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A Customised paediatric thumb web splint for management of adduction contracture of thumb
Krishnakumar Ramalingam1, Lokesh Siva1, Nisha Lenin1
1Paediatric and Preventive Dentistry, Government Dental College and Hospital, Cuddalore Dist, (Erstwhile Rajah Muthaiah Dental College and Hospital), Annamalai Nagar, Tamil Nadu, India.
Insights
A custom removable thumb web splint effectively treats scarring and contractures in children, maintaining hand function and preventing deformities after burns. This inexpensive intervention preserves thumb web expansion and allows crucial joint movement for optimal outcomes.
Area of Science:
- Orthopedic surgery
- Reconstructive surgery
- Pediatric hand surgery
Background:
- Thumb web space contractures, often resulting from hand burns, are disabling deformities impacting hand function.
- Early intervention is crucial for preventing or managing progressive adduction contractures of the first web space.
Observation:
- A case study details the use of a customized, removable web splint in pediatric patients with scarring and contractures of the first thumb web space.
- These contractures caused pain, restricted movement, and significantly impaired hand function.
Findings:
- The custom splint successfully maintained thumb web expansion in pediatric patients.
- The appliance facilitated movement at the first carpometacarpal joint, contributing to a positive functional outcome.
Implications:
- Customized removable web splints offer an inexpensive and effective conservative treatment for thumb web contractures in children.
- This approach is valuable for maintaining web space post-surgery and improving overall hand function in pediatric burn patients.
Abstract:
The thumb web has a unique anatomy, the integrity of which is vital to both form and function of the hand. Thumb web space adduction contractures are a common consequence of hand burns and are a progressive disabling deformity and prevention or early intervention is advisable. This case describes the use of a customised removable web splint in children with scarring and gradual contracture of the first web space causing pain with movement and significant restriction in the hand function to maintain the thumb web expansion. This inexpensive and effective appliance can be safely applied to an injured hand, maintain web space following surgical release and allows movement at the first carpometacarpal joint and hence obtains a good functional outcome.
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