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PubMedDate not supplied

Deformity and function in supracondylar fractures of the humerus in children variously treated by closed reduction and splinting, traction, and percutaneous pinning.

The radiographs of 137 patients with supracondylar fractures of the humerus treated by closed reduction and splinting, traction, and closed reduction and percutaneous pinning (CRPP) were reviewed to determine the adequacy of the initial reduction and the maintenance of the reduction. Eighty-four patients were examined for function and deformity. Initially, Baumann's angle was adequate and similar in all patients, but the humerocapitellar angle was better with CRPP. Maintenance of reduction in both planes was superior with CRPP, and significantly better clinical results were achieved by CRPP. Nevertheless, there was no functional loss in any patient, and no parent wanted correction of deformity.

Adolescent↗

PubMedDate not supplied

A new material for splinting neonatal limb deformities.

We report the use of Permagum, a silicone rubber dental-impression material, in the management of neonatal limb deformities. A wide range of custom-made splints can be quickly and easily made from Permagum for both the upper and lower limb. The material is not sufficiently rigid for the older, heavier child but is particularly useful in the neurologically impaired child.

Foot Deformities, Congenital↗

PubMed2005

Dental side-effects of mandibular advancement splint wear in patients who snore.

OBJECTIVES: (a) To evaluate the longer term orthodontic side-effects of a Herbst mandibular advancement splint (MAS) in subjects with sleep disordered breathing. (b) To determine whether these are related to dental occlusion, degree of mandibular advancement or duration of appliance wear. DESIGN: Retrospective, cohort study. SETTING: Teaching hospital dental school. PARTICIPANTS: Subjects with sleep disordered breathing who had been wearing an MAS regularly (a minimum of 5 h per night, six nights a week) for at least 2 years. Of 192 subjects who were identified, 30 fulfilled the inclusion criteria and were prepared to attend for review. INTERVENTIONS: Dental casts were obtained and BMI and Epworth Sleepiness Scale scores recorded. These data were compared with those collected when the subject was first referred. A questionnaire was completed concerning MAS use, side-effects and any problems associated with the device. MAIN OUTCOME MEASURES: Changes in incisor tooth position. RESULTS: Median duration of MAS wear was 3.64 years. Small, statistically significant reductions in both vertical (-0.4 mm) and horizontal (-0.5 mm) overlap of the incisor teeth were found. This correlated with the degree of vertical opening of the MAS but was not related to the amount of mandibular protrusion or the duration of appliance wear. CONCLUSIONS: Patients who are considered suitable for MAS should be warned that dental changes may occur. Thus referring surgeons should also be aware of this possibility.

Adult↗

PubMed1984

Splinting of teeth with fixed bridges: biological effect.

Forty abutment teeth with pathological mobility were splinted with telescoped removable bridges. During the first 4 weeks the bridges were fixed. From the beginning of the fifth week they were removed once a day. Mobility was measured prior to placing the bridges and at 4 and 10 weeks intervals. Average mobility of the abutment teeth and the control unsplinted teeth did not change significantly during the experimental period.

Adult↗

PubMed1986

Postsurgical acrylic ear splints for keloids.

It is generally acknowledged that earlobe keloids are best surgically resected and repaired while attempting to leave a residual skeletal cartilaginous soft-tissue framework, oftentimes composed of keloidal tissue itself. Whether grafts, flaps, or primary incision and closure are performed, the success of each procedure may require the adjuvant use of pressure to the involved ear-lobes for at least a year. Where gross deformity has existed, the use of an "oyster splint" seems to act as a pressure remolding device.

Acrylates↗

PubMed1994

Influence of acid-etched splinting methods on discoloration of dental enamel in four media: an in vitro study.

The aim of this in vitro study was to assess the staining of enamel in relation to fixation of luxated teeth. Color changes induced by chlorhexidine, red wine, tea, and coffee were detected with a Minolta Chroma Meter (CR-121) after extracted teeth were treated to simulate construction of dental splinting. L*a*b* color readings were made before and after 7 days of incubation in the above-mentioned media in teeth treated 1) by acid-etching, 2) by acid-etching followed by resin, 3) by resin and composite, 4) by Triad Gel, and 5) by Protemp. L* is an indicator of black (0) and white (100). The a* values relate to the red (+100)-green (-100) color axes, and the b* values to the yellow (+100) and blue (-100) axes. Untreated teeth served as controls. One-way analysis of variance of mean L* values revealed no statistically significant differences in treatment. Discoloration was observed in all teeth, including the control ones. However, Protemp yielded the largest changes in mean L* values. Analysis of variance of mean L* values revealed statistically significant differences between incubation liquids because no increase in staining of enamel was noted after 7 days' incubation in chlorhexidine. Red wine increased the mean L* values more than coffee or tea. Changes in a*b* readings were toward red (+a*) after incubation in red wine, except in the case of teeth treated with resin. The color of all such teeth changed more toward yellow (+b*), because the resin used was yellow.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Etching, Dental↗

PubMed2005

Pectus excavatum surgically repaired using sternum realignment and splint techniques in a young cat.

Successful surgical repair of pectus excavatum deformities has so far only been reported in very young animals. This case report describes an alternative technique for repairing pectus excavatum in a young cat. The cat had shown moderate deformity with slight respiratory impairment when young and had experienced clinical problems with age. A sternum realignment technique involving a pin associated with an external splint was used. This alternative technique was a safe and efficient procedure in the five-month-old cat.

Animals↗

PubMedDate not supplied

Management of orofacial manifestations of Parkinson's disease with splint therapy: a case report.

Patients with Parkinson's Disease display a number of orofacial manifestations. These manifestations are secondary to motor and sensory deficits, resulting in bradykinesia, muscle rigidity and tremor, and difficulties with speech, swallowing, proprioception, tactile sensitivity, and hard- and soft-tissue trauma. This case describes the use of a bruxism splint which benefited a PD patient by diminishing the occurrence of orofacial pain secondary to muscle tremor and rigidity while reducing the cumulative damage to the oral structures common with the disease. The impact of therapy on sleep, speech, and swallowing difficulties is also discussed.

Articulation Disorders↗

PubMed1977

Provisional splinting in advanced periodontal disease. Case report.

This case report describes an approach to treatment for a patient with severe bone loss resulting from advanced periodontal diseae. A provisional splint was constructed in conjunction with suitable periodontal therapy. The purpose was to allow time for evaluation prior to deciding whether to commit the patient to permanent stabilization.

Adult↗

PubMed1998

A new intermaxillary fixation method using adhesive cast splints for avoiding skin puncture.

Intermaxillary fixation using arch bars is performed for mandibular and maxillary fractures. They are applied to the respective maxillary and mandibular arches with circumdental stainless steel wires. Skin puncture may pose a risk for the surgeon. Therefore, the authors have developed and tested a method for using intermaxillary fixation using an adhesive cast splint. The resulting strength was found to be generally superior to that achieved with arch bars. Despite some problems, this technique is considered a useful method for avoiding skin puncture.

Adhesives↗

PubMed1990

A dynamic finite element analysis of impulsive loading of the extension-splinted rabbit knee.

A dynamic nonlinear finite element model was developed to study juxtarticular stresses in the splinted rabbit knee, an established laboratory model for creating osteoarthrosis due to impulsive loading. Plane strain finite element results were validated by comparison with corresponding experimental data. Parametric effects studied included the input tibial displacement speed, the local bone density distribution, and the modulus of cartilage and subchondral bone. While the computed resultant contact force magnitude was sensitive to a number of model parameters, the stress patterns, when normalized to a given resultant force magnitude, were not. Despite comparable force peaks, the finite element results showed approximately six-fold higher effective strain rate levels for a severely impulsive loading protocol known to induce rapid osteoarthrosis, versus those for a mildly impulsive loading protocol not usually associated with cartilage damage. A propensity for elevated shear in the deep cartilage layer near the contact periphery, observed in nearly all computed stress distributions, is consistent with previous experimental findings of fissuring at that level in the impulsively loaded rabbit knee.

Animals↗

PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Plaster or functional splint in gamekeepers thumb.

A short cut review was carried out to establish whether a plaster of Paris or functional splint was better for treatment of ulnar collateral ligament rupture. Altogether 50 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. A clinical bottom line is stated.

Adult↗

PubMed2002

Physiological and biomechanical principles in splinting the traumatised hands.

The aim of this article is to review the biological sequence of wound repair and the rationale of using splintage to modify the healing process. Appropriate use of splintage and controlled stress can prevent adhesion and periarticular fibrosis. Splinting prescribed at appropriate timing and methods will enhance wound healing and tissue remodelling. In reverse, it will cause permanent damage to the tissues.

Acute-Phase Reaction↗

PubMed2002

Evidence-based practice in splinting the injured hand.

Evidence-based medicine has been practised in the early 1990s in the Western countries and its model has aroused interests in the Asian countries including Hong Kong in the late 1990s. The need for evidence-based practice was called upon by Sackett and his colleagues 14-16 mainly because of the exponential growth of new evidence of treatment effectiveness. There is a great demand for clinicians to search for the best evidence and to incorporate into the daily practice so as to ensure the best quality and standard of treatment. This paper is to review the development and process of evidence-based practice in the area of hand splinting for our local clinicians. Some major problems were identified in the delivery of clinical evidence-based practice, and suggestions have been made to overcome these problems with a view in supporting its model in the local clinical field.

Evidence-Based Medicine↗

PubMed1995

Mandibular advancement splint: an appliance to treat snoring and obstructive sleep apnea.

Snoring and obstructive sleep apnea (OSA) are related to narrowing of the upper airway. A mandibular advancement splint (MAS) could improve both conditions by increasing oropharyngeal and hypopharyngeal dimensions. The effects of a MAS on snoring and OSA was evaluated 3.5 +/- 2.1 (mean +/- SD) mo after issue in 57 subjects with habitual loud snoring, 39 of whom had an apnea-hypopnea index (AHI) > or = 10. Assessment was by questionnaire (all subjects) and polysomnography (51 subjects, 47 male) including measurement of sound intensity. Use of the MAS was randomized to first or second half of study. Snores were scored where inspiratory noise was greater than 5 dB above background. Total sleep time, sleep efficiency, % REM sleep, and % sleep spent supine were similar (p > 0.05) with and without the MAS. Snores per sleep minute, corrected for time in apnea, and sound intensity of snores (% snores > or = 50 dB) decreased with the MAS from 11.0 +/- 5.8 and 42.0 +/- 25.0% to 9.0 +/- 6.0 (p < 0.01) and 26.2 +/- 25.2% (p < 0.01), respectively. Using the MAS significantly improved OSA: AHI decreased from 32.2 +/- 28.5 to 17.5 +/- 22.7 (p < 0.01) and arousal index decreased from 31.4 +/- 20.6 to 19.0 +/- 14.6 (p < 0.01). AHI decreased to < 20 with the MAS in 12 of 17 subjects where untreated AHI was between 20 and 60, and in 2 of 9 subjects where untreated AHI was > 60. Forty-five patients continued to use the MAS regularly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2001

A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea.

Although there is increasing interest in the use of oral appliances to treat obstructive sleep apnea (OSA), the evidence base for this is weak. Furthermore, the precise mechanisms of action are uncertain. We aimed to systematically investigate the efficacy of a novel mandibular advancement splint (MAS) in patients with OSA. The sample consisted of 28 patients with proven OSA. A randomized, controlled three-period (ABB/BAA) crossover study design was used. After an acclimatization period, patients underwent three polysomnographs with either a control oral plate, which did not advance the mandible (A), or MAS (B), 1 wk apart, in either the ABB or BAA sequence. Complete response (CR) was defined as a resolution of symptoms and a reduction in Apnea/Hypopnea Index (AHI) to < 5/h, and partial response (PR) as a > or = 50% reduction in AHI, but remaining > or = 5/h. Twenty-four patients (19 men, 5 women) completed the protocol. Subjective improvements with the MAS were reported by the majority of patients (96%). There were significant improvements in AHI (30 +/- 2/h versus 14 +/- 2/h, p < 0.0001), MinSa(O(2)) (87 +/- 1% versus 91 +/- 1%, p < 0.0001), and arousal index (41 +/- 2/h versus 27 +/- 2/h, p < 0.0001) with MAS, compared with the control. The control plate had no significant effect on AHI and MinSa(O(2)). CR (n = 9) or PR (n = 6) was achieved in 62.5% of patients. The MAS is an effective treatment in some patients with OSA, including those patients with moderate or severe OSA.

Adult↗

PubMed2002

Randomized crossover trial of two treatments for sleep apnea/hypopnea syndrome: continuous positive airway pressure and mandibular repositioning splint.

Mandibular repositioning splints (MRSs) and continuous positive airway pressure (CPAP) are used to treat the sleep apnea/hypopnea syndrome (SAHS). There are some data suggesting that patients with milder symptoms prefer MRS, but there are few comparative data on outcomes. Therefore, we performed a randomized crossover trial of 8 weeks of CPAP and 8 weeks of MRS treatment in consecutive new outpatients diagnosed with SAHS (apnea/hypopnea index [AHI] >or= 5/hour, and >or= 2 symptoms including sleepiness). Assessments at the end of both limbs comprised home sleep study, subjective ratings of treatment value, sleepiness, symptoms, and well-being, and objective tests of sleepiness and cognition. Forty-eight of 51 recruited patients completed the trial (12 women; age [mean +/- SD], 46 +/- 9 years; Epworth 14 +/- 4; median AHI, 22/hour; interquartile ratio [IQR], 11-43/hour). Significant (p <or= 0.01) differences between MRS and CPAP were observed for 7 of 21 variables (effect sizes, 0.3-0.6 SDs), all favoring CPAP, including AHI (15 +/- 16 and 8 +/- 6/hour, respectively), effectiveness rating, symptoms, Epworth (12 +/- 5 and 8 +/- 5, respectively), functional outcomes of sleepiness questionnaire, short-form 36 health survey mental component, and health transition scores. Objective sleepiness, cognitive performance, and preference for treatments were not different. In patients experiencing a mild form of the syndrome (AHI < 15, n = 18), symptoms, treatment efficacy and satisfaction, and subjective sleepiness were also better with CPAP than with MRS (effect sizes, 0.7-1.1 SDs). These results do not support these MRS devices as first-line treatment for sleepy patients with SAHS.

Adolescent↗

PubMed2004

Orthoses as enablers of occupation: client-centred splinting for better outcomes.

BACKGROUND: Orthotic intervention (splinting) may have become an end unto itself in the minds of therapists and clients rather than the means to enable optimal occupational performance. Some policy makers and payers seem to hold the belief that orthoses/splints are mere technical aids and as such do not require professional skill and expertise. NARRATIVES: Three client stories demonstrate how iterative collaboration and follow-up help achieve client-identified objectives. DISCUSSION: Client input is an important component of the process and an orthosis must fit into the person's lifestyle, especially if required for long-term use. Six essential considerations when providing orthoses to meet occupational goals are emphasized: client-centredness, comfort, cosmesis, convenience, less is more and follow-up. Use of the Canadian Occupational Performance Model for intervention planning and as an outcome measure is demonstrated. PRACTICE IMPLICATIONS: Orthoses that are thoughtfully designed with client input and carefully constructed can make a difference in a person's life by relieving pain, providing protection and joint stabilization and enabling valued occupations.

Adult↗