Analysis of remaining motion using one innovative upper airway opening cervical collar and two traditional cervical collars.

The aim of this study was to compare the remaining motion of an immobilized cervical spine using an innovative cervical collar as well as two traditional cervical collars. The study was performed on eight fresh human cadavers. The cervical spine was immobilized with one innovative (Lubo Airway Collar) and two traditional cervical collars (Stifneck and Perfit ACE). The flexion and lateral bending of the cervical spine were measured using a wireless motion tracker (Xsens). With the Weinman Lubo Airway Collar attached, the mean remaining flexion was 20.0 ± 9.0°. The mean remaining flexion was lowest with the Laerdal Stifneck (13.1 ± 6.6°) or Ambu Perfit ACE (10.8 ± 5.8°) applied. Compared to that of the innovative Weinmann Lubo Airway Collar, the remaining cervical spine flexion was significantly decreased with the Ambu Perfit ACE. There was no significant difference in lateral bending between the three examined collars. The most effective immobilization of the cervical spine was achieved when traditional cervical collars were implemented. However, all tested cervical collars showed remaining motion of the cervical spine. Thus, alternative immobilization techniques should be considered.

A Simple Protective Splint for Infant Nasal Reconstruction.

Nasal trauma is a common complication of nasal continuous positive airway pressure (NCPAP) and may range from erythema, edema, and skin breakdown to columellar necrosis. Although rare, columellar necrosis can be a devastating complication following NCPAP, and surgical repair remains challenging due to contour and color-match difficulties, tenuous vascularity, and limited available adjacent skin. In addition, because operative site protection is critical to a successful repair, many surgeons opt to delay surgical intervention from infancy until a later age so that the patient does not inadvertently injure and compromise the graft during the early postoperative period. Here, we present a case of composite nasal reconstruction in an infant following columellar necrosis secondary to NCPAP, along with the design and implementation of a simple, inexpensive, and protective nasal splint that allows for early repair at the time of infancy.

Removal of the Long Spine Board From Clinical Practice: A Historical Perspective.

Since the early 1970s, initial management of patients with suspected spinal injuries has involved the use of a cervical collar and long spine board for full immobilization, which was thought to prevent additional injury to the cervical spine. Despite a growing body of literature demonstrating the detrimental effects and questionable efficacy of spinal immobilization, the practice continued until 2013, when the National Association of EMS Physicians issued a position statement calling for a reduction in the use of spinal immobilization and a shift to spinal-motion restriction. This article examines the literature that prompted the change in spinal-injury management and the virtual elimination of the long spine board as a tool for transport.

Printing a 3-dimensional, Patient-specific Splint for Wound Immobilization: A Case Demonstration.

Three-dimensional (3D) printing technology can generate objects in almost any shape and geometry. This technique also has clinical applications, such as the fabrication of specific devices based on a patient's anatomy. A demonstration study is presented of a 54-year-old man who needed a thermoplastic splint to limit arm movement while a dehisced left shoulder wound healed. The patient's upper extremity was scanned using the appropriate noncontact scanner and 3D technology software, and the polylactic acid splint was printed over the course of 66 hours. This patient-specific splint was worn during the day, and after 2 weeks the wound was healed sufficiently to permit hospital discharge. Creation of an individualized splint is one of many potential medical uses of 3D technology. Although the lengthy printing time imposes limitations, the implications for practice are positive.

Various Colored Splints for Each Type of Rhinoplasty.

In rhinoplasty, one of the most popular aesthetic surgical procedures worldwide, several different techniques are utilized when performing a rhinoplasty procedure. Many complications can arise postoperatively depending on the surgical approach and technique utilized. A method to reduce immediate postoperative complications has been identified. The use of different colored nasal splints for various surgical procedures could assist in identifying high-risk patients to the postsurgical recovery team and the clinical staff. In this prospective 10-year study, patients were divided into 2 groups. In Group I, the green-colored splint was applied to all patients, whereas in Group II, patients were divided into 3 subgroups. Patients undergoing rhinoplasty and septoplasty, rhinoplasty, and minimally invasive rhinoplasty were placed in Subgroup I, Subgroup II, and Subgroup III, respectively. Different survey questionnaires were designed for patients, the surgical team, the postsurgical recovery team, the follow-up care team, and the clinical staff. A total of 2,680 (88%) patients were females, whereas 332 (12%) patients were males. There was no significant difference in surgeon's responses between 2 groups (p > .05). Between the 2 groups, there was a significant difference in the postsurgical recovery team and the follow-up care staff (p < .001). Patients in Group II were significantly more aware of their conditions and possible complications (p < .001). The current study reveals that patients undergoing rhinoplasty should be identified through colored splints, particularly patients whose surgery accompanies a high possibility of complications. In such patients, colored splint is a red flag for surgical and postsurgical nurses and staff who are providing health care to patients.

The Thomas splint--a necessary tool in the management of battlefield injuries.

The Thomas splint was developed for the stabilisation of femoral fractures at the end of the nineteenth century, and since the First World War has been extensively used by the British Army. It has been shown to improve the outcome after ballistic fractures of the femur, but recently there have been moves to abandon this device in favour of more modern splints such as the Sager splint. This is predominately due to the ease of use and smaller size of newer devices, which makes them more suitable for the pre-hospital environment. However, we present our experience of managing both ballistic and closed femoral injuries using Thomas splints during the recent Gulf Conflict. It is our belief that the Thomas splint is an essential tool in the management of military femoral injuries at role three facilities and must be retained.

Left ventricular splints and wraps for end-stage heart failure: a new approach in the new millennium.

The epidemic of heart failure and its subsequent effect on public health policy is escalating. Cardiac transplantation continues to be limited by the shortage of donor organs, and the current generation of mechanical circulatory support devices has not yet approached the goal of destination therapy. A better understanding of the role of left ventricular remodeling in the development of heart failure has resulted in novel surgical therapies and devices that may reverse or retard the remodeling process.

To splint or not to splint--past philosophy and present practice: Part I.

The purposes of this study were to document (1) the historical use of splints, (2) record the current practice of splint application, and (3) compare splint philosophy of the past with present practice. One hundred burn references were reviewed for information on the past use of splints. Present practice was determined on the basis of a survey of 99 burn centers. Information is presented as to when splints are applied to burn patients in their course of recovery for 12 body areas prone to scar contracture. The influence of burn depth is noted. A change in the practice of applying splints to burn patients appears to have occurred. Part I of this series describes the global results and details whether splints are necessary.

The Thomas splint. Questionable boast of an indispensable tool.

The Thomas splint has been used since the late 1800s. During World War I, physicians began using it for the acute management of femoral fractures and attributed its use to reduced mortality associated with these injuries. However, articles differ as to the actual percentage of mortality reduction. Even though these discrepancies exist, the Thomas splint has been useful and is still used today, especially for patient transport while awaiting definitive management.

Soft versus hard resting hand splints in rheumatoid arthritis: pain relief, preference, and compliance.

OBJECTIVES: This study compared soft versus hard resting hand splints on pain and hand function in 39 persons with rheumatoid arthritis. Splint preference was also evaluated to determine its effects on splint wear compliance. METHOD: A repeated measures research design was used to compare the two experimental conditions, wearing a soft splint versus a hard splint on the dominant hand for 28 days at night only, and an unsplinted control period of 28 days. RESULTS: Arthritis pain was considerably less during both splinted periods when compared with the pretest. Subjects identified fewer joints as being painful during the soft splint condition than during the unsplinted condition. There were no significant differences among conditions on hand function measures. Splint preference was 57% for the soft splint, 33% for the hard splint, and 10% for no splint. Splint wear compliance was significantly better with the soft splint (82%) than with the hard splint (67%). CONCLUSION: The findings indicate that resting hand splints are effective for pain relief and that persons with rheumatoid arthritis are more likely to prefer and comply with soft splint use for this purpose. Individualized splint prescription that focuses on client comfort and preference may enhance splint wear compliance.