144 Neck Splint Fabrication

Abstract Addressing the neck during burn rehabilitation is challenging, but critical as hypertrophy and contractures can result in adverse psychosocial, functional and cosmetic outcomes. Attention to the neck early in the rehabilitation process is crucial in minimizing scarring and preventing cervical contractures. This video will demonstrate fabrication of a neck splint using silicon lined low-temperature thermoplastic material. The silicone-lined material is durable and has the capability of maintaining optimal pressure and position. It can be utilized alone or in a combination with compression garment to ensure 23 hours of pressure, which is crucial in preventing neck contractures, maintaining good cervical spine alignment and ROM, maximizing function and enhancing aesthetic appearance. Based on our clinical experience, use of silicon lined low temperature thermoplastic splint allows for early and aggressive scar management. Furthermore, patients report improved compliance with wear and ease of care for this splint.

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638 Auricular Splinting Following Severe Facial Burn Injury and Reconstruction

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.259 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S164-S164

Author(s):

Lisa LePage

Keyword(s):

Low Temperature ◽

Burn Injury ◽

Surgical Reconstruction ◽

Transposition Flap ◽

Thermoplastic Material ◽

Contracture Release ◽

Scar Management ◽

The Many ◽

User Friendly ◽

Facial Burn

Abstract Introduction With a severe facial burn, injury often involves the ear(s) resulting in damage or loss which may require reconstruction. In consideration of the functional and psychological effect that loss of a defined ear lobe may entail, reconstruction is an important consideration for the burn survivor. Two cases described in detail with illustration will highlight an auricular contracture release; one with V-Y Advancement and the other with a transposition flap. Preservation of the auricular reconstruction is accomplished by implementing necessary splinting. The auricular splint fabricated was made from a combination of silicone and low-temperature thermoplastic material. A step-by-step process will illustrate the needed materials and techniques to fabricate a worthy splint in order to preserve what was surgically achieved. The splint maintains the space between the ear and head to properly position and prevent contracture through the healing and scar maturation process. It secured with a one-inch head band that is sublime enough to foster compliance with wear. The auricular splint material also serves as scar management with the many proven benefits of silicone. Methods Two case studies are reviewed with auricular contractures that required release and reconstruction. The auricular splints were fabricated to stabilize and preserve the reconstructed ear lobe. The wear schedule was intermittent during the day and overnight in combination with scar massage. The patients reported good compliance with wear and stability of splint position with overnight wear. Skin integrity was not compromised with overnight or intermittent wear. The splint fabrication process is reviewed and illustrated with a simplistic innovative end result that is user friendly. Results Surgical reconstruction was required following development of auricular contractures and partial loss. With post-operative bandage removal and wound closure, positioning was a necessary consideration to preserve post-surgical reconstruction. Conclusions In conclusion, the peri-auricular splint is fabricated with low temperature splinting material lined in silicone proved worthy for effective positioning and reported comfort with wear. Effective splinting is necessary for the preservation of surgical reconstruction and to prevent contracture from sabotaging surgical efforts. Applicability of Research to Practice Consideration of fabrication of silicone auricular splints to preserve the accomplishments of auricular surgical reconstruction.

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Ergonomic Consideration in Pillow Height Determinants and Evaluation

Healthcare ◽

10.3390/healthcare9101333 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1333

Author(s):

Jia-Xing Lei ◽

Peng-Fei Yang ◽

Ai-Ling Yang ◽

Yan-Feng Gong ◽

Peng Shang ◽

...

Keyword(s):

Cervical Spine ◽

Muscle Activity ◽

Sleep Problems ◽

Comprehensive Evaluation ◽

Sufficient Evidence ◽

Health Issues ◽

Body Dimension ◽

Current Trends ◽

Shoulder Complex ◽

Cervical Spine Alignment

(1) Background: Sleep problems have become one of the current serious public health issues. Pillow height affects the alignment of the cervical spine and is closely related to the mechanical environment of the cervical spine. An appropriate pillow height can provide adequate support for the head and neck to reduce the stress in the cervical spine and relax the muscles of the neck and shoulder, thereby relieving pain and improving sleep quality. (2) Methods: We reviewed the current trends, research methodologies, and determinants of pillow height evaluation, summarizing the evidences published since 1997. In particular, we scrutinized articles dealing with the physiological and mechanical characteristics of the head-neck-shoulder complex. (3) Results: Through the investigation and analysis of these articles, we presented several quantitative and objective determinants for pillow height evaluation, including cervical spine alignment, body dimension, contact pressure, and muscle activity. The measurement methods and selection criteria for these parameters are described in detail. However, the suggested range for achieving optimal cervical spine alignment, appropriate pressure distribution, and minimal muscle activity during sleep cannot yet be identified considering the lack of sufficient evidence. Moreover, there remain no firm conclusions about the optimal pillow height for the supine and lateral positions. (4) Conclusions: A comprehensive evaluation combining the above determinants provides a unique solution for ergonomic pillow design and proper pillow height selection, which can effectively promote the public sleep health. Therefore, it is necessary to develop a reasonable algorithm to weigh multiple determinants.

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C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

Surgical Case Reports ◽

10.31487/j.scr.2020.07.17 ◽

2020 ◽

pp. 1-3

Author(s):

Isabel Snee ◽

Catherine A. Mazzola

Keyword(s):

Cervical Spine ◽

Head Tilt ◽

Spine Injury ◽

Halo Traction ◽

Cord Injury ◽

Magnetic Resonance Imaging Mri ◽

Cervical Spine Alignment ◽

Atlanto Axial Joint ◽

Spine Radiographs ◽

Halo Device

We report a case of a seven-year-old girl who presented with a “Cock-Robin” head tilt and cervical spine injury after falling from her bed. Initial cervical spine X-ray reported a fractured clavicle. However, almost four weeks later, the torticollis had not resolved. Computerized tomography (CT) of the cervical spine revealed subluxation of the atlanto-axial joint at C1-C2. Cervical spine magnetic resonance imaging (MRI) did not show any spinal cord injury. Manual reduction and hard collar placement were attempted, yet C1- C2 subluxation recurred. The child was placed into halo traction and then into a halo vest. CT scan showed near complete resolution of C1-C2 subluxation. Three months later the halo device was removed, and the patient was placed in a hard cervical collar then transitioned into a soft collar over a four month period. During this time, the patient received physical therapy. Final cervical spine radiographs revealed proper cervical spine alignment and resolution of C1-C2 subluxation.

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Lacrosse Equipment and Cervical Spinal Cord Space During Immobilization: Preliminary Analysis

Journal of Athletic Training ◽

10.4085/1062-6050-45.1.39 ◽

2010 ◽

Vol 45 (1) ◽

pp. 39-43 ◽

Cited By ~ 11

Author(s):

Michael Higgins ◽

Ryan T. Tierney ◽

Jeffrey B. Driban ◽

Steven Edell ◽

Randall Watkins

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Repeated Measures ◽

Cervical Spinal Cord ◽

Spine Injury ◽

Imaging Center ◽

Mri Scans ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Cervical Spine Alignment

Abstract Context: Removal of the lacrosse helmet to achieve airway access has been discouraged based only on research in which cervical alignment was examined. No researchers have examined the effect of lacrosse equipment on the cervical space available for the spinal cord (SAC). Objective: To determine the effect of lacrosse equipment on the cervical SAC and cervical-thoracic angle (CTA) in the immobilized athlete. Design: Observational study. Setting: Outpatient imaging center. Patients or Other Participants: Ten volunteer lacrosse athletes (age = 20.7 ± 1.87 years, height = 180.3 ± 8.3 cm, mass = 91 ± 12.8 kg) with no history of cervical spine injury or disease and no contraindications to magnetic resonance imaging (MRI). Intervention(s): The lacrosse players were positioned supine on a spine board for all test conditions. An MRI scan was completed for each condition. Main Outcome Measure(s): The independent variables were condition (no equipment, shoulder pads only [SP], and full gear that included helmet and shoulder pads [FG]), and cervical spine level (C3–C7). The dependent variables were the SAC and CTA. The MRI scans were evaluated midsagittally. The average of 3 measures was used as the criterion variable. The SAC data were analyzed using a 3 × 5 analysis of variance (ANOVA) with repeated measures. The CTA data were analyzed with a 1-way repeated-measures ANOVA. Results: We found no equipment × level interaction effect (F3.7,72 = 1.34, P = .279) or equipment main effect (F2,18 = 1.20, P = .325) for the SAC (no equipment = 5.04 ± 1.44 mm, SP = 4.69 ± 1.36 mm, FG = 4.62 ± 1.38 mm). The CTA was greater (ie, more extension; critical P = .0167) during the SP (32.64° ± 3.9°) condition than during the no-equipment (25.34° ± 2.3°; t9 = 7.67, P = .001) or FG (26.81° ± 5.1°; t9 = 4.80, P = .001) condition. Conclusions: Immobilizing healthy lacrosse athletes with shoulder pads and no helmets affected cervical spine alignment but did not affect SAC. Further research is needed to determine and identify appropriate care of the lacrosse athlete with a spine injury.

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