The Use of Orthoplast Isoprene Splints in the Treatment of the Acutely Burned Child: Preliminary Report

Abstract

In stating that the formation of contracture deformities is one of the major problems encountered in the treatment of the burned patient; the author describes the steps taken to counteract this problem at thefirst pediatric hospital specializing in burn care. Desired positioning for the hand and wrist is described and reasons are put forward for the choice of materials used and listed with the equipment necessary for fabrication. The step-by-step method of construction of hand, elbow and knee splints is given with detailed illustration. The decision to write this paper was made following the successful application of over four hundred splints and the interest shown by both resident and visiting medical personnel. IntroductionDuring the first year of patient care at the Shriners Burns Institute, Galveston Unit, one of the major problems encountered was the occurrence of contracture deformities in the post-burn child, requiring further reconstructive surgical procedures. To reduce the formation of these contractures, I various methods of splinting and bracing were utilized but often without success.This failure was apparently due either to the inadequacy of the device in maintaining position or to the actual delay in applying the device, the damage having already begun. It became evident that to achieve any measure of success the splints and braces should be made and fitted on the premises by a member of the hospital staff.

Expanded Latissimus Dorsi Free Flap for the Treatment of Extensive Post-Burn Neck Contracture

“…Several authors have reported that contracture of grafted skin to the neck can be prevented by applying neck splints. 6,7 This may be true, when the contracture is limited to the area of the neck. However, in burn scars involving areas from the anterior neck to the face, skin grafting can obscure the chin prominence, mandibular angle, or opening of the mouth.…”

Management of contractural deformities involving the axilla (shoulder), elbow, hip, knee, and ankle joints in burn patients

“…[2][3][4][5] For more than three decades, a neck brace, a three-point extension splint, and a molded brace fabricated from thermoplastic materials, the prototypes of devices used to splint the neck, elbow and the knee joints, were used in the management of burn patients at the Shriners Burns Hospital and the University of Texas Medical Branch Hospitals in Galveston, Texas. An 'airplane splint' similarly made of thermoplastic materials was also used to splint the axilla during the period where the use of other splinting and bracing techniques, such as a 'fi gureof-eight' bandage, is not feasible.…”

Ecological Synergies in Two Groups of Zoo Chimpanzees: Divergent Patterns of Time Use

“…With regard to physical features of practice settings, the earliest occupational therapists helped patients by introducing supplies for occupations into medical settings where none had previously existed (Quiroga, 1995). Mid-20th century occupational therapists likewise put in place needed equipment and materials to engage inpatients in full schedules of self-care, recreation, and work (Reilly, 1966;Slagle & Robinson, 1941); they also invented and used many assistive devices and orthotics to enable task performance (e.g., Hopkins, 1960;Willis, 1969). Again consistent with this history, contemporary occupational therapists consider such physical environmental features as object availability and accessibility, visual and auditory cues, assistive technologies and aids, safety, and how objects and spaces can be modified to enhance performance capacities (Corcoran & Gitlin, 1997;Post, 1993).…”