Understanding the proximal volar extension (PVX) and why it is needed

When splinting the MCP joint, the web space prevents thumb splints from going far enough proximal to support the joint. The PVX curves along the volar aspect of the thumb to support under the head of the metacarpal joint and gives better alignment at the CMC joint. It can be adjusted by bending it in or out to fit the contour of the volar surface of the thumb for an exact fit. Use when there is more than 20° of hyperextension.

There are two PVX styles to choose from: The ‘U’ PVX distributes pressure around the head of the metacarpal avoiding direct pressure on a potentially sensitive area. The ‘Spoon’ PVX places more direct pressure with a curved pad that can more easily be adjusted by twisting or bending left/right. Both PVXs are designed to be equally strong.