title: "Roll-bar" for protective posture splint limits potential trauma to dorsal hand grafts.
abstract: The expectation of excellent functional and cosmetic outcomes adds to the challenges of managing the burned hand. The initial fragility of the grafted surface warrants extra measures of protection. A "roll-bar " attached to a splint over a grafted area can serve as protection against mechanical trauma. Two "intrinsic plus " protective posture splints were fabricated; one had a roll-bar extending from the D2 ray to the distal forearm. Three simulated patients wearing each of the splints attempted to contact the bed rail from supine. Pictures, transferred ink, observation, and subjective comments were used to establish percentage of the surface at risk because of bed rail contact and its ease. Without the roll-bar 100% of the dorsal surface of the hand was accessible to contact with the bed rail. With the roll-bar all subjects were prevented from contact to the dorsum of the hand and contact to the dorsal fingers was less than 40% in all subjects, decrease of risk at the wrist was also significant. The roll-bar can prevent mechanical trauma to grafts on the fingers and dorsum of the hand because of contact with the bed rail. The ease of the application and the potential benefits to patient outcome make it an appropriate addition to the protective posture splint when seeking to minimize area of the surface at risk.
authors.affiliation: Department of Acute Rehabilitation, Bridgeport Hospital, Bridgeport, Connecticut 06610, USA.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Kaine
authors.forename: Phillip
authors.initials: P
authors.lastname: Fidler
authors.forename: John
authors.initials: J
authors.lastname: Schulz
authors.forename: Shaher
authors.initials: S
authors.lastname: Kahn
authors.forename: Roselle
authors.initials: R
authors.lastname: Crombie
authors.forename: Sally
authors.initials: S
authors.lastname: Dalton
authors.forename: Andrea
authors.initials: A
authors.lastname: Warren
authors.forename: Eric
authors.initials: E
authors.lastname: LaBonte
authors.forename: John
authors.initials: J
authors.lastname: Palmer
authors.forename: Paul
authors.initials: P
authors.lastname: Possenti
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Laird
authors.forename: Nabil
authors.initials: N
authors.lastname: Atweh
mesh_terms: D001513:Beds; D002056:Burns / Q000628:therapy*; D006259:Craniocerebral Trauma / Q000517:prevention & control*; D005240:Feasibility Studies; D006801:Humans; D011187:Posture; D011482:Protective Devices; D013165:Splints; D019737:Transplants; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000517:prevention & control*