radial nerve damage and splinting

[Guest guest]

I was recently presented with a 1 year mixed breed male dog with

evident radial nerve damage- unsure cause- rescued stray. per owner x-

rays showed healed fracture elbow region which might account for radial

nerve damage (have not seen x-ray); regardless the dog has normal

shoulder function and muscularity, no movement or fusion of elbow and

disuse of the paw--- the owner wants to splint the limb in an attempt

to fuse the carpus since the shoulder is very much usable. the carpus

also demonstrates decreased extension so considering a dynasplint to

acheive as close to possible weight bearing position for long term use

while also providing a little flexability to attempt to decrease

shoulder stress. has anyone tried such a method or got a better idea

thanks, Clare DVM CCRT candidate

[Guest guest]

Thanks appreciate muchSent from my BlackBerry device on the Wireless NetworkDate: Thu, 11 Sep 2008 22:58:52 +0000To: <VetRehab >Subject: radial nerve damage and splinting I was recently presented with a 1 year mixed breed male dog with evident radial nerve damage- unsure cause- rescued stray. per owner x- rays showed healed fracture elbow region which might account for radial nerve damage (have not seen x-ray); regardless the dog has normal shoulder function and muscularity, no movement or fusion of elbow and disuse of the paw--- the owner wants to splint the limb in an attempt to fuse the carpus since the shoulder is very much usable. the carpus also demonstrates decreased extension so considering a dynasplint to acheive as close to possible weight bearing position for long term use while also providing a little flexability to attempt to decrease shoulder stress. has anyone tried such a method or got a better idea thanks, Clare DVM CCRT candidate

[Guest guest]

I think splinting is a great idea. An orthotist would be a great asset in this department. Their knowledge base could help tremendously. Maybe Ben might know soemone in your area?

Jeanine Freeberg, PT, DPT

Subject: radial nerve damage and splintingTo: VetRehab Date: Thursday, September 11, 2008, 5:58 PM

I was recently presented with a 1 year mixed breed male dog with evident radial nerve damage- unsure cause- rescued stray. per owner x-rays showed healed fracture elbow region which might account for radial nerve damage (have not seen x-ray); regardless the dog has normal shoulder function and muscularity, no movement or fusion of elbow and disuse of the paw--- the owner wants to splint the limb in an attempt to fuse the carpus since the shoulder is very much usable. the carpus also demonstrates decreased extension so considering a dynasplint to acheive as close to possible weight bearing position for long term use while also providing a little flexability to attempt to decrease shoulder stress. has anyone tried such a method or got a better ideathanks, Clare DVM CCRT candidate

[Guest guest]

I would decide between a dyna splint and a rigid splint based on the fusion. Is the fusion a soft tissue fusion or a bony fusion?Sent from my BlackBerry® wireless device from ViaeroFrom: sabsg@...Date: Thu, 11 Sep 2008 23:46:52 +0000To: <VetRehab >Subject: Re: radial nerve damage and splinting Thanks appreciate muchSent from my BlackBerry device on the Wireless NetworkFrom: msk9rehab <jason_clarecomcast (DOT) net>Date: Thu, 11 Sep 2008 22:58:52 +0000To: <VetRehab >Subject: radial nerve damage and splinting I was recently presented with a 1 year mixed breed male dog with evident radial nerve damage- unsure cause- rescued stray. per owner x- rays showed healed fracture elbow region which might account for radial nerve damage (have not seen x-ray); regardless the dog has normal shoulder function and muscularity, no movement or fusion of elbow and disuse of the paw--- the owner wants to splint the limb in an attempt to fuse the carpus since the shoulder is very much usable. the carpus also demonstrates decreased extension so considering a dynasplint to acheive as close to possible weight bearing position for long term use while also providing a little flexability to attempt to decrease shoulder stress. has anyone tried such a method or got a better idea thanks, Clare DVM CCRT candidate

[Guest guest]

there's the problem, the elbow appears to have components of both a bony fusion and I suspect the decreased extension of the carpus is due to involvement or soft tissue entrapment or fusion of the carpal flexors at the level of the elbow thats why I was considering a dyna splint to gradually lengthen or stretch the flexors. You can manually force the carpus into extension but the carpal bones themselves seem to be mal-aligned with the radial bone displaced dorsally with slight lateral rotation to the ulnar bone, this is more difficult, at this point impossible to reduce... suspect tendon involvement, once again the stretching aspect of the dynasplint. I do not have x-rays to evaluate bony changes such as shortening or rotation that might be playing a part. thanks for the input, Clare

--------- radial nerve damage and splinting

I was recently presented with a 1 year mixed breed male dog with evident radial nerve damage- unsure cause- rescued stray. per owner x-rays showed healed fracture elbow region which might account for radial nerve damage (have not seen x-ray); regardless the dog has normal shoulder function and muscularity, no movement or fusion of elbow and disuse of the paw--- the owner wants to splint the limb in an attempt to fuse the carpus since the shoulder is very much usable. the carpus also demonstrates decreased extension so considering a dynasplint to acheive as close to possible weight bearing position for long term use while also providing a little flexability to attempt to decrease shoulder stress. has anyone tried such a method or got a better ideathanks, Clare DVM CCRT candidate

[Guest guest]

Sounds a bit tricky

If you think you can reduce the contracture because it is a soft tissue issue the dyna splint works to get it to this postition. I caution...if the antagonistic muscles are compromised, the contracture will return because the muscle will tighten again without continual stretching and/or a rigid brace to maintain the postition. Also, a dyna splint is a short term brace. Most all off the shelf (OTS) braces are made for more short term bracing as the materials they are made from are not as durable. In the human world an adult with an OTS brace shows significant wear at 3 months and are not made for much more than 6 months of wear. Animals wear out braces more quickly.

Also you mentioned fusing the carpus. A dyna splint promotes motion. In order to allow a bone to fuse the motion needs to be limited to allow the bones to grow together. A dyna splint would not serve this purpose.

If the contracture is due to boney fusion, a Dyna splint will not reduce the contracture. Surgery is the only way to reduce the contracture. When surgery is not an options, you could use a rigid brace. Casting for the brace should be done in the most functional postition the proximal and distal joints can be reduced to.

Dyna splints and rigid braces are both great tools but have totally different uses depending on the goals and situation you have.

Hope this helps

Ben

Ben Blecha, CPOwww.skyprosthetics.comwww.TriAmphant.com-- Those who can laugh without cause have either found the true meaning of happiness or have gone stark raving mad.~Norm Papernick

radial nerve damage and splinting

I was recently presented with a 1 year mixed breed male dog with evident radial nerve damage- unsure cause- rescued stray. per owner x-rays showed healed fracture elbow region which might account for radial nerve damage (have not seen x-ray); regardless the dog has normal shoulder function and muscularity, no movement or fusion of elbow and disuse of the paw--- the owner wants to splint the limb in an attempt to fuse the carpus since the shoulder is very much usable. the carpus also demonstrates decreased extension so considering a dynasplint to acheive as close to possible weight bearing position for long term use while also providing a little flexability to attempt to decrease shoulder stress. has anyone tried such a method or got a better ideathanks, Clare DVM CCRT candidate