastic material that becomes soft and flexible before being shaped to your hand, wrist, or forearm. Once it cools, it hardens into a supportive, comfortable fit that works with your body – not against it.
Prefabricated splints, on the other hand, come in standard sizes and can be found at drugstores or medical supply shops. They may be a good short-term solution, but they don’t offer the same level of comfort or support – especially if you have swelling, external pins, or post-surgical needs.
Casts are a separate category altogether. Applied by a physician, casts are rigid and non-removable. They’re typically used in the early stages of healing to fully immobilize a fracture or post-surgical repair.
Who Makes Custom Splints and How Are They Made?
Custom splints are created by occupational therapists, and in some cases, physical therapists with specialized training in upper extremity rehab.
Here’s what the process looks like:
- The therapist outlines your hand or arm to create a pattern.
- This pattern is traced onto thermoplastic material and heated until pliable.
- The material is shaped directly onto your limb for a precise fit.
- Once it cools, it’s trimmed, smoothed, and finished with straps and Velcro for easy on/off.
These splints can be adjusted over time to accommodate changes like reduced swelling, surgical recovery stages, or evolving mobility needs.
What Are the Benefits of Custom Hand Splints?
Because no two hands are the same, a one-size-fits-all solution rarely works well – especially after an injury or surgery. Custom splints offer several key advantages:
- A better fit = more comfort and better compliance
- Adjustability as swelling goes down or healing progresses
- Personalized support for surgical hardware, wounds, or anatomical differences
- Improved recovery outcomes by protecting the repair and supporting proper alignment
For example, after a thumb CMC arthroplasty, your therapist can modify a forearm-based splint into a smaller, hand-based version as you recover – with your surgeon’s approval.
What Conditions or Injuries Might Require a Custom Splint?
Custom splints are often prescribed after surgery or for ongoing joint or tendon support. Common reasons include:
- Thumb CMC arthroplasty
- ORIF (Open Reduction Internal Fixation) for wrist and finger fractures
- TFCC (Triangular Fibrocartilage Complex) repairs
- Flexor or extensor tendon repairs
- Cubital tunnel release (for anti-claw support)
- Mallet finger
- Thumb arthritis or repetitive stress injuries
Therapists may also design dynamic splints to help restore range of motion after surgery by gently stretching stiff joints. For more about upper extremity rehab and splinting, the American Society of Hand Therapists offers helpful, patient-friendly resources.
What If I’m Injured at Work – Can I Still Get a Custom Splint?
Yes, but there’s a process. After a work-related injury, your physician will evaluate your needs and write a prescription for a custom splint if it’s appropriate. The clinic will then:
- Obtain the correct L code
- Submit it to your workers’ compensation insurance for approval
- Schedule your splinting appointment once authorization is received
In the meantime, you may be fitted with a cast or a prefabricated splint to protect the area while waiting for your custom device.
What Happens If I Don’t Wear My Custom Splint?
Ignoring recommendation for a custom splint can lead to serious setbacks, especially after surgery. Without the right support, you risk:
- Compromising surgical repair
- Poor bone alignment
- Prolonged pain or stiffness
- Long-term loss of mobility or hand function
- Potential need for additional surgeries
Even in non-surgical cases, not using a splint as prescribed can worsen symptoms and delay healing. Following your therapist’s guidance is key to protecting your recovery.
We’re Here to Help
At Ivy Rehab, our team is experienced in treating work-related hand and upper extremity injuries. We know how important it is to get back to work quickly – and safely. That’s why we take a personalized approach to care, offering one-on-one appointments, custom splint fabrication, and work conditioning and injury prevention strategies.
If you’ve been hurt on the job, we’ll help you regain function, reduce pain, and return to work with confidence.
Learn more about Workers’ Compensation services
Article by: Mauli Nayar, MS, OTR/L, Clinical State Manager, Ivy Rehab Workers’ Compensation Program
Mauli earned her master’s in occupational therapy from Salus University and began her Ivy Rehab career in 2021. With extensive experience in hand and upper extremity rehabilitation, Mauli specializes in treating work-related injuries, joint protection education, and ergonomic strategies. She now oversees 56 clinics across North New Jersey, helping patients transition into work conditioning programs and supporting safe, lasting recoveries.
