Night splint for contracture |
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04/01/2013 20:50
JohnG
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04/01/2013 20:50
JohnG
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Night splint for contracture
On another thread Wolfgang mentioned a Canadian paper that reported some good outcomes for using night splints. They focused on PIP contracture. It seems to me that this deserves its own thread, so here it is.
Here's what Wolfgang posted:
A night splint after NA might help keeping our finger straight. It is helping with my PIPJ of my right pinkie. I had Xiaflex injected 1.5 years ago. It didn't get the joint fully straight and the contracture came back quickly. I am keeping it stable with wearing a night splint. I wore it for nearly 12 months and afterwards occasionally for a week when I feel it is getting worse.
Splinting and massaging might even help avoiding surgery. Interesting paper: http://www.ncbi.nlm.nih.gov/pubmed/21965179
I downloaded the entire paper. It's by J. Larocerie-Salgado and J. Davidson, both from Ontario Canada. I'll summarize it:
There were 19 fingers in the study, starting mostly with 20 to 50 degrees of contracture. After about two years, only one patient showed progression of the contractures during the followup period. All the others improved somewhat or stayed the same. The paper says that it seems to be common wisdom that splinting doesn't help, but their little study shows that it does seem to help.
Here's the treatment:
The splinting regimen consisted of a hand-based volar extension splint, with an adjustable strap placed over involved PIP joints (Figure 1). Patients were instructed to wear the splint at nighttime (6–8 hours) to allow for prolonged exposure of the contracted tissue to low load forces while permitting unrestricted use of the hand during the day (Flowers and LaStayo, 1994; Glasglow et al., 2003). When appropriate, splints were adjusted to increase PIPJ extension at the time of follow-up visits. Patients were also instructed to perform stretching exercises for the PIP joint into extension within pain-free range as well as friction massage to contracted tissue (i.e. nodules and cords) during the day.
Here's the splint (figure 1):
Here are the results:
Edited 04/01/13 23:53
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04/01/2013 23:02
LubaM.
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04/01/2013 23:02
LubaM.
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Re: Night splint for contracture
The splint shown above (following NA of the PIP pinkie finger) makes much more sense to me than the one custom made for me after my second NA on that same finger. My splint was made of hard molded silicone, top and bottom, and therefore the minute the PIP started to bend a bit I had to stop wearing the splint in spite of the few attempts to adjust it to compensate for the bending finger... I stopped wearing the splint within two months of NA... and at six months, the contraction was totally back.
Now that I am considering doing NA on the other hand's pinkie I will definitely look into this kind of splint. I am a believer that splinting for a long period of time can delay recurrence. Thank you for posting this picture.
Edited 04/02/13 02:03
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04/02/2013 02:12
Tusk
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04/02/2013 02:12
Tusk
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Re: Night splint for contracture
Would that type splint have to come from a hand therapist or could you perhaps find it online somewhere?
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04/02/2013 06:42
stephenjeffrey
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04/02/2013 06:42
stephenjeffrey
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Re: Night splint for contracture
Thanks for highlighting this JohnG
Dr Meinel's presentation 45 dupuytrens symposium 2010 on YouTube. http://www.youtube.com/watch?v=882JB9cXDME
He says he is constantly amazed (2mins25secs) at the extension deficit reduction achieved when night splinting with a silicone gel !
Edited 04/02/13 18:51
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04/07/2013 12:49
Chrissienot registered
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04/07/2013 12:49
Chrissienot registered
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Re: Night splint for contracture
Hi there
I have just read about the silver ring splints. But I cannot find an outlet in the UK. Does anyone know where I can buy any of the finger only splints please? I assume Sears are in the US. Still in pain after surgery on 25th Feb. Remove splint for an hour during the day and it flexes noticeably. Surgeon says keep it on continually except when excercising every hour. Physio say leave it off all day :-(
[Same splint as shown by JohnG above]
PS I have a pressure sore developing over the base of my pinkie and the splint I have presses on my thumb muscle uncomfortably. Going back for re assessment on Tuesday.
Edited 04/07/13 15:51
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04/08/2013 21:19
JohnG
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04/08/2013 21:19
JohnG
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Re: Night splint for contracture
Chrissie, Sears is a U.S. retailer, but the splints made by SAMMONS PRESTON are sold by many vendors, not just Sears.
I pasted the following into google.co.uk and it turned up vendors that will ship worldwide:
SAMMONS PRESTON Rolyan Proximal Interphalangeal Extension Splint
If you try a splint from them, let us know if you like it.
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04/18/2013 05:53
kenny27dc
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04/18/2013 05:53
kenny27dc
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Re: Night splint for contracture
Dawn, Good luck with your hands. I had NA with Dr. Eaton 4 years ago on both hands. I just saw Dr. Bourland in Memphis this week. To get the NA procedure again on one hand. Ll the best Kenny
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04/20/2013 01:22
beamer1
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04/20/2013 01:22
beamer1
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Re: Night splint for contracture
This message is for Dawn regarding the extension splints that she is shown wearing. Can you tell me where you got these splints? I assume they were probably made by a therapist from a prescription but just in case you purchased them somewhere else I would really like to know. The idea that they can be reheated and remolded when needed would be great. I have worn splints on both hands for some time now but need to replace and prescription splints are soooo expensive. Any help you can give me would be appreciated and thanks.
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