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PubMed1987

Comparison of four ankle splint designs.

Plaster splinting is often considered the initial immobilization method for acute ankle injuries. Although the posterior splint design is most commonly recommended, clinical experience suggests that it is not the most durable in the outpatient setting. To determine the sturdiness of the four most common splint designs, each was tested for its resistance to plantar flexion 30 minutes after application. The splints tested were: standard posterior, ridged posterior, modified figure-of-eight, and sugar-tong. In six healthy subjects, significantly less plantar flexion was achieved with the sugar-tong splint than with the other designs. In addition, more force was generated per degree of plantar flexion achieved with the sugar-tong than with the other designs. These results suggest that the sugar-tong splint may be preferred in the acute treatment of ankle injuries based on its greater strength.

Ankle Injuries↗
PubMed1998

An in vitro study of the passivity of splints in dental trauma.

OBJECTIVES: The purpose of this research was to evaluate the passivity of splints which were constructed with orthodontic materials since a force could unintentionally be generated by the appliance and perturb the healing process of the injured teeth. METHODS: A specific data acquisition system, with a 2D force transducer, was developed to evaluate its passivity. Four types of splints were studied on a maxillary dental arch model and the splints were constructed with 0.559 mm standard edgewise brackets, with stainless steel square or round orthodontic wires and with 0.254 mm preformed ligatures or 3.05 mm elastomeric ones. The studied orthodontic wires were straight-lengthened or Arch Blank preformed types and three sizes of square wires and five sizes of round ones were tested. RESULTS: The orthodontic appliances were rarely passive but the splints constructed with elastomeric ligatures and an Arch Blank preformed wire were significantly different from those constructed with stainless steel ligatures and a straight wire or with stainless steel ligatures and an Arch Blank preformed wire or with elastomeric ligatures and a straight wire (P < 0.05). The best control of passivity was obtained with the 0.432 mm x 0.432 mm splints (P < 0.05) and the mean force generated by those appliances was 0.13 x 10(-2) N. CONCLUSIONS: The choice of orthodontic materials influenced the passivity of dental splints and it would seem that elastomeric ligatures and an Arch Blank preformed wire should be used for its construction.

Analysis of Variance↗
PubMedDate not supplied

The dynamic elbow suspension splint.

Elevation of the upper extremity after elbow surgery has rarely been advocated and can be difficult to achieve. Usually the extremity is elevated with the elbow at 90 degrees of flexion, so that swelling from the hand drains to the elbow but the elbow remains dependent. Excessive swelling causes discomfort and compromised wound healing, makes early mobilization difficult, and predisposes to joint contracture. We report on a dynamic elbow suspension splint, which is analogous to the Thomas splint used for femoral shaft fractures. The arm is held in full extension with an above-elbow plaster slab and is secured to the Thomas splint with skin traction. The splint is suspended on a Balkan frame at an angle of 60 degrees. We prefer to use the new Zimmer Thomas splint, because it is radiolucent and has self-adhesive sheep-skin supports that can be simply applied. It allows the patient to mobilize in bed and is well tolerated by patients and nursing staff. The dynamic elbow suspension splint is a useful adjunct after complex elbow surgery or trauma, because it reduces swelling and maintains the elbow in extension.

Elbow Joint↗
PubMed1999

The effect on nasal resistance of an external nasal splint during isometric and isotonic exercise.

The now commonplace wearing of external nasal splints by sportsmen and athletes has never been scientifically evaluated. The present study looks into the effect of both isometric and isotonic exercise on nasal resistance and examines if this is altered by the wearing of an external nasal splint. Twenty subjects who did not suffer from rhinitis were tested. Nasal resistance measurements were recorded using an anterior rhinomanometer before and after exercise, with and without an external nasal splint. Pulse and blood pressure were measured using a Criticare Inc. model 508 physiological monitor before and after exercise. Significant changes were observed in pulse (P < 0.001) and both systolic (P < 0.002) and diastolic (P < 0.001) blood pressure in response to isotonic exercise and pulse (P < 0.0001) and diastolic blood pressure (P < 0.0006) in isometric exercise. Significant differences were seen in nasal resistance when the splint was applied before (P < 0.001) and after exercise in both groups (P < 0.003). No significant difference was observed between the post-isotonic exercise groups with and without the splint (P = 0.167) but significant differences were seen in the isometric group (P < 0.0001). External nasal splints decrease nasal resistance at rest but are of little proven value when performing isotonic exercise however significantly reduce nasal resistance during isometric exercise.

Exercise↗
PubMed1998

Splinting osseointegrated implants and natural teeth in rehabilitation of partially edentulous patients. Part II: principles and applications.

Lone standing splinted implant segments are accepted as optimal. However, in the treatment of partial edentulism, clinical reality often predicates the consideration of splinting teeth and implants due to variables of tooth/implant location and available bone support. This article presents a review on biomechanical aspects of splinting teeth and some considerations of splinting teeth and implants. A proposed classification of splinting applicable to both teeth and implants is presented as well as a discussion of the clinical aspects of splinting illustrated with clinical cases.

Dental Abutments↗
PubMed2001

A local adhesive finger splint.

A new design of a local static finger splint is proposed. The splint is made by enveloping a length of wire into double-sided adhesive tape. The skin of the region to be immobilized is covered with an adhesive skin dressing, to which the splint is then adhered. This method of attachment gives more freedom in choosing a site of splint application and prevents access obstruction to the wound, blocking of tactile areas, and circulation impairment. The splint is light, low profile, and malleable at ambient temperature. The adhesive splint was used in 5 patients to maintain the first web space open or to immobilize stiff interphalangeal joints in flexion overnight.

Adhesives↗
PubMed2000

Neutral wrist splinting in carpal tunnel syndrome: a comparison of night-only versus full-time wear instructions.

OBJECTIVE: To compare the effects of night-only to full-time splint wear instructions on symptoms, function, and impairment in carpal tunnel syndrome (CTS). DESIGN: Randomized clinical trial with 6-week follow-up. SETTING: Veterans Administration Medical Center, outpatient clinic. SUBJECTS: Outpatients with untreated CTS were consecutively recruited from our electrodiagnostics lab. Twenty-one patients (30 hands) were enrolled, and 17 patients (24 hands) completed the study. INTERVENTIONS: Thermoplastic, custom-molded, neutral wrist splints with subjects receiving either full-time or night-only wear instructions. OUTCOME MEASURES: Symptoms and functional deficits were measured by Levine's self-administered questionnaire, and physiologic impairment was measured by median nerve sensory and motor distal latency. COMPLIANCE AND CROSSOVER: Almost all (92%) of the combined sample reported frequent splint use, but their adherence to specific wearing instructions was limited. A majority (73%) of the full-time group reported splint wear less than one half of waking hours, and some (23%) of the night-only group reported occasional daytime wear. Despite this tendency for treatment crossover, the two treatment groups differed in daytime wear as intended (chi2 analysis, p = .004). RESULTS: The combined sample improved in three of four outcome measures: sensory distal latency (mean = .28msec, standard deviation [SD] = .37, p = .004), symptom severity (mean = .64, SD = .46, p = .0001), and functional deficits (mean = .49, SD = .51, p = .0001). Severity of CTS was a factor only in sensory distal latency improvement (more improvement in severe CTS). Subjects receiving full-time wear instructions showed superior distal latency improvement, both motor (.35 vs -.07msec, p = .04) and sensory (.46 vs . 13msec, p = .05) when compared with subjects receiving night-only wear instructions. CONCLUSIONS: This study provides added scientific evidence to support the efficacy of neutral wrist splints in CTS and suggests that physiologic improvement is best with full-time splint wear instructions.

Adult↗
PubMed2002

Bone SPECT imaging of patients with internal derangement of temporomandibular joint before and after splint therapy.

OBJECTIVE: Temporomandibular joint (TMJ) patients with disc displacement without reduction have a misaligned disc-condyle structural relation. As the condition becomes chronic, painful osteoarthritic changes may occur. For these patients, splint therapy may help to position the condyle to a more structurally compatible and functional position and to decrease the loading force of articular surfaces. The aim of this study was (1). to evaluate osseous reactions and pain relief in patients with disc displacement without reduction after splint therapy and (2). to use single photon emission tomography (SPECT) bone imaging to compare the results with the opposite joint of the patient. STUDY DESIGN: Twelve patients, who presented with pain involving the TMJ and limited mouth opening and were confirmed by soft tissue imaging as having disc displacement without reduction, were included in the study. Each patient underwent bone SPECT imaging, after which semiquantitative evaluation of transaxial images was conducted. The ratios of affected TMJ to nonaffected TMJ, affected TMJ to occipital bone, and nonaffected TMJ to occipital bone were calculated. After 6 months of splint therapy, bone SPECT examinations were repeated. RESULTS: Before splint therapy, the ratios of affected TMJ to nonaffected TMJ and of affected TMJ to occipital bone were found to be significantly higher than the ratios after splint therapy (P < 0.005). CONCLUSION: Six-month splint therapy has a positive effect on the osseous reaction and pain related to internal derangements of TMJs.

Adolescent↗
PubMed1992

Influence of stabilization occlusal splints on sternocleidomastoid and masseter electromyographic activity.

The present work was conducted in order to determine the effect of stabilization occlusal splints on electromyographic (EMG) activity of sternocleidomastoid and masseter muscles, in subjects with tenderness to palpation in these muscles. A full-arch maxillary stabilization occlusal splint was made for each of 14 subjects. Tonic EMG activity, as well as during saliva swallowing and maximal voluntary clenching, was recorded with and without a stabilization occlusal splint inserted. Similar tonic, as well as maximal voluntary clenching EMG activity, with and without the stabilization occlusal splint, was observed. During saliva swallowing, the activity in both muscles was significantly lower with the stabilization occlusal splint. This suggests that daytime use of the stabilization occlusal splint might improve tenderness to palpation in the studied muscles, since the frequency of swallowing function is higher during waking hours.

Adult↗
PubMedDate not supplied

Femur fracture immobilization with traction splints in multisystem trauma patients.

OBJECTIVE: To evaluate the frequency of concomitant injuries that can complicate and/or contraindicate the use of traction splints (TSs) for femur fracture immobilization (FFI) in a population of multisystem trauma patients. METHODS: This was a descriptive, prospective study utilizing a data collection tool to identify patients with multisystem trauma for which a TS was in place for FFI. Patient care records and follow-up diagnoses were reviewed to identify patients with positive femur fracture(s) who concurrently had injuries that can complicate and/or contraindicate TS use. Injuries considered to complicate or contraindicate traction splint use include 1) pelvic injury, 2) patellar fracture or ligamentous knee injury, and 3) tibia/fibula fracture. RESULTS: Forty patients were identified as having a TS in place with an underlying diagnosis of multisystem trauma. All 40 had follow-up diagnosis information available, 39 of which were positive for femur fracture on the side of the extremity on which the splint was placed, or bilaterally. The incidence of complicating and/or contraindicating injuries was 38%. CONCLUSION: Traction splints are commonly used in the prehospital and transport setting for immobilization of femur fractures. There are limited data available on the benefit of traction splint use for femur fracture in the prehospital or transport environment. This study identified that concomitant injuries that complicate and/or contraindicate traction splint use are common.

Adolescent↗
PubMed1989

The stiffness of cylindrical casts enforced with splint laminations: biomechanical considerations.

Splint lamination is often used to strengthen a plaster cast while minimizing its thickness and weight. We evaluated the following lamination configurations to determine the effectiveness of each relative to a 3-mm-thick short leg cast: anterior-posterior splints, medial-lateral splints, and an anteriorly placed fin. Theoretical stiffness was calculated as a function of the area moment of inertia, and then the actual casts were tested in three-point bending on a servohydraulic apparatus. The experimental results were correlated with the calculated data, and finite element studies were performed to correlate the experimental results with the geometries of the casts. The theoretical and experimental data indicate that anterior-posterior splint lamination reinforcement stiffens a cylindrical cast to flexion-extension bending moments more effectively than does medial-lateral splint placement. An anterior fin can stiffen the cast as effectively as a splint can. However, the fin must be relatively large, which may cause it to accentuate problems with clothing and be difficult to apply.

Biomechanical Phenomena↗
PubMedDate not supplied

Extension splint for trigger thumb in children.

Sixty-two reducible trigger thumbs in 50 children with age from 0 to 4 years (mean, 1 year 11 months) were reviewed to study the effect of splinting. Thirty-one thumbs in 24 children received splinting for a mean of 11.7 weeks. The other 31 thumbs in 26 children were only observed. The results were categorized as cured, improved, or nonimproved. Follow-up was conducted after a mean of 20 months (age, 43 months). Result in the splinted group showed cured in 12 thumbs, improved in 10 thumbs, and nonimproved in 9 thumbs, whereas in the observed group, result showed 4, 3, and 24, respectively. Splinting results in 71% trigger thumbs cured or improved that is better than observation alone. The subsequent surgical release for the nonimproved trigger thumbs after splinting still had excellent results. Because surgical release for trigger thumb is not urgent, we suggest extension splinting to be a treatment option before the elective surgery.

Child, Preschool↗
PubMed2005

Dynamic versus static splinting of simple zone V and zone VI extensor tendon repairs: a prospective, randomized, controlled study.

The authors present the first prospective, randomized, controlled study comparing postoperative dynamic versus static splinting outcomes of patients following extensor tendon repair. Patients who incurred simple and complete lacerations of their extensor tendons in zones V and VI were enrolled into the study and underwent either static splinting (n = 17) or dynamic splinting (n = 17) following primary acute repair of tendons. Total active motion was improved in the dynamic group when compared with the static group in the injured digits at 4 weeks (180.5 +/- 4 degrees versus 131.3 +/- 61 degrees; p = 0.006), at 6 weeks (239 +/- 21.9 degrees versus 205.5 +/- 53.4 degrees; p = 0.048), and at 8 weeks (247+/- 19.8 degrees versus 216.3 +/- 36 degrees; p = 0.051), but not at 6 months (253.1 +/-18.8 degrees versus 250.5 +/- 32 degrees; p = 0.562). Similarly, total active motion averaged for all digits (injured and noninjured) of the involved hand was improved in the dynamic group over the static group at 4 weeks (209.8 +/- 31.3 degrees versus 140 +/- 58.2 degrees; p < 0.001) and at 6 weeks (241.5 +/- 17.2 degrees versus 217.1 +/- 42.4 degrees; p = 0.024), but not at 8 weeks (249.6 +/- 16 degrees versus 234.8 +/- 24.5 degrees; p = 0.215) or 6 months (252.3 +/- 14 degrees versus 249.1 +/- 31 degrees; p = 0.450). Grip strength outcomes demonstrated improved grip force for the dynamic group when compared with the static group at 8 weeks (81.3 +/- 18.0 percent versus 59.2 +/- 20.4 percent; p = 0.004) but not at 6 months (89.6 +/- 5.6 percent versus 82.1 +/- 22.0 percent; p = 0.595). Patients demonstrated forceful grip greater than or equal to 80 percent of the noninjured hand in 55 percent of patients in the dynamic group versus 15 percent of patients in the static group at 8 weeks. Patients demonstrated forceful grip greater than or equal to 80 percent of the noninjured hand in 100 percent of patients in the dynamic group versus 73 percent of patients in the static group at 6 months. The authors' findings suggest that dynamic splinting of simple, complete lacerations of the extensor tendons in zones V and VI provides improved functional outcomes at 4, 6, and 8 weeks but not by 6 months when compared with static splinting. Therefore, they recommend dynamic splinting of simple, complete extensor tendon lacerations in zones V and VI only to select patients who are motivated and desire earlier return to full functional capacity.

Adult↗
PubMed1980

Effects of an occlusal splint on integrated electromyography of masseter muscle in experimental tooth clenching in man.

Six male subjects exercised maximal voluntary tooth clenching until fatigue appeared in the masseter muscle and until pains and exhaustion of this muscle could no longer be endured; that is, the fatigue threshold and the pain tolerance of the muscle were determined in seconds. An occlusal splint was inserted and the clenching exercises were repeated. During these exercises, and also during 10s of clenching, the electrical activity in the masseter muscle was recorded by bipolar surface electrodes and linearly integrated. Use of the splint did not result in significant changes in the subjective sensations of onset of fatigue and endurance of pain. As the periods of clenching increased, after insertion of the splint, the electrical activity decreased consistently, and use of the splint caused a significant decrease in the electrical activity of the pain tolerance test. As induced by the splint, there was no orderly pattern in changes of the fatigue thresholds and pain tolerances in relation to changes in the electrical activities of these parameters. The mode of action of the splint, in reducing the muscle activity, might have been that of stretching the elevator jaw muscles beyond their resting length.

Adult↗
PubMed1990

The effects of an occlusal splint on the electromyographic activities of the temporal and masseter muscles during maximal clenching in patients with a habit of nocturnal bruxism and signs and symptoms of craniomandibular disorders.

The effects of a full arch maxillary plane occlusal splint on the level of electromyographic (EMG) activity in the anterior temporal and masseter muscles during maximal clenching were studied in 31 patients with a habit of nocturnal bruxism and signs and symptoms of craniomandibular disorders, before and after occlusal splint therapy. The results showed, before treatment, that the occlusal splint changed significantly (in 71% of patients) the level of EMG activity during maximal clenching. However, these changes were not consistent and differed between patients and even, in some patients, between muscles. After long-term occlusal splint therapy and improvement of the signs and symptoms of craniomandibular disorders, the number of patients who had an identical level of EMG activity during maximal clenching in the intercuspal position and on the occlusal splint tended to increase. Moreover, in these patients the level of symmetry of action in pairs of muscles during maximal clenching was strong, and the splint did not change this level of symmetry.

Adolescent↗
PubMed1991

Effect of occlusal bite-raising splint on electromyogram, motor unit histochemistry and myoneuronal dimensions in rats.

Composite resin bite-raising splints were fabricated on both sides of the upper jaw in rats. EMG activity of the deep masseter muscle was monitored continuously for 24 h before and up to 4 weeks after treatment. Together with the EMG activity, measurements of the neuromuscular junction area and muscle fibre histochemistry were made. EMG activity showed great variability immediately after splint fabrication. Some of the animals showed increased EMG activity, while others exhibited less activity 48 h after splint application. Overall, the fluctuation lasted for about 4 days, and after approximately 7 days all the animals exhibited decreased EMG activity, followed by a gradual increase in activity towards baseline levels. The neuromuscular junction territory increased significantly 5-10 days after splint application. Histochemical characterization of the deep masseter muscle revealed that it contained the three main types of muscle fibre: slow oxidative (SO), fast-oxidative-glycolytic (FOG) and fast glycolytic (FG). The frequency distribution of fibre types did not change after bite-raising splint treatment. These findings indicated that splint treatment in rats is effective in reducing EMG activity, while the muscle type characteristics remain stable. The effect of lower activity on the motor end-plates suggested that the neuromuscular junctions are quite sensitive to functional changes.

Adenosine Triphosphatases↗
PubMed2005

Comparative prospective study on splint therapy of anterior disc displacement without reduction.

A prospective randomized study was carried out to compare the therapeutic success of two different types of splint in patients with painful anterior disc displacement of the temporomandibular joint. The patients in Group I (n = 20) received stabilization splint therapy and the patients in Group II (n = 20) pivot splint therapy. Clinical investigation of the craniomandibular system was performed before and 1, 2 and 3 months after therapy and this was accompanied by subjective evaluation by the patients of their symptoms, using a validated questionnaire with visual analogue scales (VAS). There was a significant increase in maximum jaw opening and a significant reduction in subjective pain in both groups during the course of therapy (Wilcoxon test, P < 0.05). Active jaw opening increased by a mean of 8.05 mm in the group of patients treated with a stabilization splint (Group I). The comparable figure with pivot splint therapy (Group II) was 8.26 mm. The VAS scale value in Group I was reduced by 30.54 units and in Group II by 39.36 scale units. However, neither of these differences between the groups was statistically significant (Mann-WhitneyU-test, P > 0.05). It can be concluded that both types of splint provided effective therapy in patients with anterior disc displacement.

Adolescent↗
PubMed1999

Effect on nasal resistance of an external nasal splint and isotonic exercise.

OBJECTIVES: The now commonplace wearing of external nasal splints by sportsmen and athletes has never been scientifically evaluated. The present study looks into the effect of isotonic exercise on nasal resistance, and examines whether this effect is altered by the wearing of an external nasal splint. METHODS: Twenty subjects not suffering from rhinitis were tested. Nasal resistance measurements were recorded using an anterior rhinomanometer before and after isotonic exercise with and without an external nasal splint. Pulse and blood pressure were measured before and after exercise. RESULTS: Significant changes were observed in pulse (p < 0.001) and both systolic (p < 0.002) and diastolic (p < 0.001) blood pressure in response to exercise. Significant differences were seen in nasal resistance when the splint was applied (p < 0.001) and after exercise (p < 0.003). No significant difference was observed after exercise when the splint was worn (p = 0.167). CONCLUSIONS: External nasal splints decrease nasal resistance at rest but are of little value during isotonic exercise.

Airway Resistance↗