Revisiting the dogma of the Edinburgh position for safe immobilization

Since the concept was first described 50 years ago in Edinburgh by J. I. P. James, the term ‘Edinburgh position’ has been synonymous with the position of safe immobilization for the hand. Widely employed for the management of injured hands, the position is associated with splinting the metacarpophalangeal joints at 90° and the proximal interphalangeal joints completely straight, namely, ‘the intrinsic-plus position’, to help reduce the long-term consequences of a stiff hand. Over the decades, the strict joint angles of the Edinburgh position have been debated due to changes in patterns of injury, treatment and rehabilitation. This article challenges the dogma that surrounds the use of the Edinburgh position in clinical practice. The history of the position was explored, and the results of a survey about current practice of hand immobilization from two study centres in Edinburgh is presented. Level of evidence: IV