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PubMedDate not supplied

Silicone rubber splinting for athletic hand and wrist injuries.

The use of a silicone rubber protective playing splint facilitates an athlete's continued or earlier return to sport participation following injury. The purposes of this paper are to review the literature and to describe the properties, fabrication procedures, and indications for use of the silicone rubber compound materials used to splint athletic hand and wrist injuries. In general, the use of silicone rubber protective splints for stable orthopedic hand and wrist injuries has been shown to be effective.

Athletic Injuries↗

PubMed1996

Plantar fasciitis: a prospective randomized clinical trial of the tension night splint.

OBJECTIVE: The objective of this study was to evaluate the efficacy of a tension night splint (TNS) as part of a treatment regimen for the management of plantar fasciitis. DESIGN: The design was a randomized clinical trial. SETTING: The setting was a university-based primary care sports medicine clinic in California. PATIENTS: Forty patients with plantar fasciitis entered the study (age range, 20-74 years; average age, 45.7 years). Excluded from the study were patients with other concomitant ankle or foot pathology. Thirty-two patients (21 women, 11 men) completed the study with 33 treated feet. INTERVENTION: The patients were randomized to one of two treatment groups. The control group (n = 17) received standard treatment of antiinflammatory medication (Ibuprofen), a Viscoheel sofspot heel cushion (Bauerfeind USA, Kennesaw, GA, U.S.A.) and a stretching program for the gastrocnemius and soleus muscles. The tension night split group (n = 16) received the same standard treatment protocol and additionally an office manufactured custom fitted posterior splint to be used at night. Those patients in the control group not responding to treatment after 8-12 weeks were crossed over to the tension night splint group. Patients were reviewed every 4 weeks for symptom assessment and compliance. MAIN OUTCOME MEASURES: The main outcome measures were subjective assessment of pain (Visual analogue scale), plantar fascial tenderness, and ankle range of motion. Patients were discharged from either arm of the trial when they had resumed normal activities with minimal or no discomfort. This end point was recorded as weeks to cure. MAIN RESULTS: There was no significant difference in the demographics of the two groups (p > 0.05). In the control group, 6 of 17 were cured after an average interval of 8.8 weeks. The remaining 11 of 17 control group patients were crossed over to receive a TNS in addition to control modalities. Following cross over 8 of 11 of this group were cured after an average of 13 weeks. Three of the 11 failed to significantly respond. Of the 15 patients (16 feet) originally randomly assigned to the TNS group 16 of 16 were cured with an average treatment time of 12.5 weeks. The TNS treatment protocol was a significantly more efficacious treatment regime (p < 0.05). Thus, of 33 cases of plantar fasciitis treated in this study three failed treatment. CONCLUSION: When used in combination with a visco-elastic heel pad, stretching program and nonsteroidal anti-inflammatory drugs, the TNS is an effective treatment of plantar fasciitis.

Adult↗

PubMed1996

The occlusal bite splint--a noninvasive therapy for occlusal habits and temporomandibular disorders.

Traumatic occlusion and occlusal habits, such as clenching and grinding, are the cause of many dental problems. These etiologic factors must be considered and evaluated when treating the dental patient. Early diagnosis and construction of a reversible occlusal appliance is often the most effective, quickest, and least invasive means of therapy. Temporomandibular joint surgery, occlusal equilibration, reconstructive dentistry, orthognathic surgery, orthodontics, and psychotherapy have all been used with success in some cases. Such invasive, and costly, procedures should be considered only after occlusal bite splint therapy has been proven unsuccessful. Occlusal bite splints can be constructed from heat-cured acrylic or light-cured composite. The composite splint is a new material that has minimal distortion, is comfortably worn, and can be constructed in the dental office in less than 30 minutes.

Bruxism↗

PubMed1998

[The effect of splints on the status of the hard dental tissues and periodontium in patients with jaw fractures].

Effects of metal splints on the hygienic status of the oral cavity and status of dental hard tissues and the periodontium were studied in 30 patients with fractures of the jaws during the first days after treatment with splints and in the postimmobilization period. Sixty-seventy days after the splints were removed, the hygienic status of the oral cavity was worse than in normal subjects; moreover, the intensity of caries increased and the periodontal status deteriorated.

Adolescent↗

PubMed1997

Occlusal splint therapy with a positioning orifice.

The authors studied the effect of a positioning orifice introduced in the anterior palatine region of occlusal splints for patients with craniomandibular disorders of swallowing and speech patterns. The patients were evaluated in four distinct situations. It was concluded that the splint orifice significantly favored swallowing and speech while the splint was being used, and is more comfortable for the patient.

Adaptation, Physiological↗

PubMed1989

[Intraluminal splinting of problematic intestinal anastomoses with biomaterial tubes].

We performed small intestinal dissection in 80 laboratory rats. A critical anastomosis was achieved by two point adaptation of small intestine with single sutures. 10 control animals receiving no intestinal splinting died within two days of operation. The remaining 70 animals underwent intestinal internal splinting with tubes of different absorbable (Polyglactine, Collagen, and B111) and non-absorbable (Polyurethane) biomaterials. Significantly smaller leakage rates in the therapy groups proved the principle of internal splinting of complicated anastomoses in this animal model to be effective.

Anastomosis, Surgical↗

PubMed1998

[Can "internal intestinal splinting" prevent ileus recurrence? Results of a retrospective comparative study].

The high rate of recurrence after the treatment of adhesive obstruction demands special prophylactic treatment. In a 13-year period, 52 out of 95 patients with major adhesions were provided with a long nasointestinal tube for intestinal splinting intraoperatively. The was being left in situ on an average of 6.6 days. After an observation period of at least 36 months a recurrence was seen in 2 of these 52 patients (3.9%; causes: volvulus after 6 months/fibrinous peritonitis on the 6th postoperative day). Amongst the 43 'non-splinted' patients, recurrence of adhesive obstruction was documented in 8 cases (18.6%; causes: adhesions after 0.3-136.9 months). In the course of after-care abdominal complaints were significantly fewer in patients who had been splinted. Complications concerning the nasointestinal tubes did not occur. The rate of perioperative complications was similar in both groups.

Adolescent↗

PubMed1991

A provisional removable partial denture for use during construction of an anterior splint bar prosthesis.

A technique for constructing a provisional removable partial denture before and during construction of an anterior splint bar prosthesis is described. The provisional prosthesis is easily adapted to fit the splint bar prosthesis after it is cemented in place. The technique assures that the patient will enjoy the benefits of a well-fitting and esthetic provisional restoration through all phases of construction of the splint bar and the final removable partial denture.

Denture Design↗

PubMed1976

Indwelling and transrenal splint techniques for pyeloplasty.

A report is presented on experience with 118 pyeloplasties using indwelling and transrenal splints. Detailed analysis of infections with both splint modifications has confirmed that better long-term results are achieved with internal drainage, due to the absence of potential contamination between splint and renal parenchyma which exists with external drainage.

Humans↗

PubMed1995

Manipulation of rubber dam septa: an aid to the meticulous isolation of splinted prostheses.

Splinted prostheses are a problem in endodontic isolation. The traditional solution of resorting to a slit-dam technique results in an unrestrained curtain of rubber dam which not only allows for saliva seepage but can serve to compromise the endodontic access opening. This article introduces a simple, yet effective, method of improving the seal of isolated splinted prostheses. It relies on the manipulation and ligation of rubber dam septa with dental floss. Two pictorial clinical reports depict the technique and demonstrate the ease of attaining isolation with splinted prostheses.

Child↗

PubMed1998

An assessment of wrist splint and glove use on wheeling kinematics.

OBJECTIVE: The purpose of this investigation was to assess whether glove and/or splint use could effectively reduce hyperextension at the wrist during wheelchair propulsion, thus potentially reducing the conditions predisposing to median nerve dysfunction, and to evaluate the overall effects of these interventions on wheeling mechanics. DESIGN: This investigation used a randomized experimental design. BACKGROUND: The upper extremities are used for weight bearing and propulsion by individuals who are wheelchair dependent. High intracarpal pressures created by hyper-extension of the wrist and repetitive high force stresses of the hands against the wheel are suggested causes of median nerve dysfunction. METHODS: The wheeling performances of 13 subjects were recorded using two SVHS video-cameras under four different glove/splint conditions. Each subject was analysed on two wheeling cycles under all four conditions. Wrist and elbow angles, joint range of motions and wheeling speed were determined. Data were analysed using a one-way analysis of variance (ANOVA), followed by Scheffé post-hoc comparisons at the 0.05 level of significance. RESULTS: The splint and the glove/splint combination significantly reduced wrist extension during wheeling, but did not alter elbow motion or maximal wheeling speed. CONCLUSIONS: Hand and wrist protection in the form of a splint or glove/splint combination can reduce hyperextension of the wrist, and therefore may be of functional value for wheelchair users. This form of protection may therefore be useful in various orthopedic conditions of the wrist or hand commonly seen in wheelchair-dependent individuals without seriously interfering with wheeling quality.

Journal Article↗

PubMed1997

Splinting osseointegrated implants and natural teeth in rehabilitation of partially edentulous patients. Part I: laboratory and clinical studies.

A significant clinical consideration in the restoration of partial edentulism with implant and tooth-supported prostheses is whether implants and natural teeth abutments should be splinted, and if so, in what manner. This article presents a review of laboratory and clinical studies related to splinting. Stress analysis studies reveal high stress concentration around the implant neck when rigidly connected to teeth. This was not borne out in in vivo studies in short-span bridges. While stress absorbing elements have been advocated to redistribute and reduce stress concentration away from the implant neck where bone resorption is often seen, finite element analysis and photo-elastic studies demonstrate that such stress absorbing elements may be effective only when their resiliency is in the same order of magnitude as the periodontal ligament. Clinical studies reporting life table statistics in combined implant and tooth restorations do not show adverse effects of splinting teeth to implants. These studies, however, are mostly short-term reports on survival with results that are as yet inconclusive. The issue of connecting with rigid or non-rigid connectors remains unresolved with a growing body of information favouring retrievable short-span rigid connection to non-mobile teeth. Root intrusion is a potential clinical hazard of non-rigid connection.

Bone Resorption↗

PubMed1998

[Nasal splint--space holder for after-care in endoscopic paranasal sinus operations].

BACKGROUND: Scars and synechiae in the middle meatus of the nose are dreaded late complications of endoscopic sinus surgery. The placement of a stent into the ethmoidal sinus for ventilation and drainage during and after the wound healing in the nose and the sinuses seems to be advantageous. METHOD: A nasal splint (Nasensplint, Primed, Halberstadt) made of silicone, consisting of an oval shaped plate and a lateral groove with an attached strap is presented. A part of the groove should be placed in the middle meatus of the nose. The plate also acts as a stent after septal surgery. Up to now the nasal splint was placed in 32 patients after endoscopic sinus surgery and were left in place for 5-14 days. RESULTS: All patients tolerated the stents. No side effects or complications were observed. In the postoperative controls (2-12 weeks) no synechiae were observed. CONCLUSION: The nasal splint presented here seems to be a useful solution for problems in postoperative wound healing after endoscopic sinus surgery. It can help to avoid fibrin bridges between corresponding wound surfaces.

Cicatrix↗

PubMed1998

Indirect open reduction through intercartilaginous incision and intranasal Kirschner wire splinting of comminuted nasal fractures.

The majority of nasal fractures have been managed by using closed reduction and intranasal packing. In comminuted nasal fractures, open reduction and internal fixation may be indicated for accurate reduction and rigid fixation, but it is a very aggressive procedure. We developed a new technique for comminuted nasal fractures: indirect open reduction and intranasal Kirschner wire splinting. A periosteal elevator is used to elevate the mucoperiosteum posterior to the nasal bone through intercartilaginous incision and to reduce accurately the nasal bone, at the same time detecting the fracture lines. The Kirschner wire is used to insert between the nasal bone and the mucoperiosteum and to splint rigidly the nasal bone. During the follow-up period of 5 weeks to 4 months, 23 of 27 patients (85 percent) had successful cosmetic results. Four patients had slight cosmetic deformity but did not request a late rhinoplasty. Nineteen patients had accurate reduction on a computed tomography scan. Ten patients had undercorrection of the nasal septum on a computed tomography scan, and three patients had significant septal deviation with airway obstruction. Indirect open reduction through intercartilaginous incision and intranasal Kirschner wire splinting is a reliable and useful method for the treatment of comminuted nasal fractures because it achieves accurate reduction and rigid, long intranasal support, can be done comfortably under local anesthesia, permits early nasal breathing postoperatively, has no external scar, and minimizes complications such as nasal bleeding, soft-tissue injury, infection, and recurrent displacement.

Adolescent↗

PubMed2006

Is a selective splinted ureterocystostomy protocol feasible in renal transplantation? An analysis of 475 renal transplantations.

Routine splinting of the ureterocystostomy during renal transplantation lowers the urological complication rate but increases patient's morbidity. The number needed to treat to prevent one urological complication is high. The aim of this study was to identify risk factors, which can be used in the implementation of a selective splinting ureterocystostomy protocol. Retrospective analysis of 475 consecutive renal transplantations performed between January 1999 and December 2004. Donor, surgical-technical and recipient factors were assessed. Urological complications occurred in 62 (13%) patients. In 29 of these 62 patients (6.1%), only a temporary percutaneous nephrostomy catheter was necessary and in 33 (6.9%) surgical revision was required. Episodes of acute rejection and delayed graft function were identified as the only independent risk factors for a urological complication: odds ratio 2.62 [95% confidence interval: (CI) 1.38-4.97] and 2.22 (95% CI: 1.14-4.33), respectively. None of the risk factors for urological complications after renal transplantation that are known at the time of performing the ureterocystostomy are useful for the implementation of a selective splinting protocol.

Adolescent↗

PubMed1985

Shin splints--a literature review.

"Shin splints" is not a specific diagnosis. It is merely a descriptive term that describes chronic exertional shin pain in an athlete. The evidence seems clear that shin splint pain has many different causes and this reflects the variation in the anatomy. It would be preferable to describe shin splint pain by location and aetiology, for example, lower medial tibial pain due to periostitis or upper lateral tibial pain due to elevated compartment pressure. This would aid communication between physicians and also direct therapy more accurately.

Athletic Injuries↗

PubMed1991

Surgical treatment of open splint bone fractures in 26 horses.

Over a period of 16 years, 26 horses were treated for open fractures involving the splint bones. Treatment consisted of surgical excision of fracture fragments and sequestra, and curettage of infected and unhealthy tissues. The splint bone distal to the fracture was removed in nine horses in which the attachment of the splint bone to the cannon bone via the interosseous ligament did not provide adequate stability. In two horses it was considered necessary to stabilise the proximal fragment by internal fixation and infection developed in both of them; one of these horses was destroyed on humane grounds. In the other 25 horses an excellent result was obtained in terms of cosmetic appearance and return to soundness.

Animals↗

PubMed1997

Shin splints: MR appearance in a preliminary study.

PURPOSE: To investigate the magnetic resonance (MR) imaging appearance of activity-related lower leg pain (shin splints syndrome) and evaluate the relative involvement of bone and soft tissues. MATERIALS AND METHODS: Nineteen patients with activity-related lower leg pain and tenderness on palpation along the posteromedial tibia (shin splints) underwent clinical examination and MR imaging. Five also underwent plain radiography. MR findings were compared with patient demographics, clinical findings, and plain radiographs when available. RESULTS: Four MR patterns were identified: normal appearance (n = 7), periosteal fluid only (n = 5), abnormal marrow signal intensity (n = 5), and stress fracture (n = 2). Increased symptom duration correlated strongly with a normal MR image (P = .002). Plain radiographs appeared normal in all five patients for whom they were available. CONCLUSION: Patients with acute shin splints have a spectrum of MR findings, which suggests this clinical entity is part of a continuum of stress response in bone. The strong association between chronic symptoms and a normal-appearing MR image implies that this modality has less utility in these patients.

Acute Disease↗