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At least 127 records · Page 7Linked to original sources
PubMed2004

A crossover trial of custom-made and commercially available wrist splints in adults with inflammatory arthritis.

OBJECTIVE: To compare the effect of 3 wrist splints (2 prefabricated commercial splints and 1 custom made) on perceived wrist pain, hand function, and perceived upper extremity function in adults with inflammatory arthritis. METHODS: Subjects (n = 45, mean age 49 years, mean disease duration 8.6 years) were randomly assigned to treatment order in a 3-phase crossover trial. Splints were worn for 4 weeks, separated by 1-week washouts. Outcomes were assessed at baseline, after each splint phase and washout period, and at 6 months' followup using a pain visual analog scale (VAS), the Arthritis Hand Function Test, and McMaster-Toronto Arthritis Patient Function Preference questionnaire. Data were analyzed with multivariate analyses of variance (MANOVAs), t-tests, and chi-square tests. RESULTS: There did not appear to be order or carryover effects. MANOVA indicated that wrist splints significantly reduced pain (P = 0.007). The custom leather splint was most effective in reducing pain, from 4.1 cm to 2.8 cm on the VAS (P = 0.001). All splints improved hand strength, and the commercial Rolyan splint provided significantly stronger grip than the Anatech commercial splint (P = 0.04). In contrast to previous studies, splints did not compromise dexterity. There were several significant differences among splints, depending on the outcome measure. Improvements were maintained at 6 months. CONCLUSION: After 4 weeks' use, wrist splints reduce pain, improve strength, and do not compromise dexterity. Similar improvements were achieved with the custom leather splint and Rolyan commercial splint, which were superior to the Anatech commercial splint.

Adult↗
PubMed2003

The precision of computer-generated surgical splints.

PURPOSE: The purpose of this study was to assess the precision of stereolithographic surgical splints generated by the authors' computer-aided design and manufacturing (CAD/CAM) technique by comparing them with the conventional acrylic splints. MATERIALS AND METHODS: Seven volunteers were used. A pair of surgical splints, stereolithographic and conventional acrylic splints, was fabricated for each subject. A novel method was developed to quantify the airspace between the teeth and the splint. Conventional acrylic surgical splints served as a control group. The airspaces were recorded by impression materials and sliced cross-sectionally. Corresponding areas of the cross-sectional airspaces between stereolithographic and acrylic splints were measured and compared. Pearson's correlation coefficient and linear regression tests were performed. RESULTS: Seven pairs of surgical splints were created. The areas of 98 pairs of cross-sectional airspaces were measured. The average difference between the conventional and the STL splints was 0.24 +/- 0.23 mm(2). The correlation coefficient (r) of the airspace areas between the stereolithographic and conventional acrylic splints was 1.00, and the regression coefficient (beta) was 1.03 (P <.01). CONCLUSIONS: The results indicated that the stereolithographic splints, generated by the authors' CAD/CAM technique, had a high degree of accuracy. The fit of the STL splints was the same as the conventional surgical splints. In the future, traditional plaster dental model surgery will be replaced by computer-assisted surgical planning. The surgical splints will be made in the computer and the treatment plan will be directly transferred to the patient.

Acrylic Resins↗
PubMed1986

Universal polycarbonate fracture splint and its direct bonding potential.

A polycarbonate splint has been presented which offers the advantage of the ability of being bonded and/or wired into place. This new type of splint offers several advantages over traditional steel splints. The splint can be bonded and/or wired to the dental arch; the bonding method can be a time-saver. The polycarbonate material is readily malleable and does not possess an intrinsic tension or spring usually found in plastics when they are bent or shaped. The splint is highly esthetic when compared to steel splints. Polycarbonate splints are more economical than steel splints. Molded plastic surfaces are smoother and are more compatible with the oral mucosal than the stamped steel surfaces. Finally, and most importantly, the patient acceptance of polycarbonate splints appears to be very good in comparison with steel splints. The above advantages seem to indicate that the future acceptance of this type of splint for maxillofacial injuries will be good, although, it should be understood that plastic splints are not as strong as steel splints and may occasionally break after several weeks of use. Breakage, however, may not cause the splint to become unusable and usually does not occur until after the 4th week of use, if at all.

Acid Etching, Dental↗
PubMedDate not supplied

Splinting and radial nerve palsy: a single-subject experiment.

This study examines which of three splint designs most effectively improved hand function in a patient with radial nerve palsy, and demonstrates the application of a single-subject experimental design. The static volar wrist cock-up splint (splint 1), dynamic tenodesis suspension splint (splint 2), and dorsal wrist cock-up with dynamic finger extension splint (splint 3) were evaluated. Each splint was worn for 3 weeks, and hand function was assessed by means of standardized measures of function and disability. Statistical significance was calculated using the minimal level of detectable change (MDC) at the 95% confidence level. Only with splints 2 and 3 did a true change in function occur, compared with baseline scores (no splint). In addition, the patient completed all tasks while using splints 2 and 3 but did not complete three tasks while using splint 1. The hand therapists' goal is to fabricate a splint that improves function and that the patient will wear. Only splint 3 met these criteria. This experiment highlights the need to evaluate both the statistical and the clinical significance of treatment interventions.

Aged↗
PubMed2003

The effects of intraoral splints on the masticatory system of pigs.

While evidence exists to support the effectiveness of splints on conditions involving the masticatory musculature, few research projects have examined the results of long-term splint wear. The purpose of this study was to examine the function of the masticatory system over a 2-month time period of splint wear. Young adult female miniature pigs were divided into three groups: a control (C) group that wore no intraoral splint, a control splint (CS) group that wore a splint increasing bite height, and a protrusive splint (PS) group that wore a splint increasing bite height and moving the mandible anteriorly. Splints were worn constantly. Fine-wire needle EMG was performed prior to splint delivery and at 1 and 2 months post-splint delivery. Bilateral superficial masseters and zygomaticomandibularis (ZM, equivalent to deep masseter) muscles were monitored during normal feeding. Absolute EMG output, percentage output, and cycle timing were unaffected by chronic splint wear. However, chewing coordination was significantly changed in the splinted groups in both sessions post-splint delivery relative to baseline readings and to the C group (P < 0.005). Trends indicate that the coordination of the PS group was more greatly altered than that of the CS group.

Animals↗
PubMed2003

Factors that influence the duration of splint wear in peripheral nerve lesions.

OBJECTIVE: To assess the weekly frequency and overall duration of wear for splints used to treat peripheral nerve lesions and factors that possibly influence splint wear. DESIGN: A total of 78 patients (23 women, 55 men) who had been treated with a hand splint for peripheral nerve palsy were interviewed by telephone, based on a preformulated questionnaire. The duration of wear, reasons for terminating use, the effect of the splint, the patients' assessment of splint treatment, the patients' instruction, and the patients' level of education were recorded. Survival analysis for the entire period of wear and logistic regressions to determine factors that influence splint wear were performed. Comparison of effect scores between lesions in the dominant those in the nondominant hand were carried out with a test. RESULTS: The median duration of wear was 6 mo for daytime and 4 mo for nighttime splints. Daytime splints were worn by 85% and nighttime splints by 84% of patients for 5-7 days per week. The reported effect of the splint was the only significant factor that influenced the frequency of wear. The splint was reported to be significantly more effective in the dominant hand than in the nondominant hand. Numerically, radial nerve lesions and cock-up wrist splints were most common. CONCLUSION: Regular splint wear was registered in the majority of patients and was positively influenced by a good effect of the splint, which was reported to be better in the dominant hand.

Adult↗
PubMed2004

Healing of 400 intra-alveolar root fractures. 2. Effect of treatment factors such as treatment delay, repositioning, splinting type and period and antibiotics.

This is the second part of a retrospective study of 400 root-fractured permanent incisors. In this article, the effect of various treatment procedures is analyzed. Treatment delay, i.e. treatment later than 24 h after injury, did not change the root fracture healing pattern, healing with hard tissue between fragments (HH1), interposition of bone and/or periodontal ligament (PDL) or pulp necrosis (NEC). When initial displacement did not exceed 1 mm, optimal repositioning appeared to significantly enhance both the likelihood of pulpal healing and hard tissue repair (HH1). Significant differences in healing were found among the different splinting techniques. The lowest frequency of healing was found with cap splints and the highest with fiberglass or Kevlar splints. The latter splinting procedure showed almost the same healing result as non-splinting. Comparison between non-splinting and splinting for non-displaced teeth was found to reveal no benefit from splinting. With respect to root fractures with displacement, too few cases were available for analysis. No beneficial effect of splinting periods greater than 4 weeks could be demonstrated. The administration of antibiotics had the paradoxical effect of promoting both HH1 and NEC. No explanation could be found. It was concluded that, optimal repositioning seems to favor healing. Furthermore, the chosen splinting method appears to be related to healing of root fractures, with a preference to pulp healing and healing fusion of fragments to a certain flexibility of the splint and possibly also non-traumatogenic splint application. Splinting for more than 4 weeks was not found to influence the healing pattern. A certain treatment delay (a few days) appears not to result in inferior healing. The role of antibiotics upon fracture healing is questionable.

Adolescent↗
PubMed1985

Brief or new: two pronation splints.

For two years we have made pronation splints to assist quadriplegic patients who lack adequate forearm pronation but who have enough upper extremity strength to feed themselves and perform other self-care or functional activities. We have found the splints to be an appropriate alternative to the MAS. The first pronation splint fits underneath the arm, is simple in design and fabrication, and is hidden. However, occasionally the lever of the splint hangs up in the shirt, catches on the post of the wheelchair, or slips out from underneath the arm when the patient reaches away from the body. To eliminate these problems, we designed a second splint. But, this splint requires more time to make and adjust, has two parts to put on instead of one, and is more noticeable because it is worn on top of the arm rather than underneath it. When a patient uses either splint, the degree of pronation may be adjusted according to the activity by slightly rotating the splint either way when strapping it on. For example, full pronation may be required for feeding, but only half the range is necessary to operate the keyboard of a computer or typewriter. Once the Velcro straps are applied, the splints do not slip. The splints are not interchangeable from left to right and assistance is always needed to put them on. For patients with "weak" or "absent" wrist extensors, a wrist support and cuff splint may be used along with the pronation splint or a universal cuff, if wrist extension is adequate. The pronation splints are appropriate for those patients whose forearms supinate when they reach their hand to or near their mouth.

Equipment Design↗
PubMed2005

Splinting of traumatized teeth with focus on adhesive techniques.

Splinting of traumatized teeth is an important step in the treatment of periodontally injured teeth and a precondition of healing of the periodontal tissues. Although it has been shown in animal experiments that replanted teeth without splinting showed analogous healing outcomes compared to splinted teeth, the placement of a splint in dental trauma situations is warranted for medico-legal reasons, for the comfort of the patient, and for the avoidance of additional trauma during periodontal healing. Ideally, the splinting of traumatized teeth should be an easy and fast procedure for the dentist. Trauma splints should be comfortable and easy to keep clean for the patient. The splint should allow some physiologic mobility to promote healing of the periodontal tissues. The widely used and recommended wire-composite splint, with material variations, meets the ideal requirements of current splinting concepts in dental traumatology. Times of using destructive tissue-coverage splints are definitely gone. They are too rigid, compromise periodontal and gingival healing, and are uncomfortable to the patient. The objective of this article is to present the current concepts in splinting of traumatized teeth. The given recommendations about splinting techniques and splinting periods are based on experimental and clinical studies.

Composite Resins↗
PubMed2006

Analysis of relative motion splint in the treatment of zone VI extensor tendon injuries.

PURPOSE: Early protected motion after extensor tendon repair is desirable. The low-profile relative motion splint, described previously by Merritt et al, holds the affected digit in 15 degrees of extension relative to the uninjured digits to allow less-cumbersome early protected motion versus dynamic splinting. Although early clinical results have been favorable, formal biomechanic testing of this approach is lacking. We used an in vitro model to assess the effect of the low-profile relative motion splint on the biomechanics of zone VI extensor tendons by measuring tendon elongation with and without the splint. Tendon elongation also was measured after transection and repair of extensor tendons in zone VI with and without splint protection. METHODS: Ten fresh-frozen cadeveric upper extremities were prepared and mounted on a testing apparatus with the wrist in 25 degrees of extension. Alternating applications of extension and flexion loads to the tendons induced a full range of motion for 25 cycles. Differential variable reluctance transducers were applied to zone VI of the index, middle, and ring extensor tendons. Measurements of intact tendon microelongation (or strain) were obtained with and without the relative motion splint. The middle finger extensor tendon then was transected (in zone VI) and was repaired immediately. Measurements were repeated with and without splint protection. Elongation ratios were calculated and analyzed statistically. RESULTS: For the intact tendon of the middle finger splinting reduced the elongation by 1% in extension, by 2% in flexion, and by 3% in neutral position. After the transection and repair of this same tendon, the splint reduced the elongation by 5% in extension, by 7% in flexion, and by 6% in neutral position. Cycling without splint protection caused permanent stretching at the repair site. Reapplication of the splint decreased elongation at the repair site by 2% in extension, by 3% in flexion, and by 3% in neutral position. CONCLUSIONS: The relative motion splint reduces the effective strain on intact and repaired zone VI middle finger extensor tendons and supports its clinical use.

Aged↗
PubMed2003

Wound splinting regulates granulation tissue survival.

PURPOSE: Fibroblast survival within an in vitro collagen matrix is dependent on matrix anchorage to a rigid substratum. The purpose of this study was to determine whether granulation tissue survival in vivo also is dependent on matrix anchorage. We hypothesized that splinting an excisional wound (i.e., anchoring the wound edges) would promote granulation tissue survival and that desplinting a splinted wound would produce granulation tissue apoptosis. METHODS: Eighteen Wistar rats (3 months, 350 g) underwent excisional wounding (2 x 2 cm, dorsal skin) with immediate wound splinting (a metal template affixed with sutures) on day 0. On day 6, rats (n = 6 per group) underwent splint removal (desplinted), splint removal with circumferential incision of the wound edge (desplint/release), or no intervention (splinted); sacrifice of all animals was on day 7. Frozen sections of granulation tissue were stained with TUNEL or H and E; data were analyzed with ANOVA and the unpaired t test. RESULTS: The cross-sectional and surface area of the desplinted and desplint/release granulation tissue both decreased compared to the splinted granulation tissue (*P < 0.05). The nuclear density of the desplint/release granulation tissue was 25% less compared to the splinted granulation tissue (*P < 0.05). The desplinted and desplint/release apoptotic rates were twice and >10x greater than the splinted apoptotic rate, respectively (*P < 0.05). CONCLUSIONS: The rate of cell death in a splinted wound (an in vivo equivalent of an anchored FPCM) is minimal to nil, which is consistent with our hypothesis. Desplinting and releasing the wound edge of a previously splinted wound (the in vivo equivalent of a detached FPCM) results in granulation tissue regression and a large increase in apoptosis. Desplinting a wound alone results in changes somewhat intermediate to the splinted and desplint/release conditions. Loss of wound anchorage acutely promotes granulation tissue apoptosis.

Animals↗
PubMedDate not supplied

Splinting strategies and controversies.

Splinting is a common burn care intervention strategy based on logical anatomic and biomechanical principles. The persistence of scar contraction requires countermeasures, frequently splints, and most clinicians would concur that splints are valuable in opposing these contraction forces. Clinical decisions about splinting are often made on respected opinion, leading mainly to design and application options. Variables that affect splinting strategy include the risk-to-benefit ratio of the splint, the timing of the application, the choice of splint design, and duration of the splinting intervention. The most common of these variables reported in the literature is simply unique designs for splints. Although there are different splint designs for similar problems, no data exist to favor one design over another. Controversy about splinting in burn care is not based on the rationale for and success of splinting but exists because of the paucity of validation of its use.

Biomechanical Phenomena↗
PubMedDate not supplied

Comparison of range-of-motion constraints provided by splints used in the treatment of cubital tunnel syndrome--a pilot study.

Nocturnal splinting of the elbow is commonly used to treat cubital tunnel syndrome (CBTS). Rationales are based on several studies, which suggest that proper nocturnal positioning of the elbow during sleep contributes to decreased cubital tunnel symptoms. Currently there is limited scientific evidence supporting the rationale for specific splinting protocols. Splints may be custom or prefabricated. The purpose of this article is to assess the range-of-motion constraints of five nighttime elbow orthoses commonly used in the treatment of CBTS. This preliminary study was conducted using a cadaveric model, using three arms to represent three human arm sizes, and compared five different splints, and no splint. Range-of-motion testing was performed using gravity alone and then testing was repeated using gravity plus a 1-pound weight in a standardized fashion. Results showed that all splints restricted elbow flexion significantly more than the unsplinted extremity. Of the five splints, the AliMed splint allowed the most elbow flexion both in the gravity assisted, and gravity plus a 1-pound weight assisted conditions. The only splint that restricted elbow extension was the Hely & Weber splint. The Pil-O-Splint Elbow Support with stay, Hely & Weber and the Folded Towel all restricted elbow flexion to less than 90 degrees under all study conditions. The information provided may be helpful in making clinical decisions regarding splinting for CBTS.

Cadaver↗
PubMed2005

Static wrist splint use in the performance of daily activities by individuals with rheumatoid arthritis.

OBJECTIVE: In individuals with rheumatoid arthritis (RA), to identify the influence of wrist splint wear on pain, work performance, endurance, perceived task difficulty, and perceived splint benefit while performing various upper limb tasks. METHODS: This crossover study included 30 individuals with wrist involvement. Pain, work performance, endurance, and perceived task difficulty were assessed with the splint on and off. Using a work simulator, participants performed 14 tasks, 10 assessing work performance and 4 assessing endurance. A visual analog scale (VAS) was used to rate pain, task difficulty, and perceived splint benefit. RESULTS: With the splint on, pain was significantly lower in 5 tasks, as was perceived difficulty in task performance. Work performance did not differ significantly with the splint on versus off. While mean endurance scores were always better with the splint on, differences reached significance on only one task. The task with greatest overall perceived splint benefit was "chopping with a knife." CONCLUSION: Results revealed that for most tasks, there was generally a positive effect of splint use on hand function; however, perceived splint benefit was marginal. For most tasks splint use improved or did not change pain levels, did not interfere with work performance, increased or maintained endurance, and did not increase perceived task difficulty. The findings suggest that wrist splint prescription is not a simple process; clinicians and clients need to work together to determine the daily wear pattern that maximizes benefit and minimizes inconvenience according to the client's individual needs.

Activities of Daily Living↗
PubMed1994

Wrist splints in rheumatoid arthritis: a question of belief?

Wrist splints are often used in the treatment of rheumatoid arthritis (RA). We applied a questionnaire to RA patients and rheumatologists to assess wrist splint use and to assess the policy of prescription. We related the reported use to patient satisfaction, severity of disease and physician's advice. Of 44 RA patients admitted to our hospital in 1990, 32 received one or more splints. Most patients (23) had both a wrist immobilization splint and a wrist activity splint (Futuro cock-up splint). The response rate to the questionnaire sent to all (n = 109) Dutch rheumatologists was 83%; 89 of 91 rheumatologists prescribed splints. Each rheumatologist prescribed yearly a mean of 30 immobilization splints (min-max: 2-120) and 51 activity splints (min-max: 4-170). Both types were mainly prescribed to relieve pain and reduce inflammation. From the patients' point of view, only the wrist activity splints were worth regular and continued use. Our findings suggest that if one prescribed splints, more attention should be paid to patient education and compliance.

Adult↗
PubMed2006

Optimization design of thumbspica splint using finite element method.

De Quervain's tenosynovitis is often observed on repetitive flexion of the thumb. In the clinical setting, the conservative treatment is usually an applied thumbspica splint to immobilize the thumb. However, the traditional thumbspica splint is bulky and heavy. Thus, this study used the finite element (FE) method to remove redundant material in order to reduce the splint's weight and increase ventilation. An FE model of a thumbspica splint was constructed using ANSYS9.0 software. A maximum lateral thumb pinch force of 98 N was used as the input loading condition for the FE model. This study implemented topology optimization and design optimization to seek the optimal thickness and shape of the splint. This new design was manufactured and compared with the traditional thumbspica splint. Ten thumbspica splints were tested in a materials testing system, and statistically analyzed using an independent t test. The optimal thickness of the thumbspica splint was 3.2 mm. The new design is not significantly different from the traditional splint in the immobilization effect. However, the volume of this new design has been reduced by about 35%. This study produced a new thumbspica splint shape with less volume, but had a similar immobilization effect compared to the traditional shape. In a clinical setting, this result can be used by the occupational therapist as a reference for manufacturing lighter thumbspica splints for patients with de Quervain's tenosynovitis.

De Quervain Disease↗
PubMedDate not supplied

Comparison study of QuickCast versus a traditional thermoplastic in the fabrication of a resting hand splint.

Therapists are frequently presented with new splinting material promising better and faster results. Managed care and cost containment make it important to evaluate the splinting materials used in the fabrication process. A new precut splint, QuickCast, is made from a fiberglass material that becomes pliable from the heat of a standard household hair dryer. Graduate occupational therapy students participated in timed trials fabricating resting hand splints with QuickCast and Ezeform brands of thermoplastic. Second-year occupational therapy students chosen as splint makers answered a questionnaire measuring fit, edges, strap application, aesthetics, safety, and ease of positioning. First-year students who had no neurologic or orthopedic involvement in the upper extremities participated as clients. They answered a questionnaire on comfort, weight, and aesthetics of the splint and the safety and comfort of the splinting process. Analysis of timed trials revealed no significant difference in the time required to fabricate the QuickCast precut thermoplastic and the sheet thermoplastic splints. From the questionnaire, the thermoplastic splint was rated safer than the QuickCast material by splint makers. Further studies are suggested for comparing time and cost effectiveness between commercially available splinting materials.

Equipment Design↗
PubMed1988

Comparison of the flexibility of various splinting methods for tooth fixation.

An experimental model was constructed to test the flexibility of the arch bar splint and the Schuchardt splint as compared with a newly introduced wire-composite splint. Vertical movement in 4 flexible incisors was tested by producing compressive forces between 15-95 Newtons on the incisal edges. The thinnest wire-composite splint was also tested for lateral flexibility by producing palatal forces from 2 angles. Movement without the splint served as the control. The tests showed that a 0.3 mm thick wire-composite splint had the flexibility closest to the control, followed by the arch bar splint, and 0.4 mm and 0.5 mm wire-composite splints, while the Schuchardt splint virtually prevented vertical movement. Lateral movement was markedly reduced by the 0.3 mm wire-composite splint as compared with the control with both a 10 degree and a 45 degree force. The experiments showed that a 0.3 mm wire-composite splint can be regarded as acting as a functional fixation allowing slight vertical movement of the teeth during immobilisation; it should be recommended for tooth fixation whenever possible.

Composite Resins↗