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At least 451 records · Page 25Linked to original sources

PubMed2006

6 Weeks with the von Rosen splint is sufficient for treatment of neonatal hip instability.

BACKGROUND: There is no concensus on the optimal treatment time for unstable hips in the newborn. We analyzed the efficiency of a treatment program that has been used for 10 years at our hospital, in which all unstable hips (subluxatable, Barlow-positive and Ortolani-positive) are treated with the von Rosen splint for 6 weeks. PATIENTS AND METHODS: Between 1988 and 1997, 32,171 children were born alive at the hospital. During this period 247 children had a clinically unstable hip diagnosed. 223 of the 247 children underwent a radiographic follow-up after 5-15 years. RESULTS: 1 patient with bilateral instability and treated with a splint for 6 weeks showed a dislocated left hip at the radiographic examination at 8 months, which is part of the screening program, and needed operative treatment. 1 patient did not follow the treatment program and showed a dislocated hip at the age of 3. Another 4 patients required more treatment than the 6 weeks with the splint. We found no dysplastic hips at the radiographic follow-up. There was no late dysplasia and there were no late dislocations in children born in Lund between 1988 and 1997 who were diagnosed at other Swedish centers that treat developmental dysplasia of the hip (DDH). INTERPRETATION: We conclude that the present screening and 6-week treatment in a von Rosen splint prevent almost all cases of late dysplasia and late dislocation of the hip.

Adolescent↗

PubMed1991

A splint for immediate surgical orthognathic fixation and release during orthodontic treatment.

A splint has been designed for surgical use during the course of orthodontic treatment. The two-piece splint is ligated directly to the orthodontic arch wires. Surgically, the splint has the advantage of saving operative time, of ensuring precise location rapidly in all three planes, and allowing immediate release and replacement. Orthodontically, the splints allow a shorter preoperative phase of orthodontics, with the orthodontic treatment being completed postoperatively to ensure precise tooth positions and functional occlusion.

Dental Occlusion↗

PubMed1996

Effects of a modified maxillary orthopaedic splint: a cephalometric evaluation.

Taking the presence of an interplay between the vertical and sagittal components of craniofacial development into consideration, the beneficial therapeutic potential impacts of controlling vertical development on the correction of Class II discrepancies has been previously investigated. In the present study, a modified maxillary orthopaedic splint combined with an anterior high-pull headgear was used for early correction of the vertical and consequently sagittal dentoskeletal discrepancy as the initial stage of treatment. The aim was to evaluate its effects on the maxillary and mandibular dentoskeletal development, as well as rotational growth pattern. In order to compare with and distinguish from the uninterrupted growth changes, a control group was formed by matching each one of the control subjects to a subject in the treatment group according to certain criteria. The initial and second standardized lateral cephalograms of each subject was evaluated by means of an adopted and biologically more substantial cephalometric analysis. Evaluation of the changes induced by the splint in comparison with the uninterrupted growth changes revealed that the splint had both orthopaedic and orthodontic effects on the growth pattern of the dentoskeletal structures. There seemed to exist a relationship between the direction of total mandibular and maxillary rotations. In addition, it was believed that in order to cause a forward mandibular rotation, i.e. to change the rotational mandibular growth pattern from a backward into a forward direction, the posterior vertical maxillary development should be restrained, but anterior vertical maxillary development should be relatively more restrained or reversed and, thereby, the rotational growth pattern of the maxilla should be changed from a backward into a forward direction. Moreover, the bite block effect of the splint seemed to cause a favourable change in the condylar growth direction from a backward to an upward direction.

Case-Control Studies↗

PubMed2000

Craniomandibular status and function in patients with habitual snoring and obstructive sleep apnoea after nocturnal treatment with a mandibular advancement splint: a 2-year follow-up.

The aim of the investigation was to evaluate the status and function of the temporomandibular joint (TMJ) and masticatory system in patients with habitual snoring and obstructive apnoea after 2 years nocturnal treatment with a mandibular advancement splint. Thirty-two patients participated in the study, ranging from 43.0 to 79.8 years of age (mean 54.4 years, SD 8.78) at the start of treatment. All patients had been referred from the ENT department for treatment with a mandibular advancement splint. The acrylic splint advanced the mandible 50-70 per cent of maximal protrusion, opened 5 mm vertically, and was used 6-8 hours per night and 5-7 nights per week. Overjet, overbite, and molar relationship were measured on dental casts. The patients were asked to answer a questionnaire concerning symptoms of craniomandibular dysfunction (CMD). They were also clinically examined in a standardized manner, including registration of range of mandibular movements, TMJ sounds, pain on movement, and palpatory tenderness of the TMJ and the masticatory muscles. None of the patients showed more than five symptoms of dysfunction either at the start of or after 2 years of treatment. A decrease in the frequency of headache was found for nine of those 18 patients that reported headache (P = 0.004). A minor, but significant decrease in overjet and overbite was found and the molar relationship was also changed. It was concluded that 2 years' treatment with a mandibular advancement splint had no adverse effects on the craniomandibular status and function, but the observed occlusal changes requires further evaluation.

Adult↗

PubMed1988

Effect of hand splints on stereotypic hand behavior of three girls with Rett syndrome.

The purpose of this multiple baseline study was to examine the effect of bilateral hand splints on the persistent stereotypic hand movements of three adolescent girls with Rett syndrome. Among the most characteristic features of Rett syndrome are stereotypic hand-writing and hand-biting behavior and loss of previously acquired functional hand skills. The hand splints used in this study consisted of cuffs encircling the palm that positioned the subjects' thumbs in abduction. Duration percentages of subjects' stereotypic hand behavior and functional hand use were calculated from five-minute videotaped segments recorded during a finger-feeding condition and a free-time condition. All three subjects demonstrated a decrease in the amount of time spent in stereotypic hand behavior after application of hand splints, and one subject showed an increase in finger-feeding skills while wearing hand splints. Limitations of the study are discussed, and suggestions for clinical application and future research are offered.

Adolescent↗

PubMed1997

Use of neuromuscular electrical stimulation and [corrected] dorsal wrist splint to improve the hand function of a child with spastic hemiparesis.

This case report describes a program for a child with spastic hemiparesis who had previously received physical therapy with neuromuscular electrical stimulation (NMES). After a year without physical therapy, he returned to continue to receive NMES to strengthen muscles, increase sensory awareness, and improve hand function. The child quickly regained his previous level of functioning and made additional progress. After 38 sessions, he still lacked adequate wrist stability for independent hand function. A dorsal wrist splint was used to stabilize the wrist while NMES facilitated muscle activity of the hand and wrist. While wearing the splint, the child could use his hand independently without adult interference or "assistance," thus allowing motor learning to occur. After 24 additional sessions (i.e., 9 months of using the splint), the child could use the hand for activities such as tying his shoelaces without the splint. No increase in spasticity was seen in spite of strengthening the spastic finger flexors.

Activities of Daily Living↗

PubMedDate not supplied

The use of the modified Thomas splint for a patient with cultured epidermal autografts.

UNLABELLED: Because of the difficulty in handling a patient with cultured epidermal autografts in pressure areas of the limbs, we have adopted a splint that is easy to apply, allows an easy access to the wound, and is well tolerated by the patient. HYPOTHESIS: Avoiding pressure in areas with autografts is recommended. This is the reason we have used a splint that avoids the pressure and the secretion buildup. This technique helps a better "take of the grafts." METHODS: We have modified the original Thomas splint in two ways: (1) the use of a distant and upper appliance that allows to correct the foot's flexion; and (2) the use of an appliance that can be regulated, is inflatable, and can be removed, allowing the change of pressure in different areas. We have used this method with one patient with a deep degree of circumferential burn in both lower limbs. The splint has been maintained and the elevation changed every day for 15 days. Traction has been made with the use of the Kirschner stirrup. RESULTS: The dressing was changed easily and without patient pain. Good mobility was possible, with genital hygiene and grafts that were taken in 70% of the cultured epidermal autografts. CONCLUSION: This method allows maintenance of the legs in functional position during dressing changes and avoids pressure and chafing. It decreases the loss of the autograft for mechanical effects.

Bandages↗

PubMedDate not supplied

Dynamic versus static splints: a prospective case for sustained stress.

Application of constant tension to elongate tissue has been shown to be beneficial. A dynamic splint was used to achieve tissue creep and full elbow extension. Use of a static splint on the contralateral elbow did not allow elbow extension. This case report demonstrates for this patient the superiority of a dynamic elbow extension splint over a static splint when used to correct progressive loss of elbow range of motion.

Adult↗

PubMed1991

Results of surgical repair versus splinting of experimentally transected muscle.

Complete muscle tears or transections can be treated by splinting or surgical repair. Although repair is often advocated in the young and athletic population, no well-controlled studies compare the results of splinting and surgical repair. I studied the effects of surgical repair versus splinting only of transected muscles in an experimental model. In group I (n = 14), a unilateral transection of the extensor digitorum longus (EDL) muscle of the Sprague-Dawley rat was treated with splinting only. In group II (n = 14), the muscle was surgically repaired as well. Active and passive strength measurements at day 7 and 14 showed an earlier return of passive strength in group II at day 7. No statistically significant differences at day 14 were noted. In this model, earlier return of active and passive strength occurred in surgically repaired muscle disruption as compared with nonrepaired muscles.

Animals↗

PubMed2004

Temporary intermaxillary fixation using individualized acrylic splints permits image-data-based surgery of the lower jaw and oropharynx.

OBJECTIVES/HYPOTHESIS: Image-data-based surgical navigation is used as a helpful device in the operating room to localize critical structures with a high degree of accuracy. It also enables physicians to plan therapeutic performance. Because it relies on preoperatively acquired computed tomography (CT) or magnetic resonance imaging (MRI) data, there is restricted access for navigation of surgical instruments in areas that show motion uncorrelated with radiologic data. Thus, in the case of moveable structures, for example the lower jaw, navigational procedures could not yet be applied. STUDY DESIGN: We introduce a new technique using individualized intermaxillary splints that fix the mandible in a reproducible aboccluded position at the time of image-data acquisition and surgery. METHODS: Different manufacturing processes were investigated. The feasibility of uni- and bilateral intermaxillary splints was studied under clinical conditions in four patients during different procedures in the mandibular and oropharyngeal regions. RESULTS: The manufacturing of the splints showed was easily performed in a short time. With bilateral fixation, there was a high anatomic target precision of 1.6 to 2.3 mm. CONCLUSIONS: The use of bilateral intermaxillary splints that fix the patient's mandible in a reproducible aboccluded position permits an image-data-based navigated surgical approach to the oropharyngeal and mandibular regions.

Humans↗

PubMed1994

A prospective, nonrandomized study of iontophoresis, wrist splinting, and antiinflammatory medication in the treatment of early-mild carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) has become the industrial epidemic syndrome of the decade and its incidence is continuing to rise. Because of public awareness. CTS is being diagnosed much earlier in the course of the disease. Iontophoresis of dexamethasone sodium phosphate has been used for years in the treatment of many musculoskeletal inflammatory disorders and clinicians have reported using this modality in the treatment of CTS. Iontophoresis is a method of transdermal administration of ionized drugs in which electrically charged molecules are propelled through the skin by an external electrical field. However, conditions of treatment and evaluation have not been standardized. A prospective, nonrandomized study utilizing a standardized treatment protocol incorporating wrist splinting with nonsteroidal antiinflammatory medications and iontophoresis of dexamethasone sodium phosphate revealed a success rate comparable with splinting plus injection of dexamethasone into the carpal tunnel space. In a 6-month follow-up of 23 cases (hands) of early-mild CTS, 4 of 23 hands (17%) were successfully treated with splints plus nonsteroidal antiinflammatory medications alone. Of those that failed this treatment program and chose to proceed with iontophoresis of dexamethasone, 11 of 19 hands (58%) had a positive response rate to iontophoresis, leaving a combined failure rate (failing both splints, nonsteroidal antiinflammatory medications and iontophoresis) of 35%. Iontophoresis may become an alternative to steroid injections to the carpal tunnel region if further studies substantiate these findings. It provides an excellent complication and side-effect profile compared with other methods of delivering dexamethasone. No complications occurred (including no significant elevation of serum glucose in insulin-dependent diabetics.)

Adult↗

PubMed2003

Effect of the Denis Browne splint in conservative treatment of congenital club foot.

In order to discover whether or not a Denis Browne splint is an effective orthosis in the conservative treatment of congenital club foot, we investigated clinically and radiologically 34 congenital club feet treated with full-time splint wearing after serial manipulations and casts. We found objectively that the correction achieved by the initial treatments was not improved but was at least maintained. However, the age when the splint was applied statistically influenced the changes in radiological measurements. The Denis Browne splint with a well-molded heel is an effective orthosis to maintain clinical and radiological results after initial treatments, especially when it is applied at an early age.

Clubfoot↗

PubMedDate not supplied

Pavlik harness versus Frejka splint in treatment of developmental dysplasia of the hip: bicenter study.

A bicenter study was conducted to compare the results of treatment in developmental dysplasia of the hip (DDH) with Frejka splint versus Pavlik harness. Eighty-four dislocated hips were treated by the Frejka splint, and 48 dislocated hips were treated by the Pavlik harness. Failure of reduction was 10% with the Frejka splint and 12% with the Pavlik harness. Avascular necrosis (AVN, mostly type 1) was detected in 7% of Frejka patients versus 6% in Pavlik patients. The Frejka splint is simpler to use and if properly applied may be as safe as the Pavlik harness for DDH treatment.

Female↗

PubMed1989

The immediate effect of splint-induced changes in jaw positioning on the asymmetry of submaximal masticatory muscle activity.

Maxillary full-arch splints in the retruded position (RP) and in a right lateral occlusion (1.0-1.5 mm to the right of the retruded contact position) were fabricated for ten subjects. Surface electromyography of the masseter and anterior temporal muscles was performed during submaximal clenching in order to investigate the immediate effects of the splints on the activity patterns of these muscles relative to the patterns found with the subjects occlusion in the inter-cuspal position. The splints in the RP were found to have no effect on the asymmetry of the activity of the masseter and the anterior temporal muscles, while the splints in a right lateral occlusion resulted in relative increases in right anterior temporal muscle activity (P less than 0.005).

Adult↗

PubMed1993

Therapeutic effects of the plane occlusal splint on signs and symptoms of craniomandibular disorders in patients with nocturnal bruxism.

The long-term effects were studied of a full arch maxillary plane occlusal splint on chronic signs and symptoms of craniomandibular disorders (CMD) in 31 patients with nocturnal bruxism. The results revealed that the score and intensity of signs and symptoms in this type of patient fluctuate from day to day and even within a single day. In spite of continuation of nocturnal bruxism, the symptoms of CMD were cured or improved with the long-term use of the occlusal splint. However, in general, the symptoms recurred after discontinuation of splint therapy. The therapeutic mechanisms of the splint during sleep are discussed.

Adolescent↗

PubMed1994

Reflections on the Michigan occlusal splint.

Specific features related to the development, design and use of the Michigan splint have been described. Additional benefits from the Michigan splint beyond what can be expected from conventional stabilization splints and bite planes have been suggested. Important aspects of corrections and maintenance care of the Michigan splint have been stressed.

Acrylic Resins↗

PubMed1988

Efficacy of soft splints in reducing severe knee-flexion contractures.

This study evaluated the effectiveness of soft splints made from polyurethane foam in reducing severe knee-flexion contractures of patients with cerebral palsy. The splints were applied nightly over a period of 10 months. Knee-flexion contractures were reduced by an average of 24 degrees in all patients. Younger patients generally presented with less severe initial contractures and had the greatest percentage of improvement. When used on a single limb when bilateral contractures were present, sympathetic reduction of the contracture occurred to varying degrees in the unsplinted limb. It is recommended that the splints be replaced regularly to maximize their effectiveness. The benefit-to-cost ratio is extremely high and their low cost makes soft splints feasible for use in developing countries and by low-income families.

Adolescent↗

PubMed1995

A study of a dynamic proximal stability splint in the management of children with cerebral palsy.

This paper describes a study of the UPsuit, a proximal stability splint fabricated from Lycra, in the management of children with cerebral palsy. The splint improved posture and reduced involuntary movement immediately. The amount of functional improvement depended on the type and severity of impairments, the subject's attitude, their capacity for purposeful intent and compliance. Compromised lung function and pre-existing hypoactivity were medical contra-indications to UPsuit wear whilst a limited capacity for purposeful intent or a negative attitude restricted benefits. The Upsuit was of great value to one-quarter of subjects, but Lycra splinting may benefit a wider spectrum of persons with cerebral palsy in the form of less intrusive splints applied to the limbs.

Adolescent↗