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At least 325 records · Page 18Linked to original sources
PubMed2004

Upper limb splints and the right to drive--who decides?

Management of upper limb pathology frequently requires the wearing of a splint for a period of time. Our Occupational Therapy Department fits approximately 2000 thermoplastic splints per year. A significant number of these patients drive. In a bid to try and elucidate who is thought to have and who actually has responsibility for deciding which splints are safe to drive in we sent photographic questionnaires to patients, general practitioners (GPs), the police and driver and vehicle-licensing agency (DVLA). We performed a telephone survey of insurance companies. It is the duty of the patient to contact the DVLA if they have any doubt about their ability to drive safely whilst wearing the splint. Our results demonstrate only 10% of patients and 4% of GPs are aware of this. There was strong agreement between patients, GPs and the police about which splints would probably be safe to drive in, but patients need to be reviewed on an individual basis. Our study demonstrates a lack of knowledge among patients and GPs which could expose either group to adverse legal action in the event of an accident.

Arm Injuries↗
PubMed2006

The high-density foam aeroplane splint: a modified approach to the treatment of axilla burns.

Axillary burns and contractures are physically debilitating. Early splinting and patient compliance is crucial to maximise functional outcomes. Traditional treatment of axillary contractures involves fabrication of thermoplastic aeroplane splints. However, thermoplastic splints can be time consuming to fabricate, heavy, uncomfortable and difficult to don by patients and family. Due to these problems a modified high-density foam (HDF) aeroplane splint was designed. The purpose of designing a different type of aeroplane splint was to increase compliance, comfort and ease of use for health professionals, patients and family, and to decrease fabrication time.

Axilla↗
PubMed2004

Wound splinting modulates granulation tissue proliferation.

Attachment of the extracellular matrix to a substratum is important for fibroblast survival and proliferation in three-dimensional in vitro culture systems. We hypothesized that wound matrix attachment in a wound splinting model would modulate wound cell proliferation in vivo. Male rats were excisionally wounded on the dorsum, and a splint was sutured to the wound edge. In one experiment (N = 12), 6 rats were desplinted on day 5, and then all were sacrificed 24 h later, 6 h after 5-bromo-2'-deoxyuridine (BrdU) injection. In the second experiment (N = 18), 6 rats each were desplinted, desplinted with wound edge release, or not disturbed, followed by BrdU injection and sacrifice 24 h later. BrdU-labeled nuclei were quantified on frozen sections of granulation tissue, cut at three different levels. In the first experiment, the percentage of BrdU-positive nuclei per high power field (hpf) in the splinted vs. desplinted animals was 6.15 +/- 2.45 (S.D.) vs. 3.03 +/- 1.58%* p<0.001, ANOVA. In the second experiment, the number of BrdU-positive per hpf was 33.1 +/- 17.4 vs. 14.5 +/- 17.1 vs. 10.2 +/- 9.1* (splinted vs. desplinted vs. desplinted/released); *p<0.001 [analysis of variance (ANOVA)]. Removal of the wound splint decreased the rate of BrdU-labeled cells in the granulation tissue by approximately 50%; complete disruption of wound matrix attachment may have decreased this rate even further. Wound cell proliferation is modulated by lateral attachment of the wound matrix.

Analysis of Variance↗
PubMed2005

Anterior midline point stop device (AMPS) in the treatment of myogenous TMDs: comparison with the stabilization splint and control group.

Two occlusal splints, the full-arch stabilization splint and the anterior midline point stop (AMPS) device, were evaluated for their efficiency in relieving myogenous temporomandibular disorders (TMD). One hundred and fourteen patients with myogenous TMD were distributed into 3 groups. The first group was treated with the AMPS device, the second with the stabilization splint, and the third group was the control group. Pain intensity was scored using the visual analogue scale before treatment and 1 month and 3 months after treatment. Statistical Package for the Social Sciences (SPSS, Chicago, Ill) and multiple comparisons tests were used to compare results before and after treatment and to compare the groups. The use of AMPS device in the first group resulted in a significant improvement after 1 month and 3 months (P < or = .001) and showed a 56.66% pain reduction. A significant improvement was also noticed in the second group (P = .001) with a 47.71% pain reduction. Although pain reduction percentage appeared more in the first group, this was not statistically significant. There was a highly significant difference between groups treated with both kinds of splints and the control group. It was concluded that both types of occlusal splints are beneficial to patients with myogenous TMD.

Adolescent↗
PubMed1987

Long-term functional results of prosthetic airway splinting in tracheomalacia and bronchomalacia.

The long-term functional results of splinting a collapsing major airway with a silastic Marlex mesh prosthesis were assessed. Six patients in whom follow-up has been longer than 4 years (mean 5.3 years) were studied. The prosthetic semirigid splints had been implanted in five children with tracheomalacia and one with bronchomalacia. Mean age at the time of airway splinting was 4 years (range 6 months to 8 years). At their last clinical evaluation, all six children were leading normal active lives. Three had mild respiratory symptoms not related to the splinting. The only long-term complication was a serous effusion that developed around the splint and compressed the trachea in one child 2 years postoperatively. Tracheal fluoroscopy, barium swallow, and computed tomography scans of the trachea in five patients demonstrated satisfactory tracheal caliber without airway collapse during expiration and coughing. Pulmonary function testing showed a mild increase in airway resistance in one child who had had a tracheostomy. These results demonstrate that the application of composite synthetic graft to a segment of a malacic airway in young patients can provide long-term relief from airway collapse without compromising airway growth.

Airway Obstruction↗
PubMed1986

The reaction of the periodontium to different types of splints. (I). Clinical aspects.

To study the influence of splints on the periodontia over a period of time, Obwegeser and Merkx splints were applied on beagles. Clinical evaluation using different periodontal parameters was carried out before, and 48 h, 3 weeks and 6 weeks after splinting. It was shown that both splints act as plaque-retentive devices and provoke gingival inflammation. A statistically significant difference between both splints could, however, only be demonstrated for the plaque index.

Animals↗
PubMed1996

Activity of the extrinsic finger flexors during mobilization in the Kleinert splint.

This study investigated the activity of the extrinsic finger flexor muscles during active extension in the Kleinert splint. Electromyographic data on the activity of the profundus and superficialis flexor muscles in 10 healthy subjects were recorded with use of fine needle electrodes. The subjects exercised in the original Kleinert splint as well as in several modifications of the splint, which varied with respect to (1) wrist position, (2) position in which extension of the metacarpophalangeal joint was blocked, (3) number of fingers dynamically splinted, (4) nature of the spring mechanism, (5) amount of resistance, and (6) use of a palmar pulley. Persistent flexor muscle activity during active extension was observed in the majority of subjects. This coactivity was more often observed for the superficialis muscle than for the profundus muscle. The least amount of coactivity was found when extension was least resisted. This study does not support the concept that the flexor muscles relax during resisted extension in the Kleinert splint.

Electromyography↗
PubMed1997

Simplified functional splinting after extensor tenorrhaphy.

The medical records of 22 patients who had a total of 61 simple or complex lacerations of finger, thumb, and wrist extensor tendons repaired in zones V-VIII (thumb zones TIII-TV) were reviewed. By 7 days after surgery, custom-molded splints were applied to hold the patients' wrists extended (approximately 30 degrees) and the metacarpophalangeal (MP) joints flexed slightly (20 degrees-30 degrees), leaving the interphalangeal (IP) joints free. If thumb tenorrhaphies were done, the thumb carpometacarpal and MP joints were included and splinted in neutral (0 degree extension) position. Patients performed active JP joint range of motion (ROM) exercises as instructed. At a mean follow-up period of 4.5 months (range, 1.5-12 months), there were no residual impairments that interfered with patients' activities of daily living or prevented their return to preinjury employment status; 19 of 22 patients (86%) had good or excellent results, based on objective criteria of active motion. There were no tenorrhaphy failures. The results support the concept of functional splinting techniques, which allow early active IP joint ROM while protecting the repaired tendons, thus resulting in less joint stiffness than older methods of static splinting without being as complicated and labor-intensive as dynamic splinting.

Activities of Daily Living↗
PubMed1993

The Kleinert dynamic splint: where it fails and how it can be modified.

After primary tenoraphy of flexor tendons one often finds a hampered function of the DIP-joint. Analysis of the pattern of early mobilization exercised by our patients in the Kleinert splint and analysis of the excursions of the flexor tendons of fresh unembalmed specimens brought us to the conclusion that the Kleinert dynamic splint fails in maintaining a sliding movement of the deep and the superficial flexor tendons along each other because the splint excludes motion at the distal interphalangeal joint. Based on our observations we modified the Kleinert dynamic splint. Our experience with 37 patients shows that this modified splint gives a better function in the DIP-joint.

Biomechanical Phenomena↗
PubMed1987

[Influence of a splint in maintaining the opening of the first web in arthritis of the base of the thumb].

Trapezometacarpal osteoarthritis of the thumb includes an progressive aspect in the form of contracture of the first web. The wearing of a C-shaped bar splint is designed to prevent this contracture. The heat-molded plastic splint used by the authors is characterised by the following 3 points: reduction, stabilisation and comfort. The authors have systematically evaluated the action of the splint by measuring the variations in the M1M2 and TM1 angles on X-rays with and without the splint. Analysis of the quantitative data and of the X-rays shows an improvement in the opening of the first web and a reduction in the subluxation of the trapezometacarpal joint. Although they did not analyse the intrinsic process, the authors also noted a very marked reduction in pain (90% of cases) by wearing the splint.

Aged↗
PubMedDate not supplied

The biomechanics of a thumb carpometacarpal immobilization splint: design and fitting.

Splinting for the common osteoarthritis of the carpometacarpal (CMC) joint of the thumb is infrequently described in the literature, but the few splints that are described include one or both adjacent joints. This paper describes the design and biomechanics of a custom-molded thumb CMC immobilization splint that excludes the thumb metacarpophalangeal and wrist joints. The problem of the imbalance of extrinsic extensor/abductor forces against the intrinsic flexor/adductor forces is described. The accompanying weakening of the thumb CMC capsule allows dorsal shifting of the proximal end of the metacarpal, producing pain. The splint described in this paper 1) prevents motion of the first metacarpal in relation to the other metacarpals, 2) prevents tilting (flexion) of the first metacarpal during pinch, and 3) allows unrestricted thumb metacarpal and wrist joint motion. Attention to detail during construction is required for an accurate pattern, precise positioning of the CMC joint during molding, accurate molding around the first metacarpal, and well-distributed pressure. This design may also be used for protection following thumb CMC arthroplasty or thumb CMC sprain or strain and as a base for thumb metacarpophalangeal and/or interphalangeal mobilization splinting.

Activities of Daily Living↗
PubMedDate not supplied

Splinting for symptoms of carpal tunnel syndrome during pregnancy.

OBJECTIVE: To determine whether splints are effective in decreasing symptoms of carpal tunnel syndrome during pregnancy. METHODS: Case series at a military hospital of 82 pregnant women who had symptoms of carpal tunnel syndrome (135 hands). The author compared the ratings of eight subjective symptoms (tingling, numbness, pain, weakness, wakes you up, drops things, swelling, and stiffness) and grip (Jamar) and pinch (two-point, three-jaw, and key) strengths at the time of referral and 1 week after splinting (polyform volar splint with the wrist in 10 to 15 degrees of extension). Forty-eight women (82 hands) returned 1 month postpartum for reassessment. Grip and pinch strengths of an additional 26 women who had not had problems with their hands during pregnancy were measured 1 month postpartum. RESULTS: One week after splinting, there was an average increase of 5.4 pounds in grip strength and over 1 pound in each type of pinch strength (p < 0.0001). There was a decrease in each of the eight symptoms (range, -0.9 to -1.6; scale of 5). At 1 month postpartum, symptoms had resolved completely for 76% of the subjects (weakness had resolved for 76% and wakes you up for 93%). Strength was improved, but was not normal. However, the women who had not had hand problems during pregnancy did have normal strengths. CONCLUSIONS: Splinting is a noninvasive method for helping to decrease the uncomfortable symptoms of carpal tunnel syndrome during pregnancy.

Adult↗
PubMedDate not supplied

Splinting in the management of proximal interphalangeal joint flexion contracture.

Proximal interphalangeal (PIP) flexion contracture is a common complication following hand injuries and conditions. This study investigated the treatment outcome of 20 subjects with PIP flexion contracture who followed a dynamic splinting program using either a Capener or low-profile outrigger. The splint applied a 250-g force to the distal end of the middle phalanx. Each patient was instructed to wear the splint for 8 to 12 hours per 24 hours for 8 weeks followed by a 2- to 3-week weaning period. Passive extension was evaluated objectively using torque range-of-motion measurement. The average pretreatment flexion contracture was 39 degrees. Final extension deficit averaged 21 degrees, an improvement of 18 degrees. There was no statistically significant effect on final results based on joint stiffness (as expressed by the slopes of the torque angle curves). Total end-range time (TERT) averaged 10 hours per 24 hours, for an average period of 4.3 months. Statistical analysis showed that splinting time was the only statistically significant factor affecting outcome. The correlation coefficients showed that the longer the contracture was present, the stiffer the joint and the less the contracture resolved. Dynamic splinting was an effective form of treatment for PIP flexion contracture.

Adult↗
PubMedDate not supplied

An alternative splint design for trigger finger.

Conventional resting splints used to treat digital stenosing tenosynovitis (trigger finger) are often discontinued or not worn consistently by patients. Informal reports by patients indicate that the splints are too bulky, interfere with activities of daily living, and are visibly too noticeable. Since resolution of the condition may take as long as 9 weeks, this is a significant issue. A new splint design has been developed to avoid these shortcomings in hopes that physicians and therapists will have successful compliance when utilizing splinting in the treatment of this condition. It is both cost-effective and noninvasive. This article describes the condition and treatment options for digital stenosing tenosynovitis and fabrication techniques for the proposed alternative splint.

Constriction, Pathologic↗
PubMed2002

The use of knee splints after total knee replacements.

The aim of this randomised prospective study was to establish whether the use of knee splints following total knee replacement is necessary. The study included 81 patients undergoing total knee replacement who were randomised into a 'splint' and a 'no splint' group post-operatively. The following parameters were recorded: The range of movement pre-operatively, 5 days post-operatively and 6 weeks post-operatively; the length of time to straight leg raise; the blood drained from the wound; and the amount of post-operative analgesia required. We found that patients in the 'no splint' group achieved significantly greater flexion at 5 days and 6 weeks post-operatively but drained significantly more blood from the wound. Transfusion requirements were similar in the two groups. There was no other significant difference in the parameters measured between the two groups. In conclusion we found no evidence to advocate the use of knee splints following total knee arthroplasty.

Aged↗
PubMedDate not supplied

A retrospective study of standing gastrocnemius-soleus stretching versus night splinting in the treatment of plantar fasciitis.

Plantar fasciitis is the most common cause of heel pain, yet the conservative treatment of plantar fasciitis is not standardized. This open retrospective study compared the effects of standing gastrocnemius-soleus stretching to a prefabricated night splint. One hundred and sixty patients with unilateral or bilateral plantar fasciitis were evaluated and treated according to the standard regimen in addition to either night splints or stretching. Seventy-one patients performed standing stretching of the gastrocnemius-soleus complex. Eighty-nine patients utilized the prefabricated night splint without standing stretching. The night splint treatment group had a significantly shorter recovery time (p < .001), fewer follow-up visits to recovery (p < .001), and fewer total additional interventions (p = .034) compared to the stretching group. Absolute body weight, body mass index, and age did not have a statistically significant effect on the time to recovery or additional interventions needed. The duration of pain prior to this treatment was a predictive factor and was associated with increased time to recovery and increased number of treatment interventions. Its was concluded that early treatment in a standardized four-tiered treatment approach, including the night splint without standing stretching of the gastrocnemius-soleus complex, speeds time to recovery.

Fasciitis↗
PubMed2000

Evaluation of the Herbst Mandibular Advancement Splint in the management of patients with sleep-related breathing disorders.

Sleep-related breathing disorders such as snoring and obstructive sleep apnoea syndrome are the cause of significant social disruption and hypersomnolence. Several intraoral appliances for the treatment of these disorders have been described, especially where nasal continuous positive airway pressure is poorly tolerated. Mandibular Advancement Splints, such as the Herbst splint used in this study can also be offered to patients with mild to moderate sleep apnoea and simple snorers. The success and compliance rate noted in the literature are quite diverse. Few side-effects have been reported. We therefore undertook this study to assess: (1) the compliance; (2) the effectiveness; and (3) the side-effects in the long- and short-term. All patients for whom a Herbst splint had been prescribed in the last 18 months were sent a postal questionnaire regarding the above mentioned issues. In all, 179 questionnaires were posted and on analysis of the 132 returned it was noted that 82% of splints were worn and 88% of patients found the device to be effective. The long-term side-effects were minimal. In addition objective assessment on 10 patients with and without a jaw-retaining device was also obtained. We conclude that the Herbst Mandibular Advancement Splint is a justifiable option in selected subjects with sleep-related breathing disorders.

Female↗
PubMed1998

Effects of a bite-raising splint on the duration of the chewing cycle and the EMG activities of masticatory muscles during chewing in freely moving rabbits.

Metal bite-raising splints of 0.5 mm thickness were attached to the upper molar teeth on both sides of the jaw in rabbits. The effects of these splints on masticatory behaviour during the chewing of soft food (bread) by freely moving rabbits were investigated. We recorded electromyograms (EMGs) of the masseter and digastric muscles. The animals exhibited prolongation of the chewing cycle, decreased EMG activity of the masseter muscle and increased EMG activity of the digastric muscle during chewing after introduction of the bite-raising splints. The effects of the splints on the activities of masticatory muscles were abolished by bilateral sectioning of the maxillary and inferior alveolar nerves. It seems likely that afferents from oral sensory receptors were responsible for the changes in masticatory behaviour after the introduction of the occlusal splint.

Animals↗