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At least 937 records · Page 52Linked to original sources
PubMed2006

Metacarpal shaft fractures of the fingers: treatment with interosseous loop wire fixation and immediate postoperative finger mobilisation in a wrist splint.

It is widely believed that interosseous loop wire fixation of metacarpal shaft fractures alone is not rigid enough to allow immediate postoperative mobilisation. In this report, the author reviews the results in 36 cases of metacarpal shaft fractures of the fingers treated by interosseous loop wire fixation and immediate postoperative mobilisation of all finger joints. The study included 30 males and six females, with a mean age of 31 (range 12-52) years. The fracture pattern was transverse in 26 and oblique, or spiral, in the remaining 10 patients. Following loop wire fixation, the wrist was immobilised using a volar plaster splint for 3 weeks but all finger joints were mobilised immediately after surgery. After a mean follow-up of 8 weeks, all patients, except two, had regained full range of motion of the fingers and no complications were noted. It was concluded that interosseous loop wire fixation of metacarpal shaft fractures is rigid enough to allow immediate postoperative finger mobilisation in a wrist splint and achieve good functional results.

Bone Wires↗
PubMed1978

Correction of pectus excavatum without prostheses or splints: objective measurement of severity and management of asymmetrical deformities.

From 1949 to 1977, 254 children underwent surgical reconstruction of pectus excavatum by means of a variety of operations at The Johns Hopkins Hospital. From 1970 to 1977, 68 children had a modified Ravitch repair, with the addition of a tripod internal fixation technique for support of the sternum. These children obtained excellent cosmetic reconstruction without prosthetic support or splints. During an 18-month period we used a new system of caliper measurement of the spatial anatomy of the thoracic cage in more than 50 children. During the same period, we originated an operative step to correct the not uncommon asymmetrical excavatum that is usually deeper on the right and associated with a troublesome rotation of the sternum, found in 9 of the last 27 children seen. Correction was accomplished with an oblique anterior sternal osteotomy. The groups were analyzed and compared with respect to age, postoperative complications, and end results in order to identify trends in the management of children with this condition. On the basis of this experience, we feel confident in recommending a standardized operation for all forms of pectus excavatum at an elective age between 4 and 6 years and without prosthetic splints.

Adolescent↗
PubMed1999

Treatment and posttreatment effects of acrylic splint Herbst appliance therapy.

This study evaluated the skeletal and dentoalveolar changes induced by acrylic splint Herbst therapy of Class II malocclusion. The treated group comprised 55 subjects with Class II malocclusion treated with the acrylic splint Herbst appliance followed by comprehensive edgewise therapy. The mean age at Time 1 (immediately before treatment) was 12 years and 10 months +/- 1 year and 2 months. The mean age at Time 2 (immediately after debonding of the Herbst appliance) and Time 3 (posttreatment) was 13 years and 10 months +/- 1 year and 2 months and 15 years and 2 months +/- 1 year and 4 months, respectively. The two control groups were one group of 30 subjects with untreated Class II malocclusion and another group of 33 subjects with Class I occlusion. The three groups were homogeneous as to the stage of maturation of cervical vertebrae at all observation times. A modification of Pancherz's cephalometric analysis was applied to the lateral cephalograms of the three groups at Time 1, Time 2, and Time 3. Linear and angular measurements for mandibular dimensions, cranial base angulation, and vertical relationships were added to the original analysis. Differences for all the variables from Time 1 to Time 2 (active treatment effects), from Time 2 to Time 3 (posttreatment effects), and from Time 1 to Time 3 (overall treatment effects) were calculated for the treated group and contrasted to corresponding differences of both untreated groups by means of ANOVA (P <.05). The study showed that two thirds of the achieved occlusal correction was due to skeletal effects and only one third to dentoalveolar adaptations. Both skeletal and dentoalveolar effects were due mainly to changes in mandibular structures. A significant amount of relapse in molar relationship occurred during the posttreatment period, and this change could be ascribed to the mesial movement of the upper molars.

Acrylic Resins↗
PubMed1993

A longitudinal study of the clinical performance of resin bonded bridges and splints.

A total of 382 resin bonded bridges and splints were fitted, in 309 patients, in a teaching hospital. The restorations were evaluated after a period ranging from 5 months to 8 years. During the evaluation period 125 restorations (33%) debonded of which 69 (55%) were rebonded. The survival rates of the rebonded restorations at first, second, third or fourth rebond, where necessary, did not differ from the survival rate of the same restorations up to the first debond. Restorations constructed using the Rochette design had a significantly higher debond rate than the other designs. However, since they also exhibited a high rebond rate Rochette restorations continued to perform well over the study period. Splints had a higher debond rate as did restorations placed in patients in the age group 11 to 20 years, restorations involving more than two abutment teeth, and restorations containing more than one tooth pontic.

Adolescent↗
PubMed2003

Minimally displaced Colles' fractures: a prospective randomized trial of treatment with a wrist splint or a plaster cast.

Sixty-six adult patients with minimally displaced distal radial fractures were randomly assigned to treatment with either a plaster cast or a lightweight removable wrist splint. Outcome assessment was by clinical and radiological evaluation and an independent physiotherapy assessment. There were significant differences between the treatments for cast satisfaction, cast problems and the functional assessment score at 6 weeks, with the removable splint scoring better in all cases.

Activities of Daily Living↗
PubMed1991

Hypnotherapy in the treatment of the chronic nocturnal use of a dental splint prescribed for bruxism.

A behavioral medicine case is described in which the patient was treated with a combined approach involving both hypnoanalytic and hypnobehavioral techniques. A 55-year-old man with bruxism was referred after 10 years of craniomandibular treatment because of his dependency on a dental splint prescribed for nocturnal use. A projective hypnoanalytic exploration helped to uncover and consequently resolve an earlier conflict that had been reactivated in the patient's work situation and which had become a constant source of mental and muscular tension. The hypnoanalytic exploration was followed by a cognitive-behavioral hypnotic intervention that was tape-recorded and prescribed for bedtime practice. Pre- and posttherapy psychological, physiological, and self-report measurements corroborated the patient's sense of well being that came with his newly found ability to sleep without the dental splint. The importance of considering multiple etiological factors in the treatment of such psychosomatic disorders as bruxism is discussed.

Bruxism↗
PubMed1988

Shin splints. Diagnosis, management, prevention.

Our knowledge of the etiology of shin splints is incomplete. Biomechanical abnormalities are likely to be major factors in predisposing certain persons to such injury. Also, training errors are major etiologic factors. Because shin splints result from mechanical overload of various elements of the musculoskeletal system of the leg that exceed their adaptive remodeling capacity, rest and recovery should be emphasized as an important aspect of sports training. Accurate and prompt diagnosis reduces the severity and duration of the injury. Management should consist of measures to reduce inflammation and pain and to identify possible biomechanical factors that may be correctable by strengthening and flexibility exercises or by the use of an orthotic device.

Athletic Injuries↗
PubMed1991

Positioning control of the upper incisors in orthognathic surgery. Pre-operative planning with the Model Positioning Device and intra-operative application of the Sandwich Splint.

In orthognathic surgery a three-dimensional positioning of the maxilla is possible by means of the Le Fort I osteotomy and subsequent maxillary movement. In treatment planning and at the time of surgery it is very important to achieve an exact positioning of the upper incisors in relation to the upper lip and the rest of the skull. The Model Positioning Device described here allows three-dimensional positioning of the upper incisors in one- or two-jaw surgery. The reference plane is the upper surface of the upper part of a semi-individually adjustable articulator. The application of the Sandwich Splint enables the three-dimensional positioning of the maxilla in relation to the rest of the skull. The Sandwich Splint ensures that the vertical position of the mandible in relation to the rest of the skull above the osteotomy plane is exactly reproducible in the pre- and post-operative situation in both model surgery and at time of surgery. To this mandibular position the maxilla is positioned in three dimensions, as preplanned. The vertical dimension, which is identically reproducible before and after surgery is measured with a caliper. After surgery the mandible can be rotated into the planned new intercuspidation.

Calibration↗
PubMed2002

Mandibular advancement splints and continuous positive airway pressure in patients with obstructive sleep apnoea: a randomized cross-over trial.

This prospective, randomized, cross-over trial was designed to compare the efficacy of a mandibular advancement splint (MAS) with that of nasal continuous positive airway pressure (nCPAP) in patients with obstructive sleep apnoea (OSA). Twenty-four patients (20 males and four females) with mild to moderate OSA (AHI between 10 and 49 events per hour) were enrolled in the study. Each patient used both MAS and nCPAP, with the initial therapy being allocated at random. Treatment periods lasted for two months with a two-week wash-out interval between. Polysomnography was performed prior to the study and after each clinical intervention. Patient and partner questionnaires were used to assess changes in general health and daytime somnolence. The AHI decreased from 22.2 to 3.1 using nCPAP, and to 8.0 using the MAS (P < 0.001 for both devices) and there was no statistically significant difference between the two treatments. The Epworth Sleepiness Score (ESS) fell from 13.4 to 8.1 with nCPAP, and to 9.2 with MAS (P < 0.001), again with no differences between the use of MAS or nCPAP. The questionnaire data showed an improvement in general health scores (P < 0.001) after both treatments, but daytime sleepiness only improved significantly using nCPAP (P < 0.001). Despite this, 17 out of the 21 subjects who completed both arms of the study preferred the MAS. The splints were well tolerated and their efficacy suggests that the MAS may be a suitable alternative to nCPAP in the management of patients with mild or moderate OSA.

Adult↗
PubMed2001

Treating ingrown toenails by nail splinting with a flexible tube: an Indian experience.

Ingrown toenail is a common problem, and currently available treatments are either quite invasive or associated with unacceptably high recurrence rate. Recently a new non-invasive therapy. "Nail splinting", has been introduced. In this procedure, the nail is splinted with a longitudinally incised plastic tube. We conducted the present study to evaluate the efficacy and safety of this procedure in fifty patients (68 nail edges in 61 nails) with ingrown toenails at all stages. The pain disappeared almost immediately, and inflammation subsided in about one week in all nail edges. Thirty-nine patients came for regular follow-up for six months after removal of the tube. Eight (20.5%) of these patients showed recurrence of the problem. No serious side effects were noted.

Adult↗
PubMed1983

Disrupting injuries of the membranous urethra--the case for early surgery and catheter splinting.

We reviewed the outcome following primary definitive repair by catheter splinting in 16 patients presenting with total posterior urethral disruption following pelvic injury. There were two deaths in the early post-operative period due to pulmonary embolism associated with other serious injuries. Five patients were judged to have a significant stricture at the site of injury, but all proved amenable to management with endoscopic treatment or periodic dilatation. None required a urethroplasty. The two cases with stress incontinence were related to concomitant injury of the bladder neck. Impotence persisted in 2 or 5 patients followed for longer than 12 months. Complications from catheter traction were not seen using the system of light interrupted traction described. A case is made for primary management by catheter splinting of such urethral injuries.

Adult↗
PubMedDate not supplied

Surgical management of proximal splint bone fractures in the horse.

Fractures of Metacarpal and Metatarsal II and IV (the splint bones) were treated in 283 horses over an 11 year period. In 21 cases the proximal portion of the fractured bone was stabilized with metallic implants. One or more cortical bone screws were used in 11 horses, and bone plates were applied in 11 horses. One horse received both treatments. Complications of screw fixation included bone failure, implant failure, radiographic lucency around the screws, and proliferative new bone at the ostectomy site. Only two of the horses treated with screw fixation returned to their intended use. Complications of plate fixation included partial fixation failure (backing out of screws), wound drainage, and proliferative bony response around the plate. Six of the 11 horses treated by plate fixation returned to their intended use. The authors recommend consideration of plate fixation techniques for repair of fractures in the proximal third of the splint bone.

Animals↗
PubMedDate not supplied

Interstitial pressure measurements in the anterior and posterior compartments in athletes with shin splints.

We found no basis for increased intercompartmental pressure in either the anterior or posterior compartments as the cause of shin splints. The pain in all 14 of the patients studied was localized to the posterior medial border of the tibia at the origin of the posterior tibial muscle, and evidence of periostitis in this area was seen in two of our patients, suggesting the possible tearing away of the posterior tibial muscle from its origin. Shin splints is a lay term which has assumed medical diagnostic significance and should be removed from common usage by more accurately localizing the focus of pain.

Anterior Compartment Syndrome↗
PubMed2001

Adductor insertion avulsion syndrome (thigh splints): spectrum of MR imaging features.

OBJECTIVE: "Thigh splints," also known as the adductor insertion avulsion syndrome, is a painful condition affecting the proximal to mid femur at the insertion of the adductor muscles of the thigh. Scintigraphic findings in this syndrome have been described; we report a spectrum of MR imaging abnormalities involving this portion of the femur in a group of patients presenting with hip, groin, or thigh pain. CONCLUSION: Symptoms of vague hip, groin, or thigh pain may be associated with stress-related changes in the proximal to mid femoral shaft (thigh splints). When interpreting MR imaging studies of the pelvis in patients presenting with these symptoms, careful attention should be directed to this portion of the femur. This is especially important because the findings may be subtle, and this region is often at the distal edge of most MR imaging studies of the pelvis and hip.

Accidents, Occupational↗
PubMed1995

Subcapital fractures of the fourth and fifth metacarpals treated without splinting and reposition.

The aim of the study was to evaluate the results after treating subcapital fractures in the fourth and fifth metacarpals with immediate mobilisation and without splinting or reduction. We undertook a prospective clinical evaluation of 36 subcapital fractures of the fourth and fifth metacarpals treated with immediate mobilisation and without splinting or reduction during the period 1 January 1990 to 31 December 1992 in the accident and emergency department, Holstebro Central Hospital. After 4 weeks only 4 patients (11%) had restricted movement in the metacarpophalangeal joint (less than 0-80 degrees of movement). The fracture had healed in 33 patients (92%), and 31 of the patients (86%) were completely satisfied. We conclude that subcapital fractures in the fourth and fifth metacarpals can be treated without immobilisation or reposition.

Adolescent↗
PubMed1987

Nonsuture microvascular anastomosis using an Nd-YAG laser and a water-soluble polyvinyl alcohol splint.

Anastomosis of rat common carotid artery was performed without sutures, using a neodymium (Nd)-YAG laser at 20 W for 100 msec; this power and exposure had been found optimal in preliminary experiments. An intraluminal intervascular splint made of water-soluble polyvinyl alcohol, which dissolved and disappeared within a few minutes after recirculation of blood, was used for precise "intima-to-intima" coaptation. No stay sutures or glue were required during the procedure. There was a 92% patency rate 24 hours after surgery, and the anastomosed vessels were still patent on the 7th and 30th postoperative days. Complications such as aneurysm formation or stenotic change were negligible. The fusion of the muscle layer and collagen fibers of the media in the anastomosis was confirmed histologically. A tensile strength test immediately following operation and 1 week later showed that this anastomosis was significantly better than that achieved with the usual manual suture method. The major advantages of this technique, combined with use of a water-soluble polyvinyl alcohol splint, are rapidity, consistency of results, and firm fusion with no residual foreign body.

Anastomosis, Surgical↗