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Improvement with Night Splint
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08/02/2012 04:07
Maddie 
08/02/2012 04:07
Maddie 
Improvement with Night Splint

A few months ago, I posted about how pleased I was with my new custom night splint. Some people requested that I post photos of it. I agreed with Wolfgang that I would send photos and an account of my experience with the splint, to be included in the "personal experience" section of the website.

First, an apology that it's taken me so long to get that together. It's been quite a hectic summer. I do promise to send that information soon, but in the meantime wanted to tell you about the great progress I've had so far, as verified by my visit to my hand therapist today.

To recap the background -

In mid-April of this year, I traveled to see Dr. Eaton in Florida for advice on what to do about the increasing contracture in the PIP joint of my right pinkie. I had been told by two hand surgeons that they didn't think it was safe to do NA on that location, because of the risk of nerve damage. Dr. Eaton said he didn't necessarily think that was a "deal-breaker", as he put it. But he also said he didn't think I had to do the NA right away.

(to be continued)

08/02/2012 04:32
Maddie 
08/02/2012 04:32
Maddie 
Re: Improvement with Night Splint

(Continuing my previous post)

At that appointment, on April 13, Dr. Eaton measured the contracture at 30° active ROM. He recommended I get the NA when it had progressed to between 40° and 60°. He suggested that in the meantime I wear a custom night splint to slow the progression down.

On May 2, about 3 weeks later, my hand therapist made the splint for me. At that time she measured the contracture at 36°.

I loved the splint immediately - it was very comfortable and also relieved the occasional cramping the contracture caused in my hand. But to my surprise, it also began to seem like the contracture was actually decreasing (ie. improving). And it seemed to improve more and more as time went on.

I went back to the therapist today, and it turned out my active ROM in that joint is now 15°! So that is a 21° improvement - just from the splint, as far as I can see. I haven't done anything else (at least not intentionally). The improvement was so great that she had to completely remake the splint, as the old one didn't fit anymore.

Needless to say, I'm thrilled. But also curious, because I haven't heard about people having actual reductions in their contractures just from splinting. Has any else had this experience or heard of this?

And - I do promise to get those photos posted!

Maddie

08/02/2012 06:09
wach 

Administrator

08/02/2012 06:09
wach 

Administrator

Re: Improvement with Night Splint

Hi Maddie,

your experience matches what Albrecht Meinel described at the Miami conference in 2010. You can watch his presentation on http://www.youtube.com/watch?v=882JB9cXDME&lr=1 . One of his first slides says "extension splinting can prevent finger contracture". He also shows a case where, after NA, the splinting improved the residual contracture further.

The theory behind this is that the cords are a reaction of the body to forces pulling on the original nodule. The nodule, as it grows, glues together connective tissue that originally was and had to be very flexible. As the skin loses its ability to fold and stretch every movement results in a pulling at this location. The body tries to stop this pulling by building a cord and fixing the finger. When you reduce the pulling, the cords reduce. That's at least roughly the idea. Additionally Meinel claims that the contracture is not an active process but a fixing of the relaxed finger position. Relaxed fingers are usually curled. Therefore Meinel believes that by wearing a night splint you can

a) avoid further progression or recurrence

b) even improve existing contracture

Your experience is supporting Albrecht Meinel's view. Thank you for your post!

Wolfgang
PS: If for some medical reason a Dupuytren's affected joint is surgically fixed into a stiff postition (sometimes that needs to be done) then the cords at that joint gradually vanish. That's also supporting the idea that cords are a reaction to pulling forces.

Edited 08/08/12 13:18

08/02/2012 10:02
BRIANB 
08/02/2012 10:02
BRIANB 
Re: Improvement with Night Splint

I have stated previously the following ;

NA with Dr. Eaton two times right and left hand pip joints ..pinkie and middle finger. Four and two years ago.

Contractures on 95 and 60 percent . Both procedures very successful.

I have and continue to wear night spints made from Dr. Eaton's script.

Both fingers are perfectly straight . In fact slightly better than when I left the Doctors office.

Still have small nodules in fingers....but who cares !

Conclusions :

Seek an expert opinion ... Dr. Eaton .

Have a night splint designed and made for YOU by a C.H.T.

Wear gloves when mowing .. exercising ...etc.

Nodules can be softened and made smaller by steroid injections .... but at the risk of the trama triggering Dups.

08/02/2012 11:19
spanishbuddha 

Administrator

08/02/2012 11:19
spanishbuddha 

Administrator

Re: Improvement with Night Splint

Are your splints keeping the finger(s) straight, or with a slight natural curve?

I found using a night splint that keeps the fingers straight to be very uncomfortable, and it also led to having stiff finger joints in the mornings. For those reasons I stopped.

08/02/2012 13:08
BRIANB 
08/02/2012 13:08
BRIANB 
Re: Improvement with Night Splint

The splint does have a " natural curve " and supports the palms.

But when I am not using the night splint ALL fingers are perfect..
The splint is not uncomforable...fingers are a little stiff after wearing the splint all night. But the stiffness goes away rather quickly...about the time it takes to down a half a cup of coffee...

I do wear a light breathable glove under the spint....makes it move confortable..

Small price to pay for results ... at least so far ...

08/02/2012 13:30
Tusk 
08/02/2012 13:30
Tusk 
Re: Improvement with Night Splint

That is encouraging. Looking forward to your photos and to see what your splint looks like.

Do you need a prescription from a doctor or can you go straight to a CHT?
Would a custom splint work better than gloves that look something like this?

08/02/2012 14:04
BRIANB 
08/02/2012 14:04
BRIANB 
Re: Improvement with Night Splint

That glove looks ok...although rather bulky ...Mine was developed from a script from Dr. Eaton..

The palm and the involved finger are the only parts supported by the splint ...the top is open as are all non involved fingers.

The splints were heated and form fitted to me. The CHT took her time and did a great job..

I was lucky...right Doctor right CHT ...

08/02/2012 21:26
Christl 
08/02/2012 21:26
Christl 

Re: Improvement with Night Splint

What is a CHT?
My right hand goes numb and tingles at night, so I bought a night splint for Carpol Tunnel (spelling??). I added some extra soft pipe foam to rest my hand on it. I guess I made my own splint, but maybe a custom one might be better. There is also a fixx glove on the german site that can be purchased.

Christl

08/02/2012 21:47
BRIANB 
08/02/2012 21:47
BRIANB 
Re: Improvement with Night Splint

Cetrtified Hand Therapist = CHP

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