Self-adjustable Aeroplane Splint Simple, Self-adjustable Aeroplane Splint Respected seniors and fellow colleagues. Good Afternoon I am presenting a Simple, Self Adjustable Aeroplane splint.

Post-burns axillary contracture 25% patients with major burns Position of comfort Gravitational pull Hypertrophic-scar Axillary contracture is found in 25% patients with major burns. The contributing factors are Position of comfort adopted by the patient. The gravitational pull on the arm, and Hypertrophic scar contraction.

Static Axillary Splints Various designs of axillary splints are available which hold the limb in a fixed position of abduction.

The salute splint- S.V. Abhyankar British Journal of Plastic Surgery (2001), 54, 213-215 DRAWBACK- Inability of straps to support a heavy arm comfortably may result in poor compliance. Furthermore, unwanted flexion contractures may occur as the shoulder is in flexion within the splint.

80% 15% Compliance?? 1st week 12th week As per literature and our observation also, patient compliance to these static splints is poor and by the 12th week, only 15% patients were using them. The reason being:

Difficulty in passing through narrow spaces as buses, stairs, crowded areas, elevators, riding a vehicle.

User-friendly, Adjustable Maintains surgically achieved results Ideal Axillary Splint User-friendly, Adjustable Prevents recurrence Maintains surgically achieved results Lightweight, Durable Cost-effective What qualifies to be an ideal axillary splint? It showed be user friendly and adjustable, prevents recurrence of contractures, maintains surgically achieved results, light weight, durable and cost effective.  

Modified Aeroplane Splint design Arm trough Drop lock Hinge Joint Adjustable Metallic supportive bar Wrist cockup Oblique strap We modified the aeroplane splint design making it adjustable by adding few components line. 1) Hinge joint for axilla 2) Drop lock with hinge joint for elbow. 3) Adjustable metallic bar with cabin hook – eye arrangement. Other material used were Aluminum framework, Arm Trough and body shell made of polypropylene and ethaflex foam and Velcro holding straps. Body shell Cabin eye and hook Pelvic band

3 Levels of hook adjustments Cabin Hook And Eye    3 Levels of hook adjustments 130 o 110o 90o The cabin eye and hook arrangement has 3 adjustable levels providing 90o, 110o, 130o shoulder abduction.

Hinge Joint Drop Lock The drop lock and hinge joints can be easily procured from any hardware store.

Duration of Splinting 3-6 months 1-3 weeks Skin grafting Flap Duration of splinting should be atleast 3 – 6 months post skin grafting and 1 – 3 weeks post flap surgery. 1-3 weeks

When to start splinting ? Immediate Post-operatively. Ideally splinting should be started immediately post-operatively.  

Merits of self-adjustable splint Negotiating crowded & narrow spaces Serial stretching by increasing angles Preoperative, postoperative, and rehabilitative Light weight Cost-effective The merits of this self – adjustable splint are many, first and foremost is negotiating though crowded and narrow spaces, as seen in following video Easy to fabricate & clean Self-assessment tool

Merits of self-adjustable splint Serial stretching by increasing angles Preoperative, postoperative, and rehabilitative Light weight Cost-effective Other merits of this splint are Serial stretching by increasing the angles. Pre op, post op and rehabilitative use Light weight, cost effective. Ease of fabrication and cleaning. It can be used as self assessment tool by patient to detect recurrence of contracture. Easy to fabricate & clean Self-assessment tool

Reduces recurrent axillary contractures Conclusion Simple modification Improves compliance Reduces recurrent axillary contractures To conclude, It is a simple modification, which improves compliance and reduces recurrent axillary contracture.

References Dewey WS, Richard RL, Parry IS. Positioning, splinting, and contracture management. Physical Medical Rehabilitation Clinics of North America 2011;22:229–47. Helm P, Kevorkian G, Lushbaugh M, Pullium G, Head M,Cromes F. Burn injury: rehabilitation management in 1982. Archives Physical Medicine Rehabilitation 1982;63:6–16. Spires C, Kelly B, Pangilinan P. Rehabilitation methods for the burn injured individual. Physical Medical Rehabilitation Clinics of North America 2007;18:925–48. Dewey WS, Richard RL, Parry IS. Positioning, splinting, and contracture management. Physical Medical Rehabilitation ,Clinics of North America 2011;22:229–47. References used were..

Thank You

Prototype Framework