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PubMed1996

Splint therapy for trigger thumb and finger in children.

Forty-three trigger thumbs and fingers in 33 children (15 boys and 18 girls, average age 2 years and 4 months) were treated using a polyethylene splint. Affected digits included 40 thumbs, one index finger, and two middle fingers. The IP joint was stabilized in maximum extension via a strap on the dorsal side. The splint was applied only at night and during day-time naps. Twenty-four digits recovered completely in an average of 10 months, seven digits improved, and two digits required surgery. Eight patients (10 digits) dropped out of treatment. Splint therapy is effective in treating trigger thumbs and fingers in children.

Child, Preschool↗

PubMed1984

The molded polythene splint for mallet finger deformities.

Since 1970, 151 cases of mallet finger deformities with an average follow-up of 17 months have been treated with a molded polythene splint. Tendon injuries as well as fracture cases are included. This splint has been found to be highly effective, and open reduction of even major fracture fragments without subluxation of the distal phalanx has not been necessary. Although this splint was first described in 1969, detailed results and techniques have not been described previously.

Female↗

PubMed1996

Surgical treatment and postoperative splinting of recessive dystrophic epidermolysis bullosa.

Digital contractures and pseudosyndactyly, common manifestations in recessive dystrophic epidermolysis bullosa, cause significant functional impairment. The deformities progress with time, although surgery may delay the progression. The role of surgical intervention, hand therapy, and the use of prolonged splinting was examined in seven children (nine hands) with recessive dystrophic epidermolysis bullosa with an average age of 5 years, 8 months (range, 1 year, 10 months to 16 years, 4 months). The technique of surgery, postoperative regimen, and splinting differ from those previously reported. Surgery includes "de-cocooning" the hand and fingers, manipulating contracted joints, and full-thickness skin grafting to dermal defects. Surgery and the postoperative regimen of rigid night splints and web-retaining gloves for day wear has allowed arrest or minimal progression of contractures in complaint patients in short-term follow-up study of an average of 17 months (range, 12-28 months). An interdisciplinary team of physicians and surgeons, therapists, and nurses makes this care regimen possible and influences family compliance.

Adolescent↗

PubMed1999

Transient peroneal nerve palsies from injuries placed in traction splints.

Two patients thought to have distal femur fractures presented to the emergency department (ED) of a level 1 trauma center with traction splints applied to their lower extremities. Both patients had varying degrees of peroneal nerve palsies. Neither patient sustained a fracture, but both had a lateral collateral ligament injury and one an associated anterior cruciate ligament tear. One patient had a sensory and motor block, while the other had loss of sensation on the dorsum of his foot. After removal of the traction splint both regained peroneal nerve function within 6 hours. Although assessment of ligamentous knee injuries are not a priority in the trauma setting, clinicians should be aware of this possible complication in a patient with a lateral soft tissue injury to the knee who is placed in a traction splint that is not indicated for immobilization of this type of injury.

Adult↗

PubMed1999

Does 2 years' nocturnal treatment with a mandibular advancement splint in adult patients with snoring and OSAS cause a change in the posture of the mandible?

The aim of this pilot study was to investigate the effects of 2 years' nocturnal treatment with a mandibular advancement splint in adult patients with snoring and obstructive sleep apnea syndrome with respect to possible development of a forward position of the mandible or other dentofacial changes. Thirty snoring and sleep apnea patients, mean age 55.3 years (SD, 8.61; range, 46.5 to 79.8 years), referred from the Ear, Nose, and Throat Department, were treated with an acrylic splint with full tooth coverage that advanced the mandible 5 to 8 mm (70% of maximal protrusion) and used 5 mm opening vertically. The splint was used 6 to 8 hours per night and 5 to 7 nights per week. Two lateral head radiographs were taken in centric occlusion, 1 before and 1 after 2 years of treatment. A small but statistically significant forward and downward change in mandibular position was found after treatment; mean was 0.4 mm (SD, 0.53; range, 0.0 to 2.0 mm; P <.001) and 0.3 mm (SD, 0.43; range, 0. 0 to 1.5 mm; P <.001), respectively. The forward and downward movement of the mandible was accomplished by a statistically significant increase in mandibular length-mean was 0.4 mm (SD, 0.62; range, 0.0 to 2.5 mm; P <.01)-and a significant decrease in overjet (P <.001) and overbite (P <.05). However, none of the patients reported any permanent sense of altered occlusion, and the anteroposterior distance between habitual occlusion (intercuspal position) and centric relation (retruded position) did not exceed 1. 0 mm in any of the patients either before or after the treatment. The change in mandibular position might be a result of a condylar and/or glenoid fossa remodeling or condylar position changes within the fossa as a compensatory reaction to the advancement of the mandible (bite jumping). However, to visualize and analyze such possible changes in detail, additional studies using lateral tomography of the temporomandibular joints or magnetic resonance imaging are required. Furthermore, because the treatment of snoring and OSAS patients is considered to be lifelong, long-term studies are needed to analyze if the small change in mandibular position will continue with further treatment.

Adaptation, Physiological↗

PubMedDate not supplied

A protective orthoplast splint in the treatment of a patient with Colles' fracture by external fixation.

Discussion is provided of an Orthoplast splint that was used to aid in the successful treatment of a mentally deficient patient who had sustained a fracture in the distal forearm, which was managed by external fixation. This splint is advocated for the treatment of various types of uncooperative patients. Although this splint has not been tried in the treatment of children, it appears likewise applicable for a noncompliant youngster.

Aged↗

PubMedDate not supplied

Dynamic extension assist splinting of acute central slip lacerations.

The management of zone III extensor tendon injuries remains a challenging clinical problem for both the surgeon and therapist. Current treatment protocols include prolonged immobilization, controlled mobilization, or limited early dynamic splinting, but overall results are often less than optimal. This retrospective study describes an alternative treatment approach for acute central slip lacerations consisting of initial immobilization of the PIP joint in absolute 0 degrees extension for an average of 3.5 weeks followed by active flexion of the PIP joint in a finger-based dynamic extension assist splint. Therapy averaged approximately one visit weekly, and follow-up averaged 3.8 months. Mean PIP joint extension was + 1 degrees, and mean PIP joint flexion was 109 degrees. Mean DIP joint extension was -1 degree and mean DIP flexion was 67 degrees. Mean total active motion measured in composite fashion for the PIP and DIP joints was 175 degrees. This treatment approach produced excellent results, required infrequent therapy, and utilized only finger-based splinting.

Adult↗

PubMed1989

Modified acrylic cap splint for dento-alveolar fractures.

A modified method of constructing an acrylic cap splint is introduced. The splint is made from wax and is then replaced by acrylic. The splint has a uniform thickness and is therefore suited for maintenance of a proper occlusion.

Alveolar Process↗

PubMed2001

[Tension force in dynamic splints made of neoprene].

Dynamic splints are the most difficult ortheses to make. Unrestricted finger joint mobility is usually prevented by the size of their components. Ortheses made out of neoprene material have the advantage of being pliable and at the same time can be constructed as dynamic splints. Neoprene material elasticity allows conforming it into a tube that can be fitted over a finger, spreading uniform pressure. A traction slip can be cemented to the neoprene finger tube. With neoprene splints, lever arms are more efficient. Their tubular design applies and spreads traction and countertraction forces in all directions. Neoprene material's elasticity contributes in reducing edema formation as well as distributes forces applied to the finger over a large area. The risk of excessive pressure is the only drawback of an elastic tubular design, it may cause pain and tissue ischemia. A meticulous tailoring prevents this potential risk.

Biomechanical Phenomena↗

PubMed2007

Impact of sleep nasendoscopy on the outcome of mandibular advancement splint therapy in subjects with sleep-related breathing disorders.

AIM: To evaluate the impact of positive sleep nasendoscopy, with simultaneous mandibular advancement, on the outcome of mandibular advancement splint therapy in 120 subjects with sleep-related breathing disorders. METHODOLOGY: Overnight polysomnography and sleep nasendoscopy were performed prior to splint therapy. Follow-up sleep studies, with the appliance in situ, were undertaken for those patients with obstructive sleep apnoea. Subjective outcome measures assessed daytime sleepiness and snoring. RESULTS: One hundred and seven (89 per cent) subjects completed the study. Follow-up sleep studies confirmed the efficacy of treatment, with patients showing a mean reduction in apnoea/hypopnoea index (from 18.9 to 4.9, p<0.001), Epworth sleepiness scale scores (from 11 to seven, p<0.001) and partner-recorded snoring scores (from 14 to eight, p<0.001). CONCLUSION: Sleep nasendoscopy, with concomitant mandibular advancement to mimic the treatment effect, could be of prognostic value in determining successful mandibular advancement splint therapy.

Adult↗

PubMed2006

Patients' and sleeping partners' experience of treatment for sleep-related breathing disorders with a mandibular repositioning splint.

AIM: To determine in detail the complications associated with the use of mandibular repositioning splints (MRS) to treat sleep-related breathing disorders. METHOD: This prospective cross-sectional cohort study audits the management with mandibular repositioning splints of 121 patients suffering from sleep-related breathing disorders. Investigation of patients' and sleeping partners' perspectives on treatment was undertaken with the use of a questionnaire based study. RESULTS: Sixty-eight per cent of respondents reported that they were compliant with treatment; various side effects were reported of which excess salivation was the most common. Investigation of sleeping partners' perspectives revealed that 70% felt that their partners' snoring was improved and 47% felt that their partner's breathing pauses during sleep were reduced. Sixty-four per cent of the sleeping partners also reported that their own sleep pattern had improved since their partner's treatment. CONCLUSION: Mandibular repositioning splints used in the manner described by this paper are demonstrated to have a good compliance rate, provide successful treatment and exhibit only minor, reversible side effects.

Adult↗

PubMed1989

The physiology of splint therapy: a literature review.

The clinician must frequently make treatment decisions with limited knowledge of the appropriateness and consequences of the different options. Patients have specific expectations: that the treatment they receive is the usual one, that they have been informed of the alternatives and the consequences, and most importantly that the treatment has a reasonable chance of success. In TMJ therapy, as with most treatments, the patient's improvement is closely connected to a proper diagnosis based on sound physiologic principles. This investigation will review four basic splint types and discuss their success in the resolution of various temporomandibular disorders. Since the position of the condyle-disc-fossa, the occlusal contact pattern and the masticatory muscle dynamics are interrelated, this study will focus on the physiologic changes splints may cause with modification of this tooth, joint and muscle relationship. Hopefully, selection of a specific splint design appropriate to the patient's disorder will be facilitated by better understanding of its physiologic and therapeutic effects.

Bruxism↗

PubMed2005

A prospective study of the short-term treatment effects of the acrylic-splint rapid maxillary expander combined with the lower Schwarz appliance.

This prospective clinical study evaluated the short-term treatment effects of acrylic-splint rapid maxillary expander in conjunction with lower Schwarz appliance (RME-Sz) therapy to the acrylic-splint rapid maxillary expansion alone (RME-only group). Pretreatment and posttreatment lateral cephalograms were analyzed for 25 RME patients and 19 RME-Sz patients. The average time between films ranged between nine and 12 months. Statistical comparisons of the treatment changes in the RME-only and RME-Sz groups were performed by means of independent sample t-tests (P < .05). The largest difference between the two groups was in lower anterior facial height (LAFH). The normally occurring increase in LAFH was not observed in the RME-only group during the treatment period, indicating that the acrylic-splint expander had a posterior "bite block effect" on the developing craniofacial complex. LAFH increased by 1.7 mm in the RME-Sz group, a value similar to that observed in untreated individuals. Slight forward displacement of the maxilla was observed when RME was used alone, and the sagittal position of the maxilla remained unchanged in the RME-Sz group. A significant amount of intrusion of the maxillary molars (-0.8 mm) was noted in the RME-only group, whereas the maxillary molars were prevented from erupting in the RME-Sz group. The lower dentition showed a significantly greater amount of extrusion in the RME-Sz group than in the RME-only group. Finally, the Sz appliance prevented the mesial movement of the lower molars during the treatment period.

Acrylic Resins↗

PubMed2002

Immediate effect of a stabilization splint on masticatory muscle activity in temporomandibular disorder patients.

Surface electromyography (EMG) allows the quantification of the occlusal equilibrium in dysfunctional patients, for instance in those with temporomandibular disorders (TMD). Fourteen patients (ten women, four men) with internal derangement type I were selected among the TMD patients referred to a private practice in Milan. A stabilization splint with posterior contacts was made for each patient. To verify the static neuromuscular equilibrium of occlusion, EMG activity of left and right temporal and masseter muscles was recorded in all patients and the activity (ratio between the activities of the temporal and masseter muscles) index was computed over a maximum voluntary clench test of 3 s. Muscular waveforms were also analysed by computing a percentage overlapping coefficient (POC, an index of the symmetric distribution of the muscular activity determined by the occlusion). The total electrical activity was measured by calculating the area under the entire muscular waveforms. In all patients EMG was performed just before and immediately after the insertion of the splint and data were compared by paired Student's t-tests. Overall, the splint reduced the electrical activity of the analysed muscles (P < 0.005) and made it more equilibrated both between the left and right side (larger symmetry in the masseter muscle POC, P < 0.05) and between the temporal and masseter muscles (activity index, P < 0.01).

Adult↗

PubMed2001

The platform transfer splint: 2 case reports of a mobility aide for persons with arm injuries or conditions.

Limited or impaired mobility is a major obstacle to maximizing length of stay efficiency for inpatient rehabilitation. Trauma patients and others with multiple limb impairments present a mobility challenge to all rehabilitation centers. Of particular concern are patients with forearm fractures who are nonambulatory. With shorter inpatient stays, patients are being discharged home or to other settings with continued weight-bearing restrictions. These patients put great demands on their caregivers as a result of their limited mobility. The Platform Transfer Splint (PTS) has been developed to overcome limitations seen in this patient population. It is an upper extremity splint that allows weight bearing through the humerus for patients with impairments of the forearm or hand. With use of the PTS, patients can become independent in transfers and wheelchair propulsion. Two case studies are presented to show the impact of the PTS on patient mobility and discharge disposition. Fabrication of the splint is also discussed.

Activities of Daily Living↗

PubMed2001

The salute splint for axillary contractures.

A new splint for use in the treatment of burn contractures of the axilla is presented. The splint is easy to deploy, comfortable for patients and achieves the same results as other splints.

Axilla↗

PubMed1999

A simple splinting method for correction of supple congenital clasped thumbs in infants.

A splint has been designed to correct the congenital clasped thumb. It is like a short opponens splint that can keep the thumb in a position of abduction and extension without limiting wrist movement. The application of the splint was easy and adjustment for fit could be made at each visit if necessary. The device has been used in 11 infant patients (17 thumbs) with congenital clasped thumb of the supple type. The functional results were excellent in 15 of 17 thumbs, and the other two were good according to the grading system of Weckesser et al. (1968).

Female↗

PubMed2000

Static splinting of extensor tendon repairs.

In a prospective review we assessed the results of extensor tendon injuries managed postoperatively with a static splint. Thirty-three patients with 44 injured digits were assessed 4 months after primary tendon repair, using the Strickland-Glogovac criteria. Patients were managed in a static splint, the duration of which was guided by the zone of injury. Four months after repair, excellent or good results were obtained in 95%. Overall it was found that static splinting was an effective and safe method of management after extensor tendon repair.

Adolescent↗