{"id":2198,"date":"2026-01-13T00:35:20","date_gmt":"2026-01-13T00:35:20","guid":{"rendered":"https:\/\/www.bcchr.ca\/brachial-plexus\/?page_id=2198"},"modified":"2026-03-09T22:33:15","modified_gmt":"2026-03-09T22:33:15","slug":"sup-er-splint","status":"publish","type":"page","link":"https:\/\/www.bcchr.ca\/brachial-plexus\/treatment\/sup-er-splint\/","title":{"rendered":"Sup-ER Splint"},"content":{"rendered":"
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\n\t<\/span>\n\tTreatment of Brachial Plexus Palsy<\/span><\/a><\/span><\/div>\n

Sup-ER Splint<\/h1>

Learn more about the Sup-ER SPlint.<\/p><\/div>\n

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Sup-ER<\/h2>

What is it?<\/strong><\/p>

You may have noticed that your child\u2019s injured arm rests in a \u2018thumb-down\u2019 position, (Figure 1), while the other arm rests \u2018thumb-up\u2019. The Sup-ER splint has been designed to help support a \u2018thumb-up\u2019 position by maintaining the length of your child\u2019s arm and shoulder muscles (Figure 2).<\/p>\n

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Fig. 1: Arm position<\/strong><\/figcaption><\/figure>\n\n\n\n
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Fig. 2: Sup-ER Splint<\/figcaption><\/figure>\n<\/figure>\n


Just like your child, the splint is one of a kind! It is comfortable, easy to use, removable, and can be adjusted for growth. The splint is made of a lightweight plastic material shaped on your child\u2019s arm, and a special strapping system.<\/p>

How do I put the splint on my child?<\/strong><\/p>

Part 1<\/strong><\/em><\/p>

    \n\tWith the palm facing up, apply the plastic splint (as labeled) to the inside of arm\/hand (see Figure 3).  <\/li>\n\n\tWith the palm still facing up, apply the white elastic strapping.  Start with the end pointing into the palm (Figure 4), looping around the hand and through the thumbholes, twice.<\/li>\n\n\tContinue to wrap the strapping up over the arm splint (Figure 5).<\/li>\n\n\tOverlap by half the strap width.<\/li>\n\n\tApply gentle even tension. <\/li>\n<\/ol>

    Goal: The elastic strapping helps reinforce the palm-up position.<\/p>\n

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    Fig. 3 <\/figcaption><\/figure>\n\n\n\n
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    Fig. 4<\/figcaption><\/figure>\n\n\n\n
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    Fig. 5<\/figcaption><\/figure>\n<\/figure>\n


    Part 2<\/strong><\/em><\/p>

      \n\tApply the waistband, pulling the Velcro strap up between the legs, just like a diaper (Figures 6 & 7).<\/li>\n\n\tGently turn the shoulder outward (thumb pointing out, Figure 8). <\/li>\n\n\tAttach the Velcro straps (as labelled) at top of the arm and elbow, securing to back of waistband (Figure 9).<\/li>\n<\/ol>

      Note: Always position the shoulder with your hands. Do not use the strapping to pull the shoulder into position.<\/p>

      Goal: The strapping supports the outward shoulder position.<\/p>\n

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      Fig. 6<\/figcaption><\/figure>\n\n\n\n
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      Fig. 7<\/figcaption><\/figure>\n<\/figure>\n\n
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      Fig. 8<\/figcaption><\/figure>\n\n\n\n
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      Fig. 9<\/figcaption><\/figure>\n<\/figure>\n


      When should the splint be worn?<\/strong><\/p>

        \n\t22 hours per day to start.<\/strong>
          \n\tWe will review your child\u2019s progress monthly. Reducing the time required in the splint will depend on your child\u2019s overall development, and arm strength and flexibility.<\/li>\n<\/ul><\/li>\n\n\tRemove the entire splint twice per day,<\/strong>\u00a0for one hour each in morning and evening.
            \n\tUse these breaks for bathing, stretching exercises and play time.  <\/li>\n<\/ul><\/li>\n\n\tRemove the strapping for Part 2 when your child is eating or traveling in a car seat.<\/strong><\/li>\n<\/ul>

            What do I need to check?<\/strong><\/p>

              \n\tCheck finger color on a regular basis <\/strong>(especially as your child is getting used to using the splint).
                \n\tFingers that are dark purple or white mean there is poor blood flow to the hand, and the strapping may be too tight.  <\/li>\n\n\tRemove the splint immediately; allow color to return to normal, and then reapply, checking strap tension.<\/li>\n<\/ul><\/li>\n\n\tCheck the skin<\/strong>\u00a0for redness or irritation, whenever the splint is off.
                  \n\tRedness that disappears within 20-30 minutes is acceptable.  <\/li>\n\n\tContact your therapist if there is any persistent redness or irritation.<\/li>\n<\/ul><\/li>\n<\/ul>

                  How long will my child need a splint?<\/strong><\/p>

                  We recommend use of the splint for some portion of the day and\/or night (as directed), for the first year of your child\u2019s life.<\/p>

                  Should I clean the splint?<\/strong><\/p>

                  Yes! A clean splint helps keep skin healthy.<\/p>

                    \n\tWipe the arm splint every day with a damp, soapy cloth.<\/li>\n\n\tHand wash the waistband and strapping, as needed. Hang to dry.<\/li>\n<\/ul>

                    What else should I know?<\/strong><\/p>

                      \n\tDo not leave the plastic splint near any heat source \u2013 it may lose its shape and no longer fit properly.<\/li>\n\n\tBe consistent. Your child will adjust to the splint more quickly if worn regularly.<\/li>\n\n\tDo the stretching and play activities, as recommended. The splint does not replace these. \u00a0<\/li>\n\n\tMore information about brachial plexus injuries, stretching exercises, and play activities are located in your information package. The package also includes more pictures and a splint use log.<\/li>\n<\/ul>

                      Sup-ER Splint Videos<\/h3>

                      Sup-ER Splint – Assembly\u00a0(for parents and clinicians)<\/h4>\n
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