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"Dynamic" Splints Improve Forearm Movement after Fracture

Patients who break the bone on the thumb side of the forearm (the radius) may have less arm movement later. This is because bones sometimes shorten during healing. As a result, patients may have trouble rotating the arm. This can make it difficult to do everyday tasks.

Doctors have designed a special splint to improve arm movement after radius fracture. When you think of a splint, you may think of a device that keeps a limb from moving. Not so with a dynamic splint. This kind of splint actually increases movement by placing gentle, sustained force on the affected limb. The splint can enhance forearm rotation. Patients tighten the tubing around the outside of the splint to get a nonpainful stretch that improves the arm's flexibility over time.

Fifteen patients with radius fractures that had healed properly wore dynamic splints. The patients had tried regular hand therapy without success in regaining full forearm movement. Patients wore splints six to 12 hours a day for about three months.

Treatment with dynamic splints improved patients' forearm movement by more than 50 percent. Before treatment with the splint, only half of the patients had good forearm rotation. After treatment, all but one patient had good or excellent rotation. None of the patients lost movement during the year after treatment.

Before treatment, patients' forearm rotation in the outward direction, or supination, was particularly poor. It is important to correct this in order to prevent future shoulder problems. Splinting improved supination in all but four patients. Patients who did not improve did not wear their splint regularly, waited too long to start treatment, or developed other problems, such as bony growths.

Dynamic splints improve forearm rotation after radius fracture when other treatments have failed. These splints seem to have good results for a variety of fractures when used as directed within a few months of injury.

References: Munir A. Shah, MD, et al. Dynamic Splinting of Forearm Rotational Contracture After Distal Radius Fracture. In The Journal of Hand Surgery. May 2002. Vol. 27A. No. 3. Pp. 456-463.

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