| Night splinting ?? |
|
|
1 2
|
| 1 2
|
|
02/25/2013 13:16
dottyhand 
|
02/25/2013 13:16
dottyhand
|
Night splinting ??
Has anyone tried night splinting ?
I am due my phase 2 RT soon.
My doctor ( NHS surgeon ) seems a bit unhelpful and wasn't too impressed with me when I told him that I went private to have RT ( as he suggested against it ... only surgery instead )
I asked him about night splinting , but again he didn't have much to say on it. So I am thinking perhaps he is more used to surgery other than knowledge of DP.. But he is sending me off to get a splint made.
I have noticed slight improvement with my Rt and want to encourge my fingers as much as I can. I looked up night splinting of You tube and thought it looked hopeful.
Any advice , as our NHS is not very forth coming.
|
|
|
|
|
02/25/2013 14:29
spanishbuddha  Administrator
|
02/25/2013 14:29
spanishbuddha Administrator
|
Re: Night splinting ??
I think the jury is still out on the benefits of splinting after NA, Xiaflex or surgery, as the results are evenly balanced as to whether there is a difference or not.
In the case of splinting where there is no or minimal contracture, or after RT, I am not aware of any data. Don't forget there is often no progress anyway.
Some people, on here, do use a splint and will tell you they believe strongly that it helps. If it makes you feel better, then possibly no harm done. I tried it, but don't like the temporary stiffness in the fingers that you get in the morning, and I had trouble adjusting to keeping it on all night.
|
|
|
|
|
02/25/2013 23:58
Randy_H 
|
02/25/2013 23:58
Randy_H
|
Re: Night splinting ??
Yes, the stiffness in the morning is a pain but in just a few minutes you're fine. I believe my night splint helped after my NA. After eight years I have nearly 100% correction that has not changed.
spanishbuddha, are there any clinical studies that have looked at results after NA or other correction?
|
|
|
|
|
02/26/2013 01:36
hammer 
|
02/26/2013 01:36
hammer
|
Re: Night splinting ??
Splinting takes some getting used to and the stiffness after awhile is no big deal,just make a fist 2 or 3 times and its gone and fingers are back to straight.Mine r nice and warm too.Dave
|
|
|
|
|
02/26/2013 04:22
flojo
|
02/26/2013 04:22
flojo
|
Re: Night splinting ??
I'm for night splinting based on results of my own hand.
I had NA in Feb. '09 and RT in July '09. I did not use a night splint. Little by little my hand tightened across my palm and I had NA done again in July '11. After the second NA on the same hand, Dr. Denkler prescribed a night splint at my request. It was custom made. (Pictures are posted on the Forum somewhere.) It was adjusted three times before we got it right. I wore it every night for over a year and I still wear it 3-7 nights a week normally. Now when I go away on a trip, I don't take it. When I come back, I can tell my hand has tightened. I wear it and it stretches it back out again in a couple of nights.
See, I delight in fighting back against this disease. If I can beat it back a little here and a little there, I'm very happy about any little success against this relentless disease. I use my night splint as a tool against DD.
Remember that RT does not reverse cords which are like scar tissue I'm told. RT is usually effective on nodules which are the soft stage of messed up collagen in the palm.
I had a great orthopedics/orthotics specialist who made my splint. I'm having him make one for my other hand that I had RT on in September. The cords on this hand are tightening, but nodules have reduced in size or disappeared. One nodule is determined to stay but was hardened some before I had RT.
If you have questions, feel free to Private Message me.
Flora
|
|
|
|
|
02/26/2013 10:00
spanishbuddha Administrator
|
02/26/2013 10:00
spanishbuddha Administrator
|
Re: Night splinting ??
Randy_H:
spanishbuddha, are there any clinical studies that have looked at results after NA or other correction?
Yes I think there are quite a few around.
'The book' http://link.springer.com/book/10.1007/97...6312&page=1 has a chapter on night splinting, and other chapters comparing results (chapters 40 41 are examples but I no longer have a hardcopy so am not sure, although some can be read online).
The thesis http://dissertations.ub.rug.nl/faculties....l.van.rijssen/ by Anna van Rifssen cites references for pre-contracture splinting having no value, and the 1000 PNF case study http://www.centraljerseyhand.com/misc/Re...re_JHS_0412.pdf all seem to use a splint immediately after release.
There are probably others, but perhaps start with 'the book' or start with the reference site at http://dupuytren-info.org/index.html which has lots of links to full-text articles.
The thing I find with most studies though is that you can find a study that proves any point of view you would like  They need further careful study. I try to be objective on here, to balance the enthusiasm of others with their "it works for me" examples. 
I dislike the finger stiffness with the splint because I play piano, and although it clears quite quickly I just find it disturbing. So that doesn't work for me
|
|
|
|
|
|
|
02/26/2013 14:07
dottyhand
|
02/26/2013 14:07
dottyhand
|
Re: Night splinting ??
Thank you very much for all your advice. I have a appointment this Friday to get a splint made but the lady on the phone said it wouldn't work for Dupuytens... But I want to try it.. my hand .. my disease... my bad luck !! our NHS for ya
|
|
|
|
|
06/11/2013 15:36
Mary 
|
06/11/2013 15:36
Mary
|
Re: Night splinting ??
Have you any update on hand splints? My consultant today is referring me to the OT to make one for me, he wasn't convinced it would be of any benefit but happy to humour me.
|
|
|
|
|
06/11/2013 21:18
Maddie
|
06/11/2013 21:18
Maddie
|
Re: Night splinting ??
dottyhand:
Thank you very much for all your advice. I have a appointment this Friday to get a splint made but the lady on the phone said it wouldn't work for Dupuytens... But I want to try it.. my hand .. my disease... my bad luck !! our NHS for ya
Anyone who says splints "don't work for Dupuytren's" is just factually inaccurate. It would be accurate to say they don't work for all patients and in all situations -- but it is just a fact that people have had success with them, objectively measured.
I have reported previously on this forum that I started using a custom night splint to treat a PIP contracture on the little finger of my right hand. This was recommended to me by Dr. Eaton to "slow down the progression," but it actually did more than that -- it reversed it. Before the splint, the contracture was 30 - 35 degrees, as measured both by Dr. Eaton and by the hand therapist that made the splint (a certified hand therapist). After about 3 months of wearing the splint every night, the contracture had visibly diminished, and was measured by the hand therapist at about 15 degrees. It was a great success for me as it got small enough that it doesn't bother me anymore.
Now, almost a year later, the contracture remains at about 15 degrees.
I find the splint very comfortable and don't even notice it anymore. There is a little stiffness when I wake up but it goes away quickly after I've flexed my fingers a few times.
One point - I have never had NA, Xiaflex, or surgery on the finger I am splinting. However, I did have RT on it. I don't know whether or not the RT is a factor in making the splinting so successful. Could the RT have made the Dups less aggressive in that finger and therefore more amenable to being controlled mechanically? I don't know - and I don't know if there has been research on splinting as a follow up to RT (in cases like mine where cords had already grown prior to the RT).
Another important point - my splint includes a silicon-like putty that cups my finger. According to Dr. Eaton, there is evidence that silicone can soften scar tissue and cords. So I suspect this plays a role also. Plus, it makes the splint very comfortable.
Anyway, good luck -- let us know how it goes!
Maddie
|
|
|
|
|
|
1 2
|
| 1 2
|
460 users online
Login
