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Posterior Night Splint

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21. 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

22. Nasopharyngeal airway (NPA)

is to be sized correctly in patients: if the airway is too short it will fail to separate the soft palate from the pharynx and if too long it can pass into the larynx and aggravate cough and gag reflexes ( ). The NPA primarily acts as a 'splint' which maintains patency of the airway, or keeps the tongue from falling back on the posterior pharyngeal wall and occluding the airway, therefore preventing airway obstruction, hypoxia and asphyxia ( ). NPAs are generally well tolerated by conscious children (...) Nasopharyngeal airway (NPA) Nasopharyngeal airway (NPA) | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Nasopharyngeal airway (NPA) Nasopharyngeal airway (NPA) ). The purpose of a NPA is to bypass upper airway obstruction at the level of the nose, nasopharynx or base of the tongue. A correctly placed NPA will sit just above the epiglottis, having separated the soft palate from the posterior wall of the oropharynx. This knowledge is vital if the NPA

2014 Publication 1593

23. 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

25. 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

2015 British Committee for Standards in Haematology

26. Achilles Pain, Stiffness, and Muscle Power Deficits; Midportion Achilles Tendinopathy Revision

with midportion Achilles ten- dinopathy. Key elements of patient counseling could include (1) theories supporting use of physical therapy and role of mechani- cal loading, (2) modifiable risk factors, including body mass index and shoewear, and (3) typical time course for recovery from symptoms. INTERVENTIONS – HEEL LIFTS D Because contradictory evidence exists, no recommendation can be made for the use of heel lifts in patients with midpor- tion Achilles tendinopathy. INTERVENTIONS – NIGHT SPLINTS C (...) Clinicians should not use night splints to improve symptoms in patients with midportion Achilles tendinopathy. INTERVENTIONS – ORTHOSES D Because contradictory evidence exists, no recommendation can be made for the use of orthoses in patients with midpor- tion Achilles tendinopathy. INTERVENTIONS – TAPING F Clinicians should not use therapeutic elastic tape to reduce pain or improve functional performance in patients with mid- portion Achilles tendinopathy. F Clinicians may use rigid taping to decrease

2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

27. Neuromuscular Occlusion Concept-based Diagnosis and Treatment of Tempromandibular Joint Disorders: A Review of the Clinical Evidence

that TENS treatment was associated a statistically significant difference between groups in terms of the vertical evaluation; however, these differences were not provided for the anterior/posterior index or the ratio of vertical/ anterior-posterior indices. In the randomized-controlled trial by Jadidi et al., the use of contingent electrical stimulation for the treatment of TMD patients was not statistically different from placebo in terms of sleep hours during the night, maximum pain-free jaw-opening (...) The available evidence does not support the use of electromyography as a diagnostic test for temporomandibular disorder. The use of electrical stimulation for the treatment of TMD is not supported by the current evidence. No conclusions can be made on the efficacy of occlusal splint based on the neuromuscular occlusion concept. METHODS Literature Search Strategy A limited literature search was conducted on key resources including PubMed, The Cochrane Library (2012, Issue 11), University of York Centre

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

28. Tennis elbow

of the capitellum — may present with joint effusion; more common in young people especially following repetitive overhead throwing activities. Radial tunnel syndrome (compression of the posterior interosseous nerve) — maximal tenderness is localized to the area distal to the radial head, pain is often worse at night. Resisted wrist extension may not be painful, however resisted thumb and index finger extension may cause pain. Note: this condition may co-exist with tennis elbow in 5% of cases. Trauma and intra (...) of movement, and improve function [ ]. Arranging orthotics referral The recommendations on bracing (forearm straps and wrist extension splints) are based on the fact that these may provide symptom relief by offloading and decreasing stress on the diseased common extensor tendon and reducing extensor muscle activity [ ; ]. CKS notes, however, that there is limited, conflicting evidence on the benefits of orthoses in the literature. Orthotics are recommended in the ACOEM practice guideline, which cites

2017 NICE Clinical Knowledge Summaries

30. Clinical Study of Customized Adjustable Oral in Treatment of Patients With Obstructive Sleep Apnea Syndrome

on the craniofacial features assessment. The Epworth Sleepiness Scale (ESS) will be used to evaluate daytime sleepiness. They then will be fitted with a costumed adjustable oral appliance. The appliances are taken with a mandibular advancement of 2-3 mm and vertical rise of 4-5 mm, that is, the vertical position set at the minimum occlusal elevation to allow mandibular advancement and to avoid backward rotation. The participants were asked to wear the test appliance for 7 nights, and in case of compliance (...) ,application it every night at least for 6 months. The selected patients will be record their usage of the appliance and any adverse effects in a treatment journal. The research focus on the following outcomes: sleep apnea and the the volumetric changes of the upper airway. All patients were radiographically evaluated with a specific diagnostic examination: the cone beam computed tomography scan. For each patient, 3 CBCT scans were performed positioning his head in a neutral way and were performed without

2018 Clinical Trials

31. 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

32. Bone Sarcomas: ESMO Clinical Practice Guidelines

network beforebiopsy[10–13][III,A]. The medical history should focus on symptoms such as dur- ation, intensity, and timing of complaints, for example night pain or fracture. Moreover, speci?c events for bone tumours include prior benign/malignant lesions, family history, and previous radiotherapy. A recent injury does not rule out a ma- lignant tumour and must not prevent appropriate diagnostic procedures. All patients should have a full physical examin- ation. Speci?c attention should be given (...) be a strong case for immobilising the part following biopsy, usually by application of an external splint. Chemotherapy treatment can result in renal, cardiac, and auditory dysfunction, and patients undergoing this treatment must have baseline renal functiontestingandassessment ofcardiacfunctionaswellasan audiogram (in the case of treatment with platinum derivatives). Sperm storage is recommended for male patients of reproduct- ive age. For female patients, a fertility physician should be con

2015 European Society for Medical Oncology

33. Determinants of Tooth Movement in Oral Appliance Treatment of OSA.

repositioning splint therapy will include average OAM adherence (hours/night), quality of life (Functional Outcomes of Sleep Questionnaire, FOSQ), and change in mandibular incisor root length and attachment loss. Adherence will be measured by compliance monitors embedded in the oral appliance and mandibular repositioning splints. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 105 participants Allocation: Randomized Intervention Model (...) and mandibular repositioning splints. The adherence will be measured in hours per night and nights per week. Quality of Life using Functional Outcomes of Sleep Questionnaire (FOSQ-10) [ Time Frame: Data collected at 0, 1, 2, 18 and 36 months after appliance insertion. ] FOSQ-10 measures functional status and difficulty in performing everyday activities via 10 questions. The range of scores for any question is from 1 to 4. There is also a 0 score option for participants who do not engage in a particular

2017 Clinical Trials

34. Conservative Therapy Interventions in Plantar Fasciitis

tubercule of calcaneus are painful. According to the literature, non-surgical treatment modalities relieve symptoms of patients successfully. Orthotics, night splints, manipulation interventions with conventional methods are effective to decrease pain and improve function. There are various physiotherapy treatment approaches in plantar fasciitis but there is no consensus about most effective treatment program. Stretching of plantar flexor muscles and plantar fascia is one of the core elements (...) of the treatment plan. Strengthening exercises together with stretching were shown more effective than only stretching. Foot orthoses are thought to prevent increased pronation and relieving stress on plantar fascia in patients with plantar fasciitis. Usage of insoles with night splints is found more effective. Taping is also helpful to acute pain control. Short foot exercises as isolated intrinsic foot muscles strengthening helps to providing subtalar foot position and supports plantar fascia and foot arches

2017 Clinical Trials

35. Family Practice Notebook Updates 2017

with both sugar tong and posterior splint applied and a well padded heel and non-weight bearing for 6-8 weeks Subtalar fusion indications include Bohler's Angle <4 degrees or Sanders Type 4 (derm, exam, , er) Serious to life-threatening dermatosis with generalized skin erythema and Causes include underlying or , , infection (HIV, toxic shock) and Associated with significant morbidity and mortality risk Admit all patients suspected of having (pharm, , ) When s are needed, consider immediate release 10-30 (...) ) Consider deep s to reduce skin tension Avoid subcuticular as a sole method of skin closure (lung, procedure) Flush rate oxygenation at 40-70 lpm is optimal for RSI (rather than 15 lpm) (lung, procedure) Premedications ( , , ) for RSI are nearly never indicated In , does not decrease ICP with intubation ( may offer benefit, but is associated with ) (ortho, peds, ) Emergent surgery for open s, neurovascular injury (or risk of injury), unreducible joint dislocations Removable ankle splints are safe

2018 FP Notebook

36. Family Practice Notebook Updates 2017

with both sugar tong and posterior splint applied and a well padded heel and non-weight bearing for 6-8 weeks Subtalar fusion indications include Bohler's Angle <4 degrees or Sanders Type 4 (derm, exam, , er) Serious to life-threatening dermatosis with generalized skin erythema and Causes include underlying or , , infection (HIV, toxic shock) and Associated with significant morbidity and mortality risk Admit all patients suspected of having (pharm, , ) When s are needed, consider immediate release 10-30 (...) ) Consider deep s to reduce skin tension Avoid subcuticular as a sole method of skin closure (lung, procedure) Flush rate oxygenation at 40-70 lpm is optimal for RSI (rather than 15 lpm) (lung, procedure) Premedications ( , , ) for RSI are nearly never indicated In , does not decrease ICP with intubation ( may offer benefit, but is associated with ) (ortho, peds, ) Emergent surgery for open s, neurovascular injury (or risk of injury), unreducible joint dislocations Removable ankle splints are safe

2018 FP Notebook

37. Femoral Anteversion

rotation (60 to 90 degrees) Decreased external hip rotation (10 to 15 degrees) VII. Differential Diagnosis See Infants or other neuromuscular disorder Toddlers Teen and pre-teen VIII. Diagnosis Biplanar Radiography Used to Measure Femoral Anteversion IX. Management Watchful waiting until age 8 years Avoid non-helpful measures Shoe Modifications Night splints Dennis-Browne splint Twister cables Passive s Physical Therapy Femoral Rotational Osteotomy Indications Comorbid neuromuscular disease (e.g (...) Normal hip Femoral head slightly anterior to Femoral neck Retroverted hip Femoral head posterior to Femoral neck Associated with IV. Mechanism Excessive medial rotation of the femur Normal Femoral Neck Anteversion angles Adults: 15-25 degrees Children Age 3-12 months: 39 degrees Age 1-2 years: 31 degrees V. Symptoms Standing appearance: "Kissing e" Clumsy gait appearance: "Egg-Beater" feet (" ") Sitting position: "Inverted W" Sitting with hips flexed and internally rotated (feet at either side

2018 FP Notebook

39. Plantar fasciitis

recommendations are therefore based on what CKS considers to be good clinical practice. The purpose of referral is to: Reinforce . Ensure that are being carried out correctly. Check the suitability of footwear and orthoses. Consider the need for custom made orthoses (such as heel cups, longitudinal arch supports, and custom made full-length shoe insoles), taping, and night splints. Considering custom-made orthoses Expert advice can be given on the use of custom-made orthoses, although from randomized (...) controlled trials that these are superior to prefabricated orthoses is lacking. Orthotic devices theoretically work by reducing the load on the plantar fascia by reducing pronation [ ]. Considering taping and night splints Low-dye taping is thought to decrease the symptoms of heel pain by reducing fascia strain during standing or walking. A systematic review found evidence for its effectiveness in the short-term from two high quality trials included in the review [ ; ]. Night splints. CKS found no good

2015 NICE Clinical Knowledge Summaries

40. Ozone Therapy for Masticatory Muscle Pain (OTMMP)

: OzonytroneX Placebo Comparator: Placebo Sham ozone application to the greatest points of pain in the related muscle, 3 times per week for 2 weeks Device: Placebo (for Ozone) Experimental: Occlusal splint Occlusal splint use every night over a period of 4 weeks. Device: Dental treatment with occlusal splint Outcome Measures Go to Primary Outcome Measures : Change From Baseline in Pain Values (kg/cm2) on the Pressure pain threshold measurement (PPT) using a Pressure Algometry at 1 month [ Time Frame: Change (...) Description Go to Brief Summary: This study investigates the efficacy of bio-oxidative ozone application in the treatment of TMD of muscular origin. Condition or disease Intervention/treatment Phase Orofacial Pain Temporomandibular Joint Disorders Device: Ozone Device: Placebo (for Ozone) Device: Dental treatment with occlusal splint Not Applicable Detailed Description: Ozone is a natural pale blue gas that can be found in the atmosphere. Medical grade ozone is a powerful oxidizing agent which can

2016 Clinical Trials

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