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PubMed2005

The Kleinert modified dorsal finger splint for mallet finger fracture.

Injuries to the hand and digits are commonly seen in the emergency department. Lacerations, contusions, puncture wounds, and fractures comprise the bulk of these injuries. A fracture to the dorsum of the distal phalanx can result in a mallet finger deformity. These fractures must be accurately diagnosed with the proper initial treatment begun. There is some disagreement over the best treatment approach and multiple different splints have been described in the literature. Conservative treatment with a finger splint is most commonly effective. We recommend a modified dorsal finger splint for these injuries. We describe a splint to properly treat the fracture, prevent complications, maximize patient comfort during rehabilitation, and prevent mallet finger deformity.

Emergency Medicine↗

PubMed2005

A modified thumb spica splint for thumb injuries in the ED.

There are a significant number of hand and upper extremity injuries treated in US emergency departments (EDs) each year. Many of these involve the thumb and wrist. These injuries encompass the range from fractures, strains, and sprains to more specific injuries such as gamekeeper thumb and de Quervain tenosynovitis. These injuries often require diagnosis, splinting, and referral to a hand or orthopedic surgeon. The splint described in this article is presently being used for patients with de Quervain tenosynovitis, but it may have more widespread application in emergency medicine. It is a safe and simple splint that is underused in EDs for splinting thumb injuries.

Emergency Medicine↗

PubMed2005

Indications for splinting implant restorations.

PURPOSE: The purpose of this article was to review the literature concerning the need to splint implants together when restoring them with a provisional restoration immediately after implant placement. METHODS: The literature is reviewed concerning the rationale for splinting teeth and reports concerning the efficacy of splinting implants together. Based on this team's experience with a prospective series of consecutive 2 to 5 unit provisionalization cases, guidelines are included with case examples for understanding the technique. CONCLUSION: As long as canine guidance is present, and occlusion is stable, multiunit single quadrant restorations do not need to be splinted when provisionalized.

Dental Abutments↗

PubMed2004

Nasal ciliary beat after insertion of septo-valvular splints.

OBJECTIVE: At present, endonasal paraseptal splints are devices frequently employed in rhinosurgery. We evaluated the local tolerance of a newly shaped device, the Guastella/Mantovani splint (G/M-SVS), with respect to the physiological mechanism of mucociliary clearance. STUDY DESIGN AND SETTING: The study involved 20 patients who underwent septoplasty and/or turbinoplasty or other nasal surgical procedures. A sample of ciliated cells was obtained by nasal brushing and was examined ex vivo to determine the ciliary beat frequency (CBF) and morphology, before and 15 days after surgery. RESULTS: Before surgery the mean CBF was 10.87 Hz +/- 0.56 Hz and when splints were removed it was 10.25 Hz +/- 1.9 Hz. Morphological evaluation of the ciliary motion after surgery demonstrated a normal, coordinated beat. CONCLUSIONS: The G/M-SVS does not appear to interfere with the physiological mechanism of mucociliary clearance since CBF remain within a normal range. SIGNIFICANCE: This is the first study that demonstrates an optimal tolerability and safety of the septo-valvular splints on nasal mucosa.

Adult↗

PubMed2003

The design and fabrication of a segmented cast-metal resin-bonded splint.

This article describes a technique for splinting periodontally compromised teeth and for preventing orthodontically treated teeth from relapsing. The fabrication of a segmented cast-metal resin-bonded splint, with nonrigid connection of the splinted teeth, eliminates the many problems of a conventional multi-unit resin-bonded splint.

Dental Bonding↗

PubMed1975

The processed provisional splint in periodontal prostheses.

A technique has been described whereby a heat-processed provisional splint was fabricated with the factors of esthetics and long-term serviceability being of prime importance. Additional advantages of the use of a well-adapted provisional restoration in a periodontal prosthesis are as follows: (1) They facilitate periodontal treatment by allowing total visibility and access to surgical sites when the splint is removed. (2) The splinting effect may enhance healing and periodontal-ligament reattachment by stabilizing mobile abutments. (3) The patient's ability to render adequate home care for a fixed prosthetic restoration may be evaluated and reinforced before making case restorations. (4) The patient's cooperation is assured during an extended period of restorative care when an esthetic, comfortable, provisional splint is provided.

Acrylic Resins↗

PubMed1997

Clinical effect of full coverage occlusal splint therapy for specific temporomandibular disorder conditions and symptoms.

PURPOSE: The purpose of this retrospective study was to evaluate the effect of maxillary full-coverage occlusal splint (stabilization splint) therapy for specific temporomandibular disorders and their symptoms/signs. MATERIAL AND METHODS: This study assessed the outcome of 232 patients who were suffering from chronic pain on movements, joint noise except reciprocal clicking, and difficulty of mouth opening. All were treated with the stabilization splint alone. RESULTS: The total remission rate was 41% and, including those reporting some improvement, the rate was 84%. The presence of displaced disk significantly decreased the success rate. However, the presence or absence of radiographic changes in the temporomandibular joint did not influence the treatment outcome. CONCLUSION: From this study, it is suggested that the stabilization splint therapy may be a useful treatment modality in treatment of temporomandibular disorders, especially for the patients without clinical evidence of displaced disk.

Adolescent↗

PubMed1998

The short-term effect of stabilization-type splints on local cross-sectional dimensions of muscles of the head and neck.

STATEMENT OF PROBLEM: Patients with temporomandibular disorders may have a cluster of joint and muscle disorders characterized primarily by pain, joint sounds, and irregular or deviating jaw function. PURPOSE: This study evaluated changes in local cross-sectional dimensions of muscles of the head and neck associated with short-term application of "splint therapy" using the diagnostic approach of high resolution gray-scale ultrasonography. MATERIAL AND METHODS: The study included 15 subjects with signs and symptoms of temporomandibular disorders, 10 in the internal derangement type (IDT) III-a group, and 5 in the myalgia type I (MT I) and myalgia type II (MT II) group. Ultrasonographic investigation was performed with a linear (B-scan) 7.5 MHz small-part transducer to visualize the anterior temporalis, anterior and deep masseter, anterior and posterior digastric, and sternocleidomastoid muscles. The absolute asymmetry index was used to assess local muscle asymmetry patterns and to evaluate the respective effect of occluding splints, with the mean maximum muscle diameter of the respective right and left sides calculated from 3 consecutive measurements before and after splint therapy. RESULTS: A comparison of pretreatment with 2-month follow-up values revealed a slight decrease in the overall mean local cross-sectional dimensions in the internal derangement type III-a group (0.3 mm) and a moderate decrease in the myalgia type I/II group (3.3 mm). With an overall mean pretreatment absolute asymmetry index of 1.3% for the internal derangement type III-a group and 0.5% for the myalgia type I/II groups, the 2-month follow-up showed the internal derangement type III-a group to be associated with a moderate (1.2%) and the myalgia type I/II groups with a slight (0.1%) decrease in the respective overall mean pretreatment absolute asymmetry indices. CONCLUSION: This study suggests that stabilization-type splints are effective in the reduction of local muscle thicknesses and asymmetries. Further studies are necessary to evaluate muscle-site specific effects in patient and nonpatient groups and to relate these effects to variables such as bite force, preferred chewing side, facial structure, and occlusion.

Adult↗

PubMed1998

Effects of periodontal support and fixed splinting on load transfer by removable partial dentures.

STATEMENT OF PROBLEM: Periodontally compromised abutment teeth complicate the design of bilateral distal extension removable partial dentures. PURPOSE: This study investigated the stress induced in the remaining oral structures by a bilateral distal extension I-bar-retained RPD with periodontally involved abutments in a photoelastic simulation model. MATERIAL AND METHODS: Composite photoelastic models were used as a simulation model in determining the stress generating characteristics of I-bar RPDs with varying degrees of periodontal involvement of the distal abutments. Effects of fixed splinting were considered. RESULTS AND CONCLUSIONS: Under the same load conditions, the highest stresses developed in the model with the largest osseous defect. Increasing the number of splinted teeth did not provide a proportional decrease in maximum stress levels. The more severe the osseous defect, the greater assistance was provided by splinting to periodontally sound teeth. This simulation study suggests that routine cross-arch splinting may not be appropriate.

Acrylic Resins↗

PubMed1995

Functional results of dynamic splinting after transmetacarpal, wrist, and distal forearm replantation.

The results of replantation at the wrist and distal forearm are reported to be better than at the metacarpal level, in part because the latter involve direct injury to the intrinsic muscles. This study evaluates a new post-operative protocol for replantation at the metacarpal, wrist and distal forearm levels. 3 days after replantation, the patient was placed in a dynamic crane outrigger splint with MP joint control, compensating for intrinsic muscle function loss. From 4 to 12 weeks, an anticlaw splint alternated with the outrigger splint. After 12 weeks, a dynamic wrist extension orthosis was added to the anti-claw splint. 11 patients (four replantations at the transmetacarpal level, three at the wrist and four in the distal forearm) had this protocol between 1988 and 1993. For distal forearm replantation, TAM of fingers averaged 216 degrees, grip strength 42 lb, and pinch strength 7.2 lb with 75% good or excellent results. For wrist replantations, TAM of fingers averaged 243 degrees, grip strength 37 lb and pinch strength 10.6 lb with 100% good or excellent results. For transmetacarpal replantations, TAM of fingers averaged 189 degrees, grip strength 37 lb and pinch strength 5.6 lb, with 75% good and excellent results. Early protected mobilization, as described here, preserves tendon gliding, muscle strength and excursion. Our results support this protocol for wrist and distal forearm replantation and especially for transmetacarpal replantation, the results of which tend to be poor according to the medical literature.

Adult↗

PubMed1991

Results of acute zone III extensor tendon injuries treated with dynamic extension splinting.

Motivated by the favorable results of dynamic splinting in the treatment of more proximal extensor tendon injuries, we explored the use of dynamic splinting in the treatment of zone III extensor tendon lacerations. Twenty-two tendon repairs in 19 patients were available for review. On the basis of degree of extension lag and pulp-to-palm distance, 14 repairs were rated as excellent, 6 as good, and 2 as fair. Using total active motion at 10 weeks, the proximal interphalangeal and distal interphalangeal joints averaged 170 degrees. There was one mild boutonniere deformity. The results of this prospective study show that carefully monitored dynamic splinting is safe in the treatment of zone III lacerations. When results were compared with the results of our method of static splinting used prior to this prospective study, patients returned to full activities with good-to-excellent results 8 weeks earlier instead of at 16 to 18 weeks.

Acute Disease↗

PubMed1989

A new dynamic splint for postoperative treatment of flexor tendon injury.

This dynamic splint lessens resistance to finger extension and increases the arc of motion through full passive flexion of the injured fingers. Rubber bands run from the tips of the injured fingers under a spring-loaded roller bar at the metacarpophalangeal joint level to a coiled lever at the distal flexor surface of the forearm. The wrist is positioned in 45 degrees of flexion with 40 degrees to full flexion of the metacarpophalangeal joints and full flexion to full extension of the interphalangeal joints. We retrospectively compared patients treated in the new and traditional splints. Patients with coexisting fractures, extensor tendon injury, and insufficient follow-up were excluded. By use of Strickland's modified criteria in evaluating 36 patients treated in the new splint, 35 of 46 fingers with zone II tendon injury (76.1%) had excellent and 11 (23.9%) had good total active motion; none had fair or poor results or ruptures. Results were significantly better than after treatment in the traditional splint.

Equipment Design↗

PubMed1996

Comparison of a vacuum splint device to a rigid backboard for spinal immobilization.

In this study, comparison of a vacuum splint device to a rigid backboard was made with respect to comfort, speed of application, and degree of immobilization. The study was a prospective, nonblinded comparative study conducted at a statewide emergency medical services (EMS) training facility and included a convenience sample of emergency medical technician (EMT) and paramedic students. The vacuum splint was judged to be significantly more comfortable on a 10-point scale than the rigid backboard after subjects had been lying on each device for 30 minutes (P < .001). It was also faster to apply: 131.6 +/- 24.3 seconds versus 154.6 +/- 22.2 seconds (P < .001). Various measures of immobilization were similar for the two devices. The vacuum splint provided better Immobilization of the torso and less slippage on a gradual lateral tilt. The rigid backboard with head blocks was slightly better at immobilizing the head. Vacuum splints offer a significant improvement in comfort over a traditional backboard for the patient with possible spinal injury. They can be applied in reasonable time frames and provide a similar degree of immobilization when compared to a standard rigid backboard.

Emergency Medical Services↗

PubMedDate not supplied

The efficacy and comfort of full-body vacuum splints for cervical-spine immobilization.

We performed a prospective crossover study to determine the cervical spine immobilization and comfort level of healthy subjects on a full-body vacuum splint in comparison with a standard backboard, with and without cervical spine collars. Twenty-six healthy volunteers were immobilized on a backboard (BB) and a full-body vacuum splint (VS), both with and without a cervical collar (CC). Pre- and post-immobilization cervical spine range-of-motion measurements were made using an electronic digital inclinometer and a standard handheld goniometer. Subjects were also asked to subjectively grade their immobilization and discomfort both overall and in seven specific body regions. No statistically significant difference was found between the VS+CC and the BB+CC for flexion and rotation, although the VS+CC combination provided significantly superior immobilization to the BB+CC for extension and lateral bending. The VS alone, in all cases except extension, provided superior immobilization to the BB alone. A statistically significant difference in subjective perception of immobilization was noted, with the BB being less effective than the other three alternatives and the VS+CC providing the best immobilization. A significant difference in overall comfort and occipital region comfort, favoring the vacuum splint, was found. In conclusion, the vacuum splint is an effective and more comfortable alternative to the background for cervical spine immobilization.

Adult↗

PubMedDate not supplied

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

Nocturnal splinting of the wrist is commonly used to treat carpal tunnel syndrome. Rationales for overnight wrist splinting are based on several research studies, which suggest that passively and actively sustained positions of the wrist and digits during sleep contribute to elevated carpal tunnel pressures. The types of splints used for carpal tunnel syndrome include custom and prefabricated orthoses of many variations. The purpose of this paper is to assess the resting and passive range-of-motion position restrictions and parameters provided by four prefabricated orthoses commonly prescribed for or used by patients at the authors' treatment facility. A literature review provides information that supports optimal wrist and finger positioning to minimize resting carpal tunnel pressures. This information may be useful in determining the most effective splint design choices.

Biomechanical Phenomena↗

PubMedDate not supplied

Evaluation of a thermoplastic splint to protect the proximal interphalangeal joints of volleyball players.

Due to the extreme forces to which they are exposed, hand injuries are common in volleyball players. This paper evaluates the effectiveness and physical tolerance of a thermoplastic splint developed to prevent proximal interphalangeal (PIP) joint hyperextension during play. The PIP-joint splint was tested by 20 semiprofessional volleyball players (12 women and eight men), all of whom had been using functional taping, and whose court positions exposed them to possible PIP-joint injuries. After four consecutive training sessions and one match, effectiveness (rigidity and durability) of the splint was assessed by measuring any variation of its angle and subjective acceptance of the orthosis was investigated by a questionnaire. After three months, the athletes were asked whether they still used the splint, and, if so, how often. The results indicate that this inexpensive device is effective, does not hinder any volleyball maneuver, and resolves the drawbacks of taping.

Adolescent↗

PubMedDate not supplied

The use of synthetic plaster casting tape for hand and wrist splints.

In a prospective study, 40 patients were fitted with synthetic plaster splints to assess the use of such material for hand and/or wrist splints. Factors assessed in both splint fabrication and use included molding properties, elastic traction fixation, weight, ventilation, durability, patient comfort, effectiveness, practicability, time, and cost. The patients were divided into three groups according to basic pathology: tendon/nerve injuries; bone and joint disorders; and rheumatoid disease deformities. Recovery of 50-100% of active range of motion was considered a good result. Good results were obtained in 37 patients (92.5%), whereas in the remaining three patients (7.5%) the results were poor. It is suggested that synthetic plaster is a suitable material for the fabrication of splints in hand rehabilitation.

Adolescent↗

PubMed1988

The effect of interdental continuous loop wire splinting and intermaxillary fixation on the marginal gingiva.

To study the influence of interdental loop-wire splinting and intermaxillary fixation on the marginal gingiva, 30 patients were evaluated clinically using different periodontal parameters, at 5 examination times. It was shown that despite a standardized oral hygiene regime including the use of a mouthrinse, gingival inflammation occurred for the duration of the splinting period. Factors other than the presence of limited plaque, such as gingival trauma due to splint application and subsequent mechanical irritation should be considered as possible aetiological factors. All investigated marginal gingival changes had totally reversed 2 weeks following loop-wire splint removal, apart from tooth mobility which did not re-attain pre-operative levels, the difference, however, being statistically insignificant.

Bone Wires↗