Re: Splints

[Guest guest]

Hi all,

I have resting splints, working splints and ring splints and they all do a

different job.

I was supplied with and fitted for these through our local public hospital

Occupational Therapist.

The ring splints come from the Silver ring splint company in canada (I

think) Definitely overseas. and they stop the fingers (that are swan

necked) from locking when trying to embroider or use the computer and are

just so good.

The working splints are to save the wrist as it is from the wrist that the

ulnar drift comes from.

The resting splints help the whole hand and wrist by letting it rest in a

comfortable supportive position.

All of them are to prolong the use of all the joints and help me a lot.

Hope this helps.

ra Jan 97 ap May 98

Townsville Australia

jamulder@...

http://www.ultra.net.au/~jamulder/

[Guest guest]

WOW !!!!

What a great POST !!!!! Thank YOU SO MUCH !!!

> Let's see if this copies: (ok, it did. it's from the website with

the wayne.edu address. Quick summary: the splints may protect the

teeth when bruxism is occurring, but they don't eliminate bruxism at

all. More downsides: use of the splints may change your bite and may

cause gum disease and cavities under the splint, if I read that

right.)

>

> Said author: " The most common complication of splint therapy is the

creation of changes in the patient's occlusion " (Messing, 1991, p.

437). Another complication of splint therapy is decay under the

splint, which may in turn cause caries and gum inflammation. Still

another problem is severe degenerative joint disease (Messing, 438). "

>

>

> " Splints

> By far the most common treatment regime for bruxism embodies the

time-honored procedure of splint therapy (e.g., Karolyi, 1906, cited

in Ramfjord, 1961, p. 23; s, 1942). In the United States

alone, some 1.6 million splints (AKA nightguards, biteguards,

occlusal splints, biteplates, removable appliances, or interocclusal

orthopedic appliances) are annually prescribed by dentists in an

effort to combat bruxism (Pierce et al., 1995). Much current research

on the treatment of bruxism has been centered on the use of such

dental appliances.

>

> There are many variations of this appliance. The most common is the

customized, hard acrylic, variety.

>

> Fig. 3. A 1942 rubber splint, constructed to alleviate teeth

grinding (s, 1942). Fig. 4. A contemporary, acrylic, hard

splint worn by a bruxism patient.

>

>

>

>

>

>

> Some dentists prefer a customized appliance made of soft, rubber-

like, elastomeric material. Another, far less popular, variation is

the hydrostatic splint, a water-bearing pressure-equalizing appliance

(Lerman, 1987). This prefabricated disposable splint does not require

dental impressions or the manufacture of customized appliances.

Instead, it can be purchased through a dentist, ready-made for use,

and is claimed to fit the mouths of most users.

>

> Fig. 5. The hydrostatic splint (Lerman, 1987).

>

>

>

> In view of their wide use, the central question about all splints

is: Just how effective are they in treating bruxism?

>

> At the moment, a clearcut answer to this question is unavailable.

Sheikholeslam, Holmgren, and Riise (1986), for instance, report long-

term reductions in symptoms of bruxism in patients who wore the

splint for six months. Others, however, feel that the splint does not

diminish bruxing behavior over the long term, nor alleviate most

symptoms and consequences. They insist, in fact, that the splint may

only provide a measure of protection for the teeth, and, in the case

of grinders, a moderation of the sound. And even this is purchased at

a price: the splint is uncomfortable to wear, some patients remove it

during sleep, and it may negatively affect one's bite, cause tooth

decay, and lead to degenerative joint disease (Messing, 1992, p. 438).

>

> Given the popularity of the splint, and some of the claims that

have been made about its effectiveness, it may be worth while to cite

at some length what appears to be, at this point, the emerging

majority view in the research community: " The most common treatment

is a rubber device, worn over the teeth at night, called a

mouthguard. This does not actually prevent or cure the bruxism, but

it will prevent damage to the teeth when bruxism occurs " (Hartmann,

1994, p. 601). " Occlusal splints worn at night did not significantly

reduce bruxing-clenching activity in bruxing subjects " (Kydd & Daly,

1985). Pierce and Gale (1988) found that bruxing decreased by about

50% during two weeks of splint therapy, but that, following

withdrawal of treatment, it returned to baseline levels. Klineberg

(1994) concludes that occlusal splints " will protect the teeth, but

will not alter the habit in the long term. " Splints, he says,

become " worn when in use and wear and tear on the splint indicates

continuation of the habit, even though patient might report that

they were no longer aware of clenching their teeth. The longer term

effects of splint therapy indicate that clenching returns after the

splint has been removed, or with continued use of it. " (p. 15).

According to Rugh et al. (1989), splint therapy is effective at

first, but " the usual trend with longer treatment is to lose its

effects. In other words, one usually sees a dramatic decrease or

increase in EMG activity the first few nights of splint usage,

followed by a gradual return to pretreatment EMG values. " Perl (1994)

says that " there is no way of preventing the clencher or bruxer from

engaging in such parafunctional habits. Regardless, the clinician may

be able to decrease the potential for destruction by adding a

nightguard to the treatment protocol. " Dao & Lavigne (1998) say that

although " splints may limit dental damage, their efficacy remains

unestablished " (p. 355). The comparative ineffectiveness of the

traditional splint is also " borne out by the common clinical finding

that patients may bite large teeth marks into night bite guards and

frequently fracture appliances " (Trenouth, 1979).

>

> Moreover, the use of such splints may sometimes adversely affect

the patient's occlusion, e.g., cause an open bite (cf. Ahlin, 1991;

Wiygul, 1991): " As with any technique, splint therapy has both

positive and negative effects. If the complications are known and

understood, they can be included in the treatment planning process

and discussed with the patient before treatment begins. The most

common complication of splint therapy is the creation of changes in

the patient's occlusion " (Messing, 1991, p. 437). Another

complication of splint therapy is decay under the splint, which may

in turn cause caries and gum inflammation. Still another problem is

severe degenerative joint disease (Messing, 438).

>

> Fig. 6. Splint-induced open bite: after wearing a hard splint

for a year, this patient can no longer bring his front teeth

together.

>

>

>

>

> end quote.

[Guest guest]

Kathy, I have got to get me some splints, I'm just wondering if they

are real expensive? You take care of yourself, and we just got to

keep on going, hugs Tawny

> Tawny,

>

> The middle finger of my right hand is starting to go sideways at

the middle

> joint, (not the knuckle.) I've splinted it for the last 2 nights. I

think I'll

> wear the splint during the day when I am at home too.

>

> Kathy

>

>

> In a message dated 07/05/2004 6:02:40 PM Mountain Daylight Time,

> writes:

>

> > Kathy, I would also like to know about splints. I am getting

> damage

> > in my right hand now, and my middle finger is starting to turn

> > sideways. I am on meds, and I know they just slow the disease,

> but

> > hope to hear from others about the use of splints. Thanks for

> > bringing the topic up, Tawny

> >

> >

>

>

>

[Guest guest]

Kathy,

I was wearing splints for a while. My rheumatologist advised against wearing

them too often - leading to different kinds of aches & pains. Just thought I'd

let you know what they told me.

daffy11149@... wrote:

Tawny,

The middle finger of my right hand is starting to go sideways at the middle

joint, (not the knuckle.) I've splinted it for the last 2 nights. I think I'll

wear the splint during the day when I am at home too.

Kathy

In a message dated 07/05/2004 6:02:40 PM Mountain Daylight Time,

writes:

> Kathy, I would also like to know about splints. I am getting

damage

> in my right hand now, and my middle finger is starting to turn

> sideways. I am on meds, and I know they just slow the disease,

but

> hope to hear from others about the use of splints. Thanks for

> bringing the topic up, Tawny

>

>

[Guest guest]

Has anyone had any luck with splints actually stopping the turning?

I have a couple fingers that are already turning sideways...do the

splints really work at stopping the progression or just helping

stopping the pain?

> Tawny,

>

> The middle finger of my right hand is starting to go sideways at

the middle

> joint, (not the knuckle.) I've splinted it for the last 2 nights.

I think I'll

> wear the splint during the day when I am at home too.

>

> Kathy

>

>

> In a message dated 07/05/2004 6:02:40 PM Mountain Daylight Time,

> writes:

>

> > Kathy, I would also like to know about splints. I am getting

> damage

> > in my right hand now, and my middle finger is starting to turn

> > sideways. I am on meds, and I know they just slow the

disease,

> but

> > hope to hear from others about the use of splints. Thanks for

> > bringing the topic up, Tawny

> >

> >

>

>

>

[Guest guest]

i have to say a sam splint and ace wrap i like because it is simple to

use and cost effective, i have also used vaccuum splints not back easy

to use and form well to any size they have shapes for

shoulder,wrists,knees, ankles and off course the vaccuum backboard as a

full body splint.

>

> Gents and Ladies,

>

> I have recently found some old inflatable 'pneumosplints'. I think I

> remember reading that this style of splint was no longer in vogue.

>

> Does anyone know if they are still a viable form of splinting.

>

> If not can anyone recommend a good replacement.

>

> Tony Ewing

>

[Guest guest]

My personal experience with this type of splints has found that by the

time I am responsible for them, they usually have broken down and

developed leaks, making them pretty useless.

They are typically an uncovered plastic and therefore tough on exposed

skin and as with any pneumatic device are affected by changes in

altitude (i.e. evacuation) to some extent. I have rarely looked at them

as the best option.

For those that have the space, budget and need, I am a big fan of

vacuum splint kits such as Hartwells Medical's Evac-u-splint system.

These will also be affected by atmospheric changes but it takes quiet a

bit.

Of course a pillow, cardboard, or SAM splints usually will get the job

done and often quicker.

[Guest guest]

Good afternoon all! Pneumatic pants can still be used for splinting if nothing

else is available. A great splinting device is the vacuum splints, they don't

take up much room and also come in various sizes, which may be combined for long

bone fractures if the patient is too tall for the largest size. They also come

in a mattress style, which work great with someone with a hip fracture or has a

curvature of the spine. They can be quite pricey depending on the manufacturer.

I have had great success with these. They completely coccoon the injured site/

patient, and allow you to check for pulses and provide more comfort to the

patient. Just remember if you purchase these do not store the hand held vacuum

in the package with the splints as it can puncture the splint.

Hope this helps,

Lorie aka Blondie

Splints

Gents and Ladies,

I have recently found some old inflatable 'pneumosplints' . I think I

remember reading that this style of splint was no longer in vogue.

Does anyone know if they are still a viable form of splinting.

If not can anyone recommend a good replacement.

Tony Ewing

________________________________________________________________________________\

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[Guest guest]

Quoting antony ewing <tonytone@...>:

> Gents and Ladies,

>

> I have recently found some old inflatable 'pneumosplints'. I think I

> remember reading that this style of splint was no longer in vogue.

>

> Does anyone know if they are still a viable form of splinting.

>

> If not can anyone recommend a good replacement.

Prosplint fit the bill quite well

Simple and fast and adequate

http://online.boundtree.com/store/product_index.asp?Cat= & SubCat= & Prod=5800%2D51

Item: 5800-51 $218.25 / EA

Description:SPLINT KIT EXTREMITY PROSPLINT 113908

Catalog Page: 169

prosplints are quick and easy to use, taking only a few moments to apply and

remove. since splints are constructed of 100% non-absorbent material, blood, gas

and other fluids are easily removed and cleaned with warm water and soap. the

splints have no metal stays, are shock absorbing, and conform quickly to your

desired needs. hook and loop closures make application easy day or night, wet or

dry. prosplints are universal in design and may be used on either the right or

left side limbs. in case of multiple injury, arm and leg splints can be

interchanged. these splints are unaffected by temperature extremes, remaining

pliable from -100°f to 200°f. prosplint kits come in a ballistic nylon bag.

If you have money

Less simple but very good :

ttp://online.boundtree.com/store/product_index.asp?Cat= & SubCat= & Prod=563100

Item: 563100 $425.00 / EA

Description:DELUXE VACUUM SPLINT KIT W/SM, MED & LG SPLINTS, PUMP & CARRY CS

Catalog Page: 170

these quality, lightweight hartwell medical splints effectively immobilize the

patient without placing undue pressure on the injured area. eliminates axial,

lateral, and rotational movement during normal patient transport. easy to

manipulate into a variety of configurations depending on the type of injury.

polystyrene beads help reduce body heat loss and provide maximum comfort. great

for infant and pediatric immobilization. radiologic and mri compatible. easy to

clean and disinfect. quick and easy to use and molds precisely to body contours.

durable aluminum vacuum pump included. operating range of -30of to +180of.

deluxe extremity splint kit includes three splints (1 large, 1 small, 1 medium),

repair kit, vacuum pump and carry case.

The 2 above items also point to brand preferences