Abduction Splint Research Articles

Chronic osteomyelitis of the clavicle

From 1978 to 1987, 139 children were treated for osteomyelitis at our institution, among them 6 with osteomyelitis of the clavicle. All six patients presented with a primary chronic osteomyelitis. Three children sustained a trauma anamnestically. Pathohistological examinations revealed a chronic, unspecific inflammation in all cases. Immobilisation was achieved by means of a DESAULT-cast or an abduction splint for 7 to 36 weeks, antibiotics (clindamycin) were given for 6 to 55 weeks, starting with intravenous administration for 1 weeks maximally. All patients were primarily operated on, mostly undergoing curettage of affected regions or partial resection. After 4 to 10 years, 4 children are well and without evidence of recurrence, 2 children are still under treatment for recurrences.

Stability of the hip joint after reduction of late-diagnosed congenital dislocation of the hip.

Nine children with late-diagnosed congenital dislocation of the hip underwent ultrasonography for determination of the influence of hip flexion on hip stability after reduction. No medication was used, and the investigation was performed in existing abduction splints during active movements of the leg. Redislocation of the joint was related to the minimal degree of flexion (120, 110, 100, or 90 degrees) permitted by the splint. All hips redislocated when flexion was less than 100 degrees. Five joints need 100 degrees and two 110 degrees of flexion for prevention of redislocation, and two hips required as much as 120 degrees.

A New Dynamic Abduction and Extension Splint

SummaryA new ingenious innovation to maintain abduction of the Ist web space in adduction contractures of the thumb and to maintain extension and abduction of the fingers in treating flexion contractures and syndactylies has been developed at the Postgraduate Department of Plastic Surgery, King George's Medical College, Lucknow. Their ability to prevent adduction contractures of the thumb and flexion contractures of the fingers respectively has been evaluated. These are noninvasive and fairly inexpensive devices which can be easily fabricated and have been found to be perfectly acceptable.

Periosteal thickening as a manifestation of trauma in infancy

This paper reports the findings in a study of the incidence of periosteal elevation in children and its possible relationship to child abuse. Two separate sets of radiographs of the skeleton of children were taken for a variety of diagnostic purposes. The suspected abuse set consisted of 59 radiographs taken for suspected child abuse. The mean age for all patients examined was 1.22 years whereas, the mean age for patients with cortical thickening was 0.5 years, suggesting that cortical thickening occurs in a relatively young population. Cortical thickening was assessed by reason for examination. A significant difference ( p = .05) was detected with 6 8 (75%) of the patients with cortical thickening from the suspected child abuse groups and only 2 8 (25%) of the patients from the seizure-diagnostic category. The two infants who were noted to have periosteal elevation but were not suspected of abuse had experienced unusual circumstances, one was wearing an abduction splint and the other was a severely hypotonic premature. It is our impression that periosteal thickening is not a normal finding in infants and does not represent a consequence of normal infant care practices. In each case in which cortical thickening was detected, there was evidence to suggest that the child had experienced abnormal or rough handling. As a result of these findings, we believe that cortical thickening of the long bones detected on radiograph is an indication of child abuse.

Primary anterior congenital dislocation of the hip in infancy.

Primary anterior congenital dislocation of the hip can be diagnosed in infancy as an entity distinct from the more common posterior dislocation. Anterior dislocations are characterized by a visible and palpable fullness in the femoral triangle, marked limitation of abduction, a severe pelvic tilt or obliquity, marked apparent shortening of the linb on the involved side, absence of telescoping, and a rest position of external rotation. Conservative treatment is recommended. An abduction splint should be used to minimize the adduction contracture before a closed reduction is performed under general anesthesia. The position of a stable reduction is one of flexion, abduction, and internal rotation. Immobilization in a spica cast is required for six or seven months. Most patients will require a derotation osteotomy for correction of anteversion of the femoral neck during this time.

Congenital muscular dystrophy: the importance of early diagnosis and orthopaedic management in the long-term prognosis

had regular physiotherapy; four had been immobilised for treatment of dislocated hips. Successful surgical release and mobiisation has been achieved in only four. In contrast, seven extremely weak children diagnosed early (mean age 1.7 years) and given regular physiotherapy have minimal or no contractures. Five of these are now walking, two with calipers. Of eight children with milder weakness who walked independently by the age of two years, only one has developed contractures requiring operation. Overall, only two patients have progressive weakness, in sixteen power has improved and in eight the disorder has remained static. One infant is too young for the outcome to be assessed. Of seven children with congenital dislocation of the hips, only one responded to abduction splints. In the face ofsevere weakness, operative intervention is probably best delayed until the child is old enough to be mobiised in calipers. In view of the relatively good prognosis for maintenance or improvement of

Dr Kvittingen's yoke-splint for the upper arm

An abduction splint made of polyester reinforced with fibre glass is presented and points are submitted as advantages of this method of splinting the arm.

Capital Necrosis, Metaphyseal Cyst and Subluxation in Coxa Plana

Three specific elements associated with a poor prognosis in Legg-Calvé-Perthes disease, i.e., capital necrosis, metaphyseal cyst and subluxation, have been selected for study to determine the effect of each on the end result. A retrospective analysis was made of 337 children who received non-weight-bearing treatment. Half of the patients were treated in abduction splints, over a third with bed rest and traction and the remainder with a variety of routines including sling and crutches, wheelchair or bed rest alone. The group was treated as representing a common pool of therapy and was analyzed statistically in this overall manner. End results were graded by the Knud Mose method (concentric circle matching plus epiphyseal quotient determinations). Good and fair results were combined into an acceptable category while the poor results were considered unacceptable. Femoral capital necrosis was present either segmentally or totally. A classification was devised of three grades of partial epiphyseal involvement and one of total necrosis. The patients with total necorsis (Group IV) had a higher percentage of poor results than those with segmental involvement (Groups I, II and III). The lowest percentage of poor results correlated with the least involvement of the femoral head (Group III). Total head involvement occurred in the unacceptable group one and one half times as frequently as it did in the acceptable group. Metaphyseal cyst formation exhibited a close relationship to the fragmentation of the capital epiphysis. It is suggested that the metaphyseal lesion itself is part of the overall necrotic process and that the "cyst" is resorption associated with revascularization as healing is taking place. We noted twice the frequency of metaphyseal cysts in patients with poor results in comparison to that found in the acceptable group. Subluxation is defined as loss of acetabular centration of the femoral head due to upward and outward displacement. Increased distance between the medial margin of the metaphysis and the lateral limb of the "tear drop" figure is practically a universal finding on early roentgenograms and was not considered "subluxation" in this prognostic evluation. In the series under study there were three times as many subluxations in the poor result group as in the group with acceptable results. A prognostic profile revealing three of the above-listed features was associated with a poor result and should constitute an objective basis of evaluation of new forms of therapy.

Congenital Dislocation of the Hip in the New born (I)

From may 1970, 391 babies were born at National Kokura Hospital, New Kokura Hospital and Syu Hospital, and tested by Barlow's methode from birth to age 7 days.This test was positive in the 11 babies (2.8%). The babies (male 2, female 9) were treated in a sponge rubber abduction splint (35cm×20cm×1.5cm).We want follow up this treatment.

Treatment of Congenital Dislocation of the Hip in Infant Using F-O Type Abduction Splint Instrument.

Treatment of Congenital Dislocation of the Hip in Infant Using F-O Type Abduction Splint Instrument.

Shoulder abduction splint.

A shoulder abduction splint constructed from a unitary block of synthetic foam material is illustrated providing in a single disposable support a splint for selectively positioning the arm in a substantially 90 degree position with respect to the body or an intermediate position with respect to the body as dictated by the results of surgery on the shoulder.

FRACTURES OF THE HUMERUS

Undisplaced fractures of the neck of the humerus or impacted fractures in patients of the older age group (over sixty) are best treated by a collar-and-cuff sling and early, active exercise5. Impacted adduction fractures of the neck must be reduced and immobilized in abduction. As a rule, abduction fractures without avulsion of the greater tubercle may be reduced by manipulation and immobilized in a hanging cast. If the tubercle and rotator cuff are displaced, they must be reduced accurately, usually by surgery. The treatment of choice for all fractures of the shaft at any level is the hanging cast, provided: (1) that traction is never excessive; (2) that angulation and apposition are controlled; and (3) that the hanging-cast rules are observed. Although fractures of the shaft may be treated successfully by the abduction splint, return of function will be delayed, the apparatus will require continual attention, and the patient will be less comfortable than with the hanging cast. The shoulder spica is rarely indicated in the treatment of any fracture of the humerus. Anaesthesia is seldom necessary for reduction of uncomplicated fractures of the neck or shaft, provided that traction is properly utilized. Thus, the necessity for hospitalization is reduced to a minimum. Since medullary fixation is gaining wide popularity, it is well to re-emphasize the success of conservative treatment of these fractures.

CONGENITAL DYSPLASIA OF THE HIP

1. The examination of fifty-one infants presenting signs of unilateral dysplasia (preluxation) of the hip disclosed the existence of an abduction-contracture in the opposite "normal" hip. 2. The abduction-contracture was not infrequently found in the newborn, but seemed to attract attention mostly between the second and fifth month of life. It was seldom found after the sixth month. 3. The dysplasia in the contralateral hip showed the usual features. 4. The relationship between the degree of abduction-contracture and the degree of dysplasia was a direct one only occasionally; in most cases they seemed unrelated to each other. 5. Observation of these patients showed that the abduction-contracture followed a constant course towards gradual and spontaneous regression. The dysplasia progressed in one of the following directions: spontaneous recovery, rapid or slow recovery with treatment by abduction splint, subluxation, or true dislocation. 6. It is submitted that the coexistence of unilateral dysplasia of the hip and abduction-contracture in the opposite hip is not fortuitous. It is believed that the abduction-contracture determines the development of the dysplasia in the opposite hip through the faulty mechanics caused by "fixed pelvic obliquity." 7. The discovery of unilateral abduction-contracture soon after birth should be a warning that dysplasia may develop in the opposite hip. A careful watch should therefore be kept for signs of abduction-contracture and for the later development of dysplasia.

Preparations and Appliances

Preparations and Appliances

Comminuted Fracture-Dislocation of the Shoulder: Result Seven Years after Excision of Fragments and Treatment on Abduction Splint

Comminuted Fracture-Dislocation of the Shoulder: Result Seven Years after Excision of Fragments and Treatment on Abduction Splint

THE PAINFUL SHOULDER Review of One Hundred Personal Cases with Remarks on the Pathology

1. In a series of one hundred personal cases of "painful shoulder" rupture of the musculotendinous cuff was proved by operation in eighteen cases and was presumed in eight further cases, namely, in about one quarter of the series. 2. Of the eighteen cases treated by operation through the transacromial approach, perfect results were obtained only in four. The other results were unsatisfactory. In five, movement was good but there was pain or weakness of the limb. In nine the condition was unaltered or made worse. 3. Conservative treatment of traumatic lesions of the supraspinatus tendon is therefore advocated. The advisability of rest of the shoulder joint in an abduction splint for five or six weeks is stressed. Operative exposure, through a transacromial approach, is recommended only when conservative measures have failed. 4. When there is rupture of the cuff there is evidence that simple longitudinal suture of the gap after freshening of the margins is likely to give better results than attempts to suture the medial end of the rupture to the greater tuberosity. Most ruptures have a longitudinal extension of the initial transverse tear, and direct suture of the medial edge of the gap to the greater tuberosity may lead to shortening of the tendon and interference with its function. 5. Ruptures of the supraspinatus tendon may cause no symptoms, lead to complete loss of function, or cause a painful arc of movement during mid-elevation. The clinical state depends upon whether or not the condition of the ruptured tendon is causing pain, and whether the other short rotator muscles of the shoulder can compensate in tensor and fixator actions for the loss of action of the supraspinatus. 6. Capsulitis is a convenient term by which to describe inflammatory lesions of the capsule and bursae around the shoulder joint. The initial stage of irritative capsulitis may develop to the later stage of adhesive capsulitis. Differentiation is important because treatment in the first stage is by rest, and in the second by manipulation and exercise. 7. The subdeltoid bursa is the "peritoneum" of the spinatus tendons; like the peritoneum it shares the pathology of the organs it protects and is itself seldom the site of primary pathological processes. 8. The management of the "frozen shoulder," whether loss of movement is protective or adhesive, calls for time and patience but the ultimate outlook is good.

A Simple Abduction Splint for the Upper Extremity

A Simple Abduction Splint for the Upper Extremity Donald B. Slocum, Medical Corps, U. S. Army Donald B. Slocum, Medical Corps, U. S. Army Search for other works by this author on: Oxford Academic Google Scholar The Military Surgeon, Volume 91, Issue 1, July 1942, Pages 26–29, https://doi.org/10.1093/milmed/91.1.26 Published: 01 July 1942

An Abduction Splint used in War Surgery in China

An Abduction Splint used in War Surgery in China

An Abduction Splint for the Upper Extremity

An Abduction Splint for the Upper Extremity

Voelcker. A new method for the treatment of underarm hydradenitis. (Bruns. Beitr. 1936, 163, 3, 435—436)

A. recommends the treatment of hydroadenitis of the armpit on an abduction splint with the laying of a hand on it, taken away at right angles from another cell; in the presence of abscesses, the latter are opened with small incisions, and the dressing is not applied to the wound.