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Posterior Night Splint

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1. Posterior Night Splint

Posterior Night Splint Posterior Night Splint Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Posterior Night Splint Posterior Night (...) Splint Aka: Posterior Night Splint II. Indications refractory to basic measures III. Mechanism Keeps foot in maximal dorsiflexion May be uncomfortable if >90 degrees May interfere with sleep IV. Preparation Layer 4" dry glass material into 12 plies Length to extend between high calf and proximal toes Put material inside tube gauze Apply material to foot and leg Maximize dorsiflexion Patient may hold tube gauze to dorsiflex foot Apply soaked ace wrap around splint Remove ace wrap when splint hardened

2018 FP Notebook

2. Posterior Night Splint

Posterior Night Splint Posterior Night Splint Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Posterior Night Splint Posterior Night (...) Splint Aka: Posterior Night Splint II. Indications refractory to basic measures III. Mechanism Keeps foot in maximal dorsiflexion May be uncomfortable if >90 degrees May interfere with sleep IV. Preparation Layer 4" dry glass material into 12 plies Length to extend between high calf and proximal toes Put material inside tube gauze Apply material to foot and leg Maximize dorsiflexion Patient may hold tube gauze to dorsiflex foot Apply soaked ace wrap around splint Remove ace wrap when splint hardened

2015 FP Notebook

3. Effect of Laser Therapy Versus Anterior Re-positioning Splint in the Treatment of Disc Displacement With Reduction

therapy Biolase laser device Active Comparator: anterior re-positioning splint therapy anterior re-positioning splint worn for 8 hours during night time for 3 months Device: anterior re-positioning splint hard acrylic anterior re-positioning splint Other Names: occlusal splint TMD splint Placebo Comparator: inactive laser therapy placebo laser for 12 sessions over 3 months Device: inactive Laser therapy sham Laser, with inactive beam Outcome Measures Go to Primary Outcome Measures : Level (...) Effect of Laser Therapy Versus Anterior Re-positioning Splint in the Treatment of Disc Displacement With Reduction Effect of Laser Therapy Versus Anterior Re-positioning Splint in the Treatment of Disc Displacement With Reduction - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2018 Clinical Trials

4. Suspected neurological conditions: recognition and referral

neurological deficit such as vertical or rotatory nystagmus, new-onset unsteadiness or new-onset deafness: if the person has diabetes, check for and treat hypoglycaemia if the person does not have diabetes, or treating hypoglycaemia does not resolve the symptoms, and benign paroxysmal positional vertigo or postural hypotension do not account for the presentation, refer immediately to exclude posterior circulation stroke, in line with the NICE guideline on stroke and transient ischaemic attack in over 16s (...) 1.7.9 For adults with clear features of compression neuropathy of the radial nerve, common peroneal nerve or ulnar nerve and no features of a nerve root lesion (radiculopathy): refer to orthotic services for a splint review the symptoms after 6 weeks, and refer for neurological assessment if there is no evidence of improvement. For adults with features of radiculopathy, see cervical or lumbar radiculopathy. 1.7.10 Advise adults with compression neuropathy to avoid any activity that might lead

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

6. Exam Series: Guide to the Knee Exam

hinge joint and one of the most common sites of MSK injuries. Fortunately a diagnosis is usually possible with a good history and physical exam! Four ligaments – the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) connect the femur to the tibial plateau, ensuring proper alignment and providing stability. Two menisci cushion the articulating surfaces while several bursa further reduce friction around the knee (...) joint. The suprapatellar and posterior bursa communicate directly with the joint cavity and will be enlarged with a joint effusion, posteriorly this is known as a Bakers cyst. The popliteal artery, vein, peroneal and tibial nerve run through the popliteal fossa. Anatomy of the Knee 1 Approach to the History A thorough history can provide several diagnostic clues and help to risk stratify patients. In some cases the physical examination may be limited by pain or a large effusion, so the history helps

2018 CandiEM

7. Ankle and Foot Surgical Guideline

the exposure is acute and related to significant occupational-related trauma to the heel or plantar fascia. Treatment of plantar fasciitis may include orthotics (pads), heel cord stretching exercises, anti- inflammatory medication, activity modification, night splinting, steroid injection to the site, or surgery. 23, 30 Surgical treatment (e.g. fasciotomy) is rarely indicated, with less than 5% of patients undergoing surgery. 31 D. Osteoarthritis A complicating factor when trying to establish work (...) Tendon Repair or Reconstruction 22 2 Washington State Department of Labor and Industries Surgical Guideline for Work-related Ankle and Foot Injuries – October 2017 Repair at Insertion 23 Repair 23 Reconstruction 23 H. Posterior Tibialis Tendon Reconstruction 23 PTTD and Work-relatedness 24 I. Tarsal Tunnel Release 24 J. Amputations 25 Amputations Contemplated in the Setting of Chronic Pain 25 VII. Return to Work 26 VIII. Acknowledgements 27 IX. References 28 3 Washington State Department of Labor

2017 Washington State Department of Labor and Industries

8. Spasticity in adults: management using botulinum toxin - 2nd edition

(eg splints, casts or positioning) to provide passive stretch of sufficient duration and intensity when there is still potential for reversibility. 4.2 Task-practice training (repetitive practice) should be considered when RA E1 E2 Moderate improvement in activity performance and motor control are the target or goal of treatment.Summary of the recommendations © Royal College of Physicians 2018 xi 5 Prescribing, supply and administration by non-medical practitioners Grade of Strength evidence 5.1 (...) sterile intramuscular injection techniques, anatomical assessment. Spasticity in adults: management using botulinum toxin xii © Royal College of Physicians 2018 6 Follow-up, documentation and outcome evaluation Grade of Strength evidence 6.1 All injections should be followed by: E1 E2 Moderate • therapy review in 7–14 days for assessment and if necessary orthotics/splinting • MDT review at 4–6 weeks to assess effect and patient status • MDT review at approximately 3–4 months to plan future management

2018 British Society of Rehabilitation Medicine

9. CRACKCast E053 – Shoulder

of the acromion and directed anteriorly towards the coracoid process. Video: 3) Best splint for posterior dislocation Unlike ant dislocation where we accept an internally rotated sling, ortho has often requested a sling with 90 degrees of ext. rotation for up to 4 weeks! This post was uploaded and copyedited by Riley Golby ( ) (Visited 1,918 times, 2 visits today) Justin Roos Justin Roos is an emergency medicine resident at the University of British Columbia. His interests include mountain and wilderness (...) avulations, and affected patients may benefit from arthroscopic repair. Call yo’ surgeons 10) Describe 4 X-ray findings in posterior shoulder dislocation AO – loss of half moon elliptic overlap of humeral head and glenoid fossa AP – rim sign – distance between glenoid rim and humeral head in increased Drumstick sign – internal rotation of humeral head appears like ‘drumstick’ or light bulb Reverse hill-sachs (impaction fracture of anteromedial humeral head 11) Describe 4 tests for Impingement syndrome

2016 CandiEM

10. CRACKCast E052 – Orthopedics – Humerus and Elbow

the reduction Regular neurovascular checks pre, during and post reduction. When to attempt reduction in the ED? When a displaced SC # is associated with neurovascular compromise: Steps: [fig 52-19] Counter Adults: Adults have the reverse problem compared to kids: they usually suffer a posterior elbow dislocation Any limb threatening injury needs immediate reduction, splinting and OR Open # need antibiotics 5) Describe the management of humeral shaft fractures – displaced and non-displaced Usually broken (...) and arm in supination with distal traction If not successful, apply downward pressure on the proximal forearm and use the fingers to pull the olecranon forward When reduced and stable, splint elbow in at least 90 degrees of flexion Thorough post-reduction exam and radiographs Follow-up and begin ROM at 3-5 days post **loss of median nerve or brachial artery function need immediate ortho/vascular consultation** Median and lateral dislocations are managed like a posterior dislocation Anterior

2016 CandiEM

11. CRACKCast E050 – Orthopedics – Hand Injuries

of: Phalangeal and metacarpal fractures Lots to get through here! See all the x-ray figures in the chapter, also check out Fig 50-29 for some good images and how to describe hand fracture location (i.e. neck vs. base) Distal phalangeal fractures Tuft fractures most common Symptomatic treatment Angulated fractures of the DP – may attempt reduction but often unsuccessful. Splint and refer. Watch out for Jersey Finger (more on this later) Proximal and middle phalangeal fractures Watch for malrotation (...) and scissoring – the nails should all point to the scaphoid Transverse fractures usually stable, oblique less so Reduce if necessary but normally not displaced If undisplaced: Buddy tape to provide support and allow ROM of DIP & PIP “Dynamic splinting” – with ROM exercises in first 3-5 days. If displaced (less common): reduce and splint/cast. Should be seen in follow-up, preferably with a hand surgeon Metacarpal shaft fractures: Can tolerate some angulation and some shortening. They cannot tolerate any

2016 CandiEM

12. CRACKCast E042 – Facial Trauma

, glands, and ducts of the face. At what ages do the sinuses appear? The posterior bones of the face form the anterior calvaria (brain-containing part of the cranium), thus whenever facial injuries are present always have a high index of suspicion for intracranial injury The anterior face is primarily formed by the large frontal bone making up the forehead, the maxilla and zygoma that form the cheeks, and the mandible which forms the lower mouth and chin. There are also two paired and symmetric nasal (...) for the patient. The reimplanted tooth should be secured with a splint and the patient referred to a dentist for followup. Optimum reimplantation time is less than one hour (66% success), and viability falls off rapidly after 3 hours (20% success). Beware aspirated teeth, and consider radiographic investigation for aspirated teeth. What is a luxed tooth? How is it managed? Luxation of a tooth is loosening of or displacement of the tooth in the socket, without avulsion Four major types: Subluxation – loosened

2016 CandiEM

14. Management of Carpal Tunnel Syndrome

” quality study for recommending for or against the intervention. 6 HISTORY INTERVIEW TOPICS Moderate evidence supports not using the following as independent history interview topics to diagnose carpal tunnel syndrome, because alone, each has a poor or weak association with ruling-in or ruling-out carpal tunnel syndrome: ? Sex/gender ? Ethnicity ? Bilateral symptoms ? Diabetes mellitus ? Worsening symptoms at night ? Duration of symptoms ? Patient localization of symptoms ? Hand dominance ? Symptomatic (...) a recommendation for or against the intervention. IMMOBILIZATION Strong evidence supports that the use of immobilization (brace/splint/orthosis) should improve patient reported outcomes. Strength of Recommendation: Strong Evidence Description: Evidence from two or more “High” strength studies with consistent findings for recommending for or against the intervention. 10 STEROID INJECTIONS Strong evidence supports that the use of steroid (methylprednisolone) injection should improve patient reported outcomes

2016 American Academy of Orthopaedic Surgeons

15. AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery

contractures after stroke can affect gait quality and safety. The use of an ankle-foot orthosis (AFO) can improve gait in patients with active plantarflexion during the swing phase of gait but also may be beneficial in preventing ankle contracture. For nonambulatory patients, the use of a resting ankle splint at night, set in the plantigrade position (ankle at 90° and subtalar neutral), or standing on a tilt table for 30 min/d is probably useful in preventing contracture. Prevention of Deep Venous (...) the first 4 months. These contractures can cause pain and make self-care, including dressing and hygiene, difficult. Many clinicians recommend daily stretching of the hemiplegic limbs to avoid contractures, and patients and families should be taught proper stretching techniques to avoid injury and to maximize effectiveness. Resting hand splints are often applied to prevent contractures in hemiplegic wrist and fingers, but their effectiveness is not well established. , There is controversy over

2016 American Heart Association

16. Bracing After Knee Arthroscopy

, Knee/ or Posterior Cruciate Ligament/ or Anterior Cruciate Ligament Reconstruction/ 11988 5 (((arthroscop* or reconstruct* or repair* or surg* or orthop*) and (anterior cruciate ligament* or posterior cruciate ligament* or meniscal or menisci or meniscus or menisectom* or semilunar cartilage* or ACL or PCL or MCL)) or (arthroscop* and knee*)).ti,ab. 19935 6 or/3-5 24981 7 exp Braces/ or exp Immobilization/ 27502 8 (brace* or bracing or splint* or immobilis* or immobiliz*).ti,ab. 96489 9 7 or 8 (...) is to decrease pain, protect the knee from injury or graft strain, and help achieve knee extension. These braces can range from splints with complete immobilization to a hinged brace that allows varying limits on range of motion. Functional braces are braces worn after return to physical activity or sport. With functional braces, the intent is to stabilize the knee and decrease the risk of re-injury. (2) As legislated in Ontario’s Excellent Care for All Act, Health Quality Ontario’s mandate includes

2014 Health Quality Ontario

17. Management of acute chest syndrome in sickle cell disease

embolism, which can present with chest pain and tachypnoea but without a new infiltrate on chest X‐ray. Whilst this group of patients have a hypercoagulable state and are at an increased risk of pulmonary embolism, the clinical picture is usually distinct from ACS. Hypoventilation/atelectasis Severe bony pain from rib infarcts can lead to splinting and regional hypoventilation in the areas of pain (Rucknagel et al , ; Gelfand et al , ). Alveolar hypoventilation can also occur secondary to opiate (...) higher mortality compared to those without neurological features (Vichinsky et al , ). A recent history of ACS is a risk factor for overt stroke, silent stroke and posterior reversible encephalopathy syndrome in children (Ohene‐Frempong et al , ; Henderson et al , ). An acute drop in haemoglobin concentration with an associated increase in markers of haemolysis prior to the onset of ACS is common. Reported falls from steady state haemoglobin values have varied from 7 g/l for all genotypes (Vichinsky

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2015 British Committee for Standards in Haematology

19. Joint Hypermobility - Identification and Management of

dysfunction (Balli 2013 [4a]) ? GI symptoms (nausea, stomach ache, diarrhea and constipation) (Zarate 2010 [4a], Adib 2005 [4a], Hakim 2004 [4a]); eosinophilic esophagitis (EE) (Abonia 2013 [3a]) ? Nonspecific (allergy, rash, nocturia, dysuria, flushing, night sweats, fever, lymph gland pain) (Kirby 2007 [4a]) ? Clumsiness/poor coordination (Adib 2005 [4a]) ? Prior therapy and response to the intervention(s) (Keer 2003 [5a], Hakim 2003 [5b]) 4. It is recommended that therapists complete a comprehensive (...) , and therapists consider the addition of the following: ? UE orthoses (LocalConsensus 2014 [5], Murray 2006 [5a], Russek 1999 [5a]) Evidence-Based Care Guideline for Management of Pediatric Joint Hypermobility Guideline 43 Copyright © 2014 Cincinnati Children's Hospital Medical Center, all rights reserved. Page 10 of 48 Note 1: Splinting of hypermobile joints may be used to promote optimal joint positioning and prevent overuse/strain with specific activities (LocalConsensus 2014 [5]). Note 2: Splinting

2014 Cincinnati Children's Hospital Medical Center

20. Royal Flying Doctor Service Western Operations Clinical manual part 1.Clinical guidelines

with treatment ? Antisocial, explosive or impulsive personality traits or personality disorders In addition patients suffering delirium and dementia in particular may be worsened by unfamiliar environment and night-time conditions. Escalation of care: 1. Ensure during pre-flight assessment that adequate history for warning signs and risk factors taken. 2. Ensure adequate pre-flight sedation including adequate antipsychotics for patients suffering from psychotic illness. 3. Doctor accompaniment 4. Additional (...) elevation = 1mm in 2 contiguous limb leads ? Persistent ST elevation = 2mm in 2 contiguous chest leads ? New left bundle branch block (LBBB) ? Changes consistent with posterior infarct (tall R in V1, deep anterior ST depression, ST elevation in V4 R) ? ECG changes of right ventricular infarct (ST elevation in leads aVR and V4R) NSTEMI Consistent history without ECG changes consistent with STEMI, plus positive troponin and positive creatine kinase (CK). Angina ? High Risk, (positive troponin but negative

2014 Clinical Practice Guidelines Portal

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