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Rollerblading injuries in children attending an accident & emergency department: should the use of wrist splints be compulsory?

Our aim was to determine the incidence and nature of injuries in children from rollerblading attending a district general hospital Accident & Emergency (A&E) department in Scotland. Children, aged between 5-16 years, presenting with an injury from rollerblading, were studied prospectively over a three month period. A total of 34 children attended the department with a rollerblading injury. Boys (53%) and girls (47%) were injured almost equally. The wrist was the most frequently injured area of the body (62%) with 12 fractures and 9 soft tissue injuries. No children were wearing any form of protective equipment. Rollerblading is an increasingly popular, but expensive, activity amongst children in Scotland. Wrist injuries from falling were the most common presentation which may result in prolonged school absenteeism. Emphasis is normally placed on protective headgear, however, with wrist injuries more common, consideration must be given to the active promotion of injury prevention and the wearing of wrist splints.

Adolescent↗

Intraoral acrylic splints for maxillofacial fracture repair.

Maxillofacial fractures in dogs and cats occur secondary to vehicular trauma, falls, kicks, gunshots, and fights with other animals. Pathologic mandibular fracture may occur secondary to periodontal disease, neoplasia, and metabolic diseases. The primary objective for repair of maxillofacial fractures in small animals is return to normal function. Therefore, it is necessary to maintain occlusal alignment while providing adequate stability for bony union. Basic principles of maxillofacial fracture repair include anatomic reduction and restoration of occlusion, application of a stable fixation to neutralize negative forces on the fracture, gentle handling of soft tissues, avoidance of iatrogenic dental trauma, extraction of diseased teeth within the fracture line, and minimizing excessive soft tissue elevation. This review article will describe the application of intraoral acrylic splints for maxillofacial fracture repair.

Animals↗

Use of maxillary and mandibular splints for restoration of normal occlusion following jaw trauma in a cat: a case report.

A compression fracture of the maxilla in a young cat was treated by splinting the maxillary canine teeth. Wire-reinforced composite resin was used to keep these teeth from tipping palatally. This technique stabilized the fracture with anatomic reduction and minimal invasion of the tissues. A mandibular symphyseal separation was also stabilized with a cerclage wire and composite resin bonded wire fixation of the mandibular canine teeth. Two years later, occlusion was normal.

Animals↗

Treatment of plantar fasciitis with a night splint and shoe modification consisting of a steel shank and anterior rocker bottom.

Seventy-one feet in 57 patients with plantar fasciitis were treated with the combination of a night splint and a shoe modification consisting of a steel shank and anterior rocker bottom. At average follow-up of 16 months, symptoms were resolved in 42 (59%), improved in 13 (18%), not changed in 11 (15%), and worse in 5 (7%) of the feet. No relation was found between outcome and age, gender, duration of symptoms, and bilateral involvement. The method is effective for the treatment of plantar fasciitis.

Adult↗

Non-apneic snoring and the orthodontist: the effectiveness of mandibular advancement splints.

OBJECTIVE: Non-apneic snoring is a very common problem, which impacts on all family members. Oral appliances have been used in the management of snoring. These posture the mandible forward during sleep, opening the airway and so reducing the potential for noise generation. This articles aims to objectively evaluate the effectiveness of mandibular advancement splints (MAS) in non-apneic snorers. DESIGN: Prospective clinical trial. SETTING: University Dental Hospital and School. SUBJECTS AND METHODS: 35 consecutively referred adults with proven non-apneic snoring. INTERVENTIONS: Subjects were fitted with a removable, adjustable Herbst MAS. MAIN OUTCOME MEASURES: Questionnaires determined changes in snoring incidence, daytime tiredness, any side effects and their duration. Eleven subjects completed overnight domiciliary sleep recordings of oxygen saturations, pulse rates and sound profile, before and 1 month after fitting the MAS. RESULTS: The questionnaires and sleep recordings suggested that the MAS significantly reduced snoring incidence (p<0.05) and improved sleep quality. Daytime tiredness, as assessed by the Epworth Sleepiness Scale, was significantly reduced (p<0.001). Initial side effects of muscular and TMJ discomforts were mostly resolved after 1 month of appliance wear. CONCLUSIONS: Use of a MAS improves snoring incidence and sleep quality in most patients with non-apneic snoring.

Adult↗

A comparison of high-profile and low-profile dynamic mobilization splint designs.

Despite claims that the high-profile dynamic mobilization splint design requires less frequent adjustments than the low-profile design, the authors are not aware of biomechanical evidence supporting such claims. The purpose of this study was to reexamine this claim and quantitatively analyze each design as well as the differences between designs with respect to the actual deviation from a 90 degrees angle of applied force for 60 degrees, 30 degrees, 20 degrees, and 10 degrees gains in proximal interphalangeal joint (PIP) extension. Additionally, for 10 degrees, 20 degrees, and 30 degrees gains in PIP extension, the authors determined the corrective and shear forces as a function of the deviation from a 90 degrees angle of applied force for each design, as well as the difference between the designs. Results show that in all instances examined, the actual difference between the designs is quite small. Implications of such findings are discussed along with newly identified relationships of potential utility to the hand therapist.

Biomechanical Phenomena↗

Static progressive splint for composite flexion.

Frequently when one sustains an injury to a digit, multiple soft tissue structures can be involved. As a result, the MCP, PIP, and DIP joints can be affected, thus limiting the ability to fully flex the finger. As hand therapists, one of our primary goals is to improve functional grasp/grip. These authors have designed a single-digit, composite flexion splint to help achieve this goal.

Biomechanical Phenomena↗

Toxic shock syndrome following septoplasty using plastic septal splints.

Toxic Shock Syndrome (TSS) is an acute multisystem disease that has been recognized to occur in a variety of clinical settings. Postoperative TSS has been described following nasal surgery associated with the use of postoperative nasal packing. We report a case of classic TSS following septoplasty where intranasal splints without nasal packing were used. Recommendations for prevention of TSS associated with nasal surgery are presented.

Adult↗

Custom cervical splint for use during head and neck surgery.

A custom-made plaster cervical/occipital splint was described that was made to immobilize a patient with vertebral metastases during neck surgery. This is a single example of a problem solved by the cooperation between the head and neck surgeon and the maxillofacial prosthodontist.

Adult↗

Modern splinting bandages.

We have assessed the current range of synthetic splinting bandages, using physical and mechanical tests and the subjective opinions of patients, volunteers and orthopaedic staff. Modern bandages have some better properties than standard plaster bandage but do not conform as well, are more expensive, and potentially more hazardous.

Bandages↗

Fractures of the carpal scaphoid. A critical study of the standard splint.

The effect of the position of splintage on displacement of fractures of the waist of the scaphoid was studied during operations and in cadavers. We found that these fractures were best splinted in neutral or slight palmar flexion with no ulnar deviation. Providing the wrist was not ulnar deviated, the position of the thumb had no effect on displacement.

Biomechanical Phenomena↗

Modification of the Koken nasal splint.

Koken nasal splints have been found effective postoperatively in treating cleft-lip nose deformity. In our experience, their retention has been poor, so reducing the molding effect. This paper presents a modification designed to overcome the problem of retention.

Cleft Lip↗

Fixation of mandibular body fracture with combination of one-piece cast splint and miniplate.

A method for fixation of mandibular body fracture within the dental arch using a combination of a rigid one-piece cast splint and a pliable miniplate screwed at the inferior border of the mandible was developed with the highest priority placed on restoration of occlusion. This paper presents the results obtained in 36 patients treated by this method. The postoperative occlusion was analyzed using the T-scan system in 20 fully dentate patients without major caries. The data obtained in the patients were well comparable to those in normal subjects.

Adolescent↗

Effect of mandibular advancement splint on psycho-intellectual derangements in patients with sleep apnea syndrome.

The mandibular advancement splint (MAS) was recently introduced for the management of sleep apnea syndrome (SAS), although its effects on psycho-intellectual functions have not been elucidated yet. We examined psycho-intellectual function before and after treatment with MAS in patients with SAS. Twenty patients with SAS underwent psycho-intellectual function testing before and after treatment with MAS for 3 to 4 weeks. The apnea index significantly decreased from 19.0+/-15.6 to 2.4+/-1.9. The state anxiety score significantly decreased from 44.6+/-12.1 to 33.7+/-11.1, the trait anxiety score significantly decreased from 46.2+/-13.4 to 37.6+/-13.8, and the depression scale score significantly decreased from 39.2+/-11.0 to 30.8+/-9.9 with MAS treatment. By the Cornell Medical Index and the Yatabe-Guilford test, the patients became less neurotic and less eccentric after treatment. By the Uchida-Kraepelin psychodiagnostic test, calculation ability significantly increased from 1247.4+/-402.1 to 1950.2+/-651.9. We conclude that MAS treatment reduces apneic episodes and improves psycho-intellectual derangements in patients with SAS.

Adult↗

A vacuum-formed splint for luxated tooth with a repositioning on the model.

The results of fixation of a luxated tooth using a vacuum-formed splint, formed on a plaster model after repositioning of the luxated tooth on the model are presented. This may be useful where the adjacent tooth gap is wide or only minimal anchorage and support are available from the adjacent teeth.

Child↗

The use of removable partial denture splints in the treatment of postsurgical tooth mobility.

The theory and clinical use of removable partial denture splints has been offered as a tenable solution to the problem of postsurgical tooth mobility. The close cooperation of the periodontic and prosthetic specialties is in many cases vital to the ultimate success of treatment and longevity of the dentition. Although not presented as a panacea, it is hoped that clinicians will bear this clinical entity in mind as an option in the treatment of periodontally debilitated dentitions.

Denture Design↗

The acetabular response to proximal femoral varus rotational osteotomy. Results after failure of post-reduction abduction splinting in patients who had congenital dislocation of the hip.

The acetabular response to proximal femoral varus rotational osteotomy was studied radiographically in twenty-eight patients who had had thirty-three congenitally dislocated hips. All of the patients had previously been managed with open or closed reduction followed by use of a spica cast and had worn an abduction orthosis for at least one year after the reduction. The indications for the femoral osteotomy were a persistently increased acetabular index or subluxation, or both. The average of the patients at the time of the femoral osteotomy was twenty-five months. The average preoperative acetabular index was 32 degrees. At an average of seven years after the osteotomy, the acetabular index had improved to an average of 16 degrees. Four hips had had one subsequent procedure for persistent acetabular dysplasia. Despite a failure of the acetabulum to respond to use of an abduction splint, the proximal femoral varus rotational osteotomy stimulated improvement in the acetabular index to within normal limits in twenty-nine of the thirty-three hips.

Acetabulum↗

Position of the wrist associated with the lowest carpal-tunnel pressure: implications for splint design.

Increased carpal-tunnel pressure has been implicated in the pathophysiology of carpal tunnel syndrome, but it is not known whether splints that immobilize the wrist in a functional position of extension minimize carpal tunnel pressure. To determine the position of the wrist that results in the lowest carpal-tunnel pressure, twenty control subjects and four patients who had carpal tunnel syndrome were evaluated with use of a new, dynamic method that continuously measures carpal tunnel pressure throughout the range of motion of the wrist. The pressure was measured by means of a pressure transducer connected to a flexible catheter that had been inserted into the carpal canal. The position of the wrist was measured simultaneously with use of a two-axis electrogoniometer. Aided by a computer monitor that displayed a moving line of real-time carpal-tunnel pressure, each subject was instructed to move the wrist throughout the range of motion and to adjust it to the position that corresponded to the lowest carpal-tunnel pressure. For the control subjects, the lowest carpal-tunnel pressure averaged 8 +/- 4 millimeters of mercury (1.07 +/- 0.53 kilopascals), and the average position of the wrist associated with the lowest pressure was 2 +/- 9 degrees of extension and 2 +/- 6 degrees of ulnar deviation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗