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PubMed2002

Management of simple finger injuries: the splinting regime.

Mallet finger injury, ligamentous sprain and dislocation of proximal interphalangeal (PIP) joint of fingers are very common types of simple hand injuries. Immediate correction of alignment and protection of the injured area will facilitate early joint movement while maximising functional recovery. This article is to introduce the fabrication of three simple finger splints to tackle these injuries for quick and effective conservative treatment. They are the mallet finger splint, buddy splint and dorsal finger block splint. The indications and functions of the three types of splints are discussed. The fabrication process will be illustrated; including materials needed, pattern drafting and steps of molding. Wearing regime and precautions will be highlighted to ensure effective patient compliance to splinting programme for the finger injuries.

Equipment Design↗
PubMed2002

Splinting programme for patients with burnt hand.

Splintage is commonly used in conjunction with pressure therapy to tackle the contracted scars, make it supple and thus minimise dysfunction. A static or dynamic splint can provide valuable therapy that goes beyond any treatment session. The patient's active participation in the splint programme can facilitate early recovery. A good splinting design and wearing regime often depends on the therapist's understanding and integration of visco-elastic properties in soft tissues, maturation process of hypertrophic scars and mechanical principles in splinting. Different types of splints serve different functions at different stages of rehabilitation. A suitable and efficient application of splints can minimise most of the corrective surgical intervention and alleviate psychological trauma. This article attempts to highlight the clinical rationale and special considerations when applying different splintage on burns patients with upper limbs involvement.

Axilla↗
PubMed1994

Thermoplastic splint for use after nasal fracture.

I have used this splint on 16 patients between November 1992 and July 1993. The device works as well as or better than other similarly designed thermoplastic nasal splints that are commercially available, and it is significantly less expensive. Commercially available splints run about 5 to 10 dollars per unit. This device as described costs approximately 50 cents per unit. This method of external splinting of the nose is extremely reliable and satisfactory to both myself and the patient. No splint is unobtrusive, and I have found that my patients like these bright and colorful splints.

Hot Temperature↗
PubMed2005

A change of occlusal conditions after splint therapy for bruxers with and without pain in the masticatory muscles.

Bruxism has been suggested as an initiating or perpetuating factor in a certain subgroup of temporomandibular disorders (TMD), however, the exact association between bruxism and TMD remains unclear. This study aimed to demonstrate the difference in responses between bruxism and a subgroup of TMD to a full-arch maxillary stabilization splint from the standpoint of an occlusal condition. This study was conducted to verify the null hypothesis that there were no differences between bruxer groups with and without myofascial pain (MFP) with respect to the changes in occlusal conditions after the use of a splint. Thirty bruxers with MFP and 30 without MFP participated. Occlusal conditions were examined before and after splint therapy, and occlusal changes following the use of a splint were compared between the two groups. The frequency of occlusal changes after splint therapy was significantly higher in the MFP bruxer group than the non-MFP bruxer group (p < 0.05) for the occlusal conditions investigated in the present study. However, no statistical differences were found with regard to each occlusal condition. This result may show the variety of splint effects and may demonstrate a heterogeneous aspect to bruxism and myofascial pain.

Bruxism↗
PubMed2006

Surgery is more cost-effective than splinting for carpal tunnel syndrome in the Netherlands: results of an economic evaluation alongside a randomized controlled trial.

BACKGROUND: Carpal tunnel syndrome (CTS) is a common disorder, often treated with surgery or wrist splinting. The objective of this economic evaluation alongside a randomized trial was to evaluate the cost-effectiveness of splinting and surgery for patients with CTS. METHODS: Patients at 13 neurological outpatient clinics with clinically and electrophysiologically confirmed idiopathic CTS were randomly allocated to splinting (n = 89) or surgery (n = 87). Clinical outcome measures included number of nights waking up due to symptoms, general improvement, severity of the main complaint, paraesthesia at night and during the day, and utility. The economic evaluation was performed from a societal perspective and involved all relevant costs. RESULTS: There were no differences in costs. The mean total costs per patient were in the surgery group EURO 2,126 compared to EURO 2,111 in the splint group. After 12 months, the success rate in the surgery group (92%) was significantly higher than in the splint group (72%). The acceptability curve showed that at a relatively low ceiling ratio of EURO 2,500 per patient there is a 90% probability that surgery is cost-effective. CONCLUSION: In the Netherlands, surgery is more cost-effective compared with splinting, and recommended as the preferred method of treatment for patients with CTS.

Carpal Tunnel Syndrome↗
PubMed1999

Avascular necrosis and the Aberdeen splint in developmental dysplasia of the hip.

Between January 1987 and December 1988 there were 7575 births in the Swansea maternity unit. Of these 823 (10.9%) were considered to be at 'high risk' for developmental dysplasia of the hip (DDH). Static ultrasound examination was performed in each case and the results classified on the basis of the method of Graf. A total of 117 type III-IV hips in 83 infants was splinted using the Aberdeen splint. Radiographs of these hips were taken at six and 12 months. Hilgenreiner's measurements of the acetabular angle were made in all cases and the development of the femoral capital epiphysis was assessed by measuring the epiphyseal area. The effect of splintage on the acetabular angle and the epiphyseal area between the normal and abnormal splinted hips was compared. Radiographs of 16 normal infants (32 normal unsplinted hips) were used as a control group. This cohort has now been followed up for a minimum of nine years. There have been no complications as a result of splintage. The failure rate was 1.7% or 0.25 per 1000 live births. No statistical difference was found when comparing the effect of splintage on the acetabular angle and epiphyseal area between normal and abnormal splinted hips and normal unsplinted hips. Our study has shown that while the Aberdeen splint had a definite but small failure rate, it was safe in that it did not produce avascular necrosis. The current conventional view that a low rate of splintage is always best is therefore brought into question if the Aberdeen splint is chosen for the management of neonatal DDH.

Acetabulum↗
PubMed1991

Functional splinting versus plaster cast for ruptures of the ulnar collateral ligament of the thumb. A prospective randomized study of 63 cases.

In a prospective randomized study that included 63 consecutive thumbs with injuries of the ulnar collateral ligament of the metacarpophalangeal (MCP) joint of the thumb, plaster cast immobilization was compared with functional treatment with a splint. The splint allowed flexion and extension of the MCP joint, but prevented ulnar and radial deviation of the thumb. The study included both operated on and nonoperated on cases where surgery was performed only when the torn ligament was regarded as displaced. Of 40 thumbs treated nonsurgically, 21 were treated with a cast and 19 with a splint. Of 23 thumbs treated surgically, 10 were immobilized postoperatively in a plaster cast and 13 were treated with the splint. At the follow-up examination after 15 (11-41) months, there was no difference between the treatment groups as regards stability, range of motion, strength of the injured thumb, and length of sick leave. However, the patients considered the splint more comfortable than plaster cast immobilization. We conclude that immobilization of the thumb after a ligamentous injury with a movable splint is strongly preferred by the patients and that the functional results of this technique are equal to plaster cast immobilization after both surgical and nonsurgical treatment.

Adolescent↗
PubMed1983

Low profile dynamic splinting of the injured hand.

Dynamic splinting is a well-accepted modality in gaining joint motion in the injured hand. Presented is a splinting design system referred to as "low profile" dynamic splinting whereby high outriggers are avoided. A review of the literature reveals that this technique is based on the original design approach used by Dr. Sterling Bunnell. Described are the basic principles of the low profile design system, with illustrations of the system in specific splints and specific construction details. This splinting system is indicated for a stiff hand that has sustained direct trauma. Hands with a muscle imbalance secondary to a central nervous system or peripheral nerve lesion require a different splinting approach, which is not within the scope of this paper.

Finger Injuries↗
PubMed1990

An adjustable splint for forearm supination.

The adjustable supination splint is used in select cases in which traditional mobilization therapy is not productive in supination gains. The success of the splint varies depending on many factors, including the type and severity of the injury; the timing of the intervention; the patient's age; and the patient's tolerance of and compliance with the treatment program. The therapist must consult with the physician and have his or her approval before initiating the treatment regimen. Splint use is contraindicated in patients with unstable fractures or with injuries that require surgical intervention before splinting. Therapists should watch for edema, pain, and neurological changes. Depending on the severity of these symptoms, the splint may need to be discontinued or the wearing time and tension adjusted. In our experience at Union Memorial Hospital and in our weighing of the above considerations, we have found favorable results in the use of the adjustable supination splint, with gains in range of motion and function in select patients.

Adolescent↗
PubMed2001

The impact of using intranasal splints on morbidity and prevalence of adhesions.

OBJECTIVE: To study the effect of using intranasal splints for prevention of adhesions and to assess the morbidity associated with their use. METHODS: A retrospective study based on 2 tertiary hospitals from 1988-1995. One hundred and fourteen patients were divided into 2 groups. Group one with splints and group 2 without. The splints were used for 10 days and nasal toilet was carried out twice. Score of adhesions, perforation, bleeding, pain, crusting, and septum position were recorded. RESULTS: Adhesions in both groups were almost the same as well as septum medialization and perforation scores. Pain and crusting were more common in the splinted group (p-value <0.001). CONCLUSION: The use of intranasal splints should be individualized. Nasal irrigation is of importance to prevent crusting. The morbidity associated with intranasal splints should be considered before use.

Adolescent↗
PubMed2000

[To probe into the practicability of using the jaw position of eliminating TMJ clicks as the therapeutic position of repositioning splint].

OBJECTIVE: To evaluate that it was practicable to use the jaw position of eliminating TMJ clicks as the therapeutic position of repositioning splint and to probe into the therapeutic mechanism of repositioning splint. METHODS: 25 patients with reducible disc displacement were treated with repositioning splint. The therapeutic jaw position was the position without TMJ clicking, then verified by Arthrography. The treatment effect was observed. RESULTS: Among 25 cases, 19 discs were completely recaptured, 5 incompletely recaptured, 1 not recaptured. Once the splints inserted, the movements of disc-condyle complex were smooth. After treatment finished, the opening types were improved, the clicks were lessened. CONCLUSIONS: It's practicable to use the jaw position of eliminating clicks as the treatment jaw position of repositioning splint. The therapeutic mechanism of repositioning splint may be that it altered the relationship of disc and condyle and improved their movement. That was favorable to fibrize the retrodiscal tissue and to strengthen the posterior band of disc.

Adolescent↗
PubMedDate not supplied

Effects of prosthesis materials and prosthesis splinting on peri-implant bone stress around implants in poor-quality bone: a numeric analysis.

PURPOSE: A 3-dimensional finite element model consisting of a bone block and 2 simulated premolar crowns supported by 2 adjacent cylindric implants without immediately surrounding cortical bone was generated and used to investigate the effects of prosthesis materials and prosthesis splinting on the peri-implant bone stress under static loads. MATERIALS AND METHODS: The peri-implant maximum equivalent bone stress (von Mises [VM] stress) was evaluated when a vertical or a horizontal load of 1 N was applied to the center of a single resin, gold alloy, or porcelain crown, nonsplinted or splinted to the adjacent crown. RESULTS: The numeric results indicated that: (1) in a single crown, no significant difference could be found in the maximum VM stress between different materials for both vertical and horizontal loading; (2) splinting the crowns reduced the maximum VM stress induced by the horizontal load, and the maximum VM stress increased about 14% for the horizontal loading when the restorative material was changed from gold alloy or porcelain to resin. DISCUSSION: Under the condition of this study's analysis, prosthesis materials of a single crown have insignificant effects on the peri-implant bone stress. Splinting the crowns reduced the peri-implant bone stress under horizontal load, and gold alloy and porcelain each demonstrated less peri-implant bone stress than resin in the splinted crown situation under static horizontal load. CONCLUSION: Splinting the crowns of adjacent implants with relatively stiff restorative materials is recommended for implants surrounded by poor-quality bone.

Alveolar Bone Loss↗
PubMed1992

Temporomandibular joint movement. Evaluation of protrusive splint therapy with GRASS MR imaging.

Ten temporomandibular joints (TMJs) of 5 healthy volunteers and 19 TMJs of internal derangements in 16 patients with splint therapy were examined with MR imaging. T1-weighted images were obtained only in the closed mouth position, and gradient recalled acquisition in steady state (GRASS) images were obtained in active opening and closing phases, allowing a pseudodynamic display of TMJ movement. All patients received protrusive splint treatment. The usefulness of MR imaging to assess the efficacy of splint therapy was evaluated. Corrected disk position with the splint in place was clearly demonstrated in 9 TMJs, corresponding with elimination of reciprocal clicking. Ten other TMJs of anterior disk displacement without reduction showed uncorrected disk position by the splint. This information could confirm the therapeutic efficacy, or suggest other treatment alternatives. GRASS MR imaging can provide accurate and physiologic information about disk function in initial and follow-up assessment of protrusive splint therapy.

Adolescent↗
PubMed2006

[A rapid prototype fabrication method of dental splint based on 3D simulation and technology].

The conventional design and fabrication of the dental splint (in orthognathic surgery) is based on the preoperative planning and model surgery so this process is of low precision and efficiency. In order to solve the problems and be up to the trend of computer-assisted surgery, we have developed a novel method to design and fabricate the dental splint--computer-generated dental splint, which is based on three-dimensional model simulation and rapid prototype technology. After the surgical planning and simulation of 3D model, we can modify the model to be superior in chewing action (functional) and overall facial appearance (aesthetic). Then, through the Boolean operation of the dental splint blank and the maxillofacial bone model the model of dental splint is formed. At last, the dental splint model is fabricated through rapid prototype machine and applied in clinic. The result indicates that, with the use of this method, the surgical precision and efficiency are improved.

Computer-Aided Design↗
PubMed1994

[Splinting in the treatment of small intestinal obstruction caused by adhesions].

The article discusses the results of small intestine splinting in various modifications with the use of a standard and specially designed silicon catheter. In the period between 1985 and 1990 operations were performed on 28 patients whose ages ranged from 16 to 81 years; all of them were operated on in a state of acute obstruction of the small intestine by adhesions, no fatal outcomes occurred. Various combinations of interventions were accomplished in 5 cases. The splinting catheter had to be removed prematurely in 2 cases because of stoma suppuration; one patient was operated on again 12 months after splinting, a doubtful result was noted in another 3 cases. In the early period the splinting catheter ensures adequate decompression of the intestine and effective prevention of postoperative paresis. The method for fixation of the standard splinting catheter is chosen individually depending on the concrete intraoperative situation. A special catheter with an inflatable cuff can be used which allows splinting of the small intestine without opening its lumen.

Adolescent↗
PubMed1996

Fabrication and strategic significance of a special resin composite splint in advanced periodontitis.

The usefulness of splinting of severely loosened teeth in advanced periodontitis has been discussed extensively, both positively and negatively. Retention of patients own teeth through the aid of this simple and inexpensive resin composite splint provides a satisfactory solution for many affected patients. The fabrication and placement techniques for splints for the anterior and posterior regions are described, as are additional indications for such splints, which are fabricated from resin composite and glass fiber bundles. Such splinting can be provided even for severely loosened, periodontally diseased teeth without danger of intraoperative tooth loss. Long-term retention of such teeth can be ensured only through a risk-oriented postoperative program of oral hygiene and regular examination of the splint.

Adolescent↗
PubMedDate not supplied

Chewing movements in TMD patients and a control group before and after use of a stabilization splint.

PURPOSE: This study assessed the effect of using an occlusal stabilization splint in the maxilla for 6 weeks on certain parameters of chewing movements in subjects with and without temporomandibular disorder symptoms. MATERIALS AND METHODS: Twelve male and 30 female temporomandibular disorder patients with and without a prior whiplash incidence, and individuals without signs and symptoms of temporomandibular disorders participated. The participants formed three groups matched according to gender and age (n = 3 x 14). A maxillary stabilization splint was used during sleep for 6 weeks. An optoelectronic system (MacReflex, Qualisys) was used to record chewing movements at baseline, before using the splint, and after 6-weeks' use of the splint. Calculated parameters were the duration of the chewing cycles, the spatial displacement, and the mean velocity of the mandible while chewing paraffin wax for 20 seconds. RESULTS: On a group basis, the use of an occlusal stabilization splint for 6 weeks did not change the jaw movement parameters in a predictable pattern as recorded under the conditions of this study. On an intraindividual basis, large variations in changes of chewing parameters over time were observed. CONCLUSION: The use of an occlusal stabilization splint for 6 weeks did not alter the jaw movements when chewing a substance with a soft consistency.

Adult↗
PubMed1999

Finite element stress analysis on the effect of splinting in fixed partial dentures.

STATEMENT OF PROBLEM: Long-span fixed partial dentures usually require splinting of multiple abutments to overcome mechanical problems associated with the long edentulous span. Most information and indications for the use of multiple splinted abutments have been empirically derived. PURPOSE: This study analyzed the stress levels in the teeth and supporting structures of a fixed prosthesis and ascertained how the addition of multiple abutments in a fixed prosthesis modifies the stresses and their deflection. MATERIAL AND METHODS: The finite element method was used to analyze mechanical behaviors of a prosthesis and its supporting structures when a fixed prosthesis with several designs replaced a mandibular second premolar and a first molar. Variations of the standard finite element model were made by changing the number of splinted teeth and the level of bone support. RESULTS: A reduction of stress and deflection was observed in the supporting structures when a fixed partial denture was fabricated and teeth were splinted together. Increasing the number of splinted abutments did not reveal a proportional reduction of stress in the periodontium. Stress concentrations were seen in the connectors of prosthesis and in the cervical dentin area near the edentulous ridge. CONCLUSION: Increasing the number of the splinted abutment did not compensate for the mechanical problems of a long-span fixed partial denture sufficiently.

Alveolar Bone Loss↗