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The severely twisted nose. Treatment by separation of its components and internal cartilage splinting.

Adequate treatment of the deviated nose requires a detailed evaluation of the deformity present. A new method of component separation with internal cartilage splinting has been used with success to correct the severely deviated nose. The separation of the components allows detection and correction of all areas of cartilage deviation. The internal cartilage splinting allows long-term support and avoidance of mid-vault collapse.

Adolescent↗

[Treatment of hip dislocations and subluxations by Petit's splints].

PURPOSE OF THE STUDY: The management of DDH in infants less than one year old is not yet definite. Many ambulant therapeutic methods are described and Pavlik's harness is widely employed. The use of Petit's splints is less well known and we report our experience with 169 cases. MATERIAL AND METHOD: Between 1973 and 1991, Petit's splints were used in 112 cases, following abduction cushions in 55 cases and after Pavlik's harness in 2 cases. 103 hips were dislocated but reducible. This permitted progressive abduction of the hips in order to obtain the reduction of the dislocation and to ensure stabilization by retraction of the slack articular capsule. RESULTS: Only 8 dislocations (4,7 per cent) couldn't be reduced by this procedure and necessitated another treatment. Hips were normal after 5 years of follow up in 118 cases and there were 43 residual dysplasias. 6 post reductional avascular necrosis (3,7 per cent) were recorded as a complication of this method among which only one was a serlous from. DISCUSSION: This ambulatory method for treatment of congenital hip dislocation seems to be forsaken by many authors. Nevertheless its effectiveness has been demonstrated with a complication rate lower than with Pavlik's harness procedure.

Female↗

The Thomas splint. Questionable boast of an indispensable tool.

The Thomas splint has been used since the late 1800s. During World War I, physicians began using it for the acute management of femoral fractures and attributed its use to reduced mortality associated with these injuries. However, articles differ as to the actual percentage of mortality reduction. Even though these discrepancies exist, the Thomas splint has been useful and is still used today, especially for patient transport while awaiting definitive management.

Equipment Design↗

Cardiorespiratory and metabolic effects of walking, standing, and standing with a splint during the recuperative period from maximal exercise in horses.

OBJECTIVE: To determine the effects of walking, standing, or standing with a splint on 1 forelimb on rate of recuperation of horses after a brief, intense bout of exercise. ANIMALS: 6 adult Thoroughbreds (435 to 542 kg). PROCEDURE: Horses were preconditioned by exercise on a treadmill to establish a uniform level of fitness. Once fit, the treadmill speed causing each horse to exercise at 120% of its maximal oxygen consumption was determined and was used in simulated races at 14-day intervals. Horses were instrumented for collection of arterial and mixed venous blood samples for measurement of acid-base status, concentrations of metabolites, and cardiopulmonary indices. The horses were exercised at a speed inducing 120% of their maximal oxygen consumption until fatigued or for a maximum of 2 minutes. Three recuperative interventions were evaluated: walking at 1.8 m/s for 30 minutes, then standing for the remainder of the 90-minute trial; standing stationary for 90 minutes; and standing stationary for 90 minutes with a splint on the right forelimb. RESULTS: Walking significantly increased cardiac output during the recuperative phase and hastened recovery of normal acid-base status and return of blood lactate concentration to baseline values. CONCLUSION: Limiting movement of horses during the recuperative period delays recovery from maximal exercise. Most measured indices returned to baseline by 60 minutes after exercise. All measured cardiopulmonary indices returned to baseline values by 90 minutes after exercise. CLINICAL RELEVANCE: Horses that are not allowed to walk during recuperation from exercise may have a prolonged recovery period.

Acid-Base Equilibrium↗

[Clinical observation of TMJDS treated with pivot splint].

The pivot splint was applied to 50 patients with temporomandibular joint dysfunction syndrome that included 30 patients of anterior disc displacement without reduction, 12 patients of anteriordisc displacement with partial reduction and 8 patients of upward condyle displacement. The mouth opening and joint space of the TMJ tomographies before and after treatment were measured for each case. The results indicated that treatment with pivot splint was very effective for the patients with downward diplacemenr of the condyle. As a result, among 50 patients, 36 patients were cured (72%) and 14 patients were improved (28%). The results of 3 years follow-up indicated that original symptoms of the patients had no recurrence.

Adolescent↗

Treatment of hand and wrist pain. A randomized clinical trial of high voltage pulsed, direct current built into a wrist splint.

To determine the effectiveness of high voltage pulsed current (HVPC) in reducing chronic hand edema, 120 individuals were randomly assigned to one of two treatment groups. Group I clients were given an appropriate sized wrist splint, incorporating an energized, high voltage pulsed unit. Group II clients were given an identical splint with a non-energized unit. Each client received daily treatments at the worksite consisting of 30 minute sessions totaling 20 treatments during a 35 day period. Pre-treatment and post-treatment evaluations included measurements of pain, grip strength, and edema volume; repetitive task testing; and Semmes-Weinstein Monofilament sensory testing. In the energized group, post-treatment evaluation showed statistically significant decreases in the amount of stimulation required to stimulate the median nerve and the amount of hand edema and pain. The energized group also had improved repetitive task times. None of these improvements occurred in the non-energized group. Based on these results, HVPC appears to be an effective method for minimizing the severity of repetitive stress injuries of the wrist.

Chronic Disease↗

Tooth splinting for severely mobile mandibular incisor teeth in a dog.

Periodontal disease, in its advanced stages, causes tooth mobility. The tooth movement further damages the periodontium, accelerating the disease process leading to tooth loss. Dental splinting can provide coaptive stability to the teeth as an important component of a periodontal treatment plan. This report documents results four years following splinting of the mandibular incisor teeth in a 3 year old Miniature Schnauzer dog.

Animals↗

[Dynamic splinting after flexor tendon injuries of the hand in childhood].

Ninety severed flexor tendons were repaired in 24 boys and 14 girls in a four-year-period at the Department of Pediatric Surgery in Graz. Mean age was 4.9 years. In 16 patients (42%) additional lesions were found. Direct repair was performed with modified techniques of Kirchmayr (23) or Kleinert (8). In four fingers, flexor tendon reconstructions were carried out. Postoperatively, the dynamic Kleinert splint was used for early nonresistive motion, beginning on average on the second postoperative day. Intensive training of motion was performed in physiotherapeutic sessions during a mean period of five months, postoperatively. In five cases tenolysis was performed; in one case a rupture of a sutured tendon had to be corrected. 27 patients (71%) with 42 injured fingers were followed-up on average 2.7 years after the operation. In accordance with the Buck-Gramcko classification, very good results were achieved in 37 cases (88%), and a poor result in one patient (2%). Atraumatic technique, dynamic splinting, consequent physiotherapeutic training by experienced physiotherapists, and well informed parents will yield excellent results after flexor tendon repair in the paediatric age group.

Child↗

[Active movement therapy after flexor tendon suture using a new dynamic control splint].

The authors constructed a new dynamic guiding splint assisting the active mobilisation after flexor tendon repair distal to the wrist. In these cases, the "inverse" wrist position seems to be the best position for mobilisation. This means that finger flexion should be carried out during wrist extension, and finger extension during wrist flexion. The splint guides and co-ordinates the movements of the wrist and the fingers, and it limits the free usage of the hand.

Electromyography↗

Immediate and long-term results of the splinting for acute closure trial.

The ability of coronary splinting to salvage acute coronary occlusion was prospectively studied in 22 patients whose coronary occlusion was refractory to a 15-min balloon dilatation. Splinting was successful in 20 patients (91%). One patient required emergency bypass surgery, and one patient was treated medically for continued coronary occlusion. There was no late ischemic events. The peak CK was 1081 +/- 733 U/L and 1,451 +/- 1,646 U/L for the study and control patients (P = NS). The peak CK-MB was 110 +/- 102 mg/dl and 78 +/- 84 mg/dl, respectively (P = NS). There were no differences in electrocardiographic changes or Q-wave myocardial infarction between the groups. At 6-month follow-up, one patient required coronary artery bypass graft surgery. There were no late myocardial infarctions or deaths.

Aged↗

[Adhesion prophylaxis: treatment with tube splints (author's transl)].

One of the stated goals of the abdominal surgeon is to find a sure prophylaxis for the threat of ileus due to adhesions. The numerous conservative methods, such as intra-abdominal dispensing of campher oil, olive oil, etc., are viewed in relation to the operative procedures of small intestine plication according to Nobel and mesenteric plication according to Child. Both operations, however, are accompanied by numerous complications. Inner intestinal splints with long tubes have proved efficacious in the prophylaxis of adhesions in early postoperative ileus. The tube is doubly effective: It relieves the intestine and thereby aids in better microcirculation of the intestinal wall and simultaneously guarantees a splinting of the intestine in the physiologically correct position. On the average, the tube is removed after 12-14 days.

Humans↗

Adductor insertion avulsion syndrome, "thigh splints": relevance of radiological follow-up.

We present a case of chronic osteomyelitis in a 13-year-old girl which was originally diagnosed as adductor insertion avulsion syndrome ("thigh splints") on the basis of the clinical presentation, patient history, initial radiographs and MRI examination. However, at follow-up with persistent pain and altered radiographic and MRI appearances, surgical biopsy was indicated. Histopathological findings confirmed a bone abscess. This case underlines the necessity of clinical follow-up and imaging in certain patients with apparent thigh splints.

Adolescent↗

Cardiac dilatation after cardiopulmonary bypass: ceramic plate technique for sternal splinting.

Intraoperative sternal closure after cardiopulmonary bypass in patients with cardiac dilatation and dysfunction may cause fatal deterioration of their hemodynamics. To avoid this complication, a ceramic plate made from methyl methacrylate was used for sternal splinting. This simple splint can avoid chest wall compression to the overdilated heart, maintaining stable hemodynamics after cardiopulmonary bypass without postoperative respiratory complications or mediastinal infection.

Bone Cements↗

A clinical evaluation of plaster-of-Paris and eight synthetic fracture splinting materials.

A number of new synthetic orthopaedic splinting materials, all claiming substantial advantages over the traditional plaster-of-Paris, have been introduced in recent years. However, although their properties have been extensively measured in the laboratory, little has been documented concerning their performance in clinical use. This study was therefore initiated as a comparative evaluation of the clinical characteristics and ease of use of these relatively expensive materials in the fabrication of below-knee weight-bearing casts. The study encompassed nine materials--seven based on water-activated polyurethanes, one thermoplastic and plaster-of-Paris, and involved a total of 203 patients. It was concluded that plaster-of-Paris should be used for all routine splinting applications, but that in cases in which cast weight, cast bulk, or the time to bearing weight is important, a synthetic material, chosen principally on the basis of cost, is indicated.

Adolescent↗

A comparative prospective study of splinted and unsplinted Brånemark implants in mandibular overdenture therapy: a preliminary report.

Thirty-six edentulous patients, each provided with two Bränemark implants in the mandible to anchor an overdenture, were selected for this study and randomly divided into three groups of 12 patients each. In each group a different attachment system was used: (1) magnets, (2) ball attachments, and (3) straight bars with clips (control). The mean loading time was 12.4 months (range 3 to 24 months). This study investigated (1) the clinical behavior of loaded implants by means of overdentures related to their connection system (splinted versus unsplinted) and (2) the clinical performance of prosthetic treatment. Preliminary results indicate no differences; no failures occurred and the level of marginal bone height, as well as the probing attachment level, changed similarly in the three groups. Although splinted bar-retained overdentures scored better objectively, subjective satisfaction ratings did not differ. It was concluded that for the short follow-up period, the state of connection did not influence the clinical success of implants. However, no definite conclusions may be drawn until long-term data become available.

Adult↗