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The Kleinert dynamic splint: where it fails and how it can be modified
W J Theuvenet1, J M Kauer, G F Koeijers
1Department of Plastic and Reconstructive Surgery, Sint Radboud University Hospital, Nijmegen, The Netherlands.
Annales De Chirurgie De La Main Et Du Membre Superieur : Organe Officiel Des Societes De Chirurgie De La Main = Annals of Hand and Upper Limb Surgery
|January 1, 1993
Summary
A modified Kleinert dynamic splint improves distal interphalangeal (DIP) joint function after flexor tendon repair. This new splint design enhances tendon gliding, overcoming limitations of the original Kleinert splint for better patient outcomes.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Rehabilitation medicine
Background:
- Primary repair of flexor tendons can lead to hampered distal interphalangeal (DIP) joint function.
- The standard Kleinert dynamic splint may not adequately maintain tendon gliding.
- Exclusion of DIP joint motion by the splint is a potential cause of impaired function.
Purpose of the Study:
- To analyze the limitations of the original Kleinert dynamic splint in early mobilization after flexor tendon repair.
- To develop and evaluate a modified Kleinert dynamic splint designed to improve DIP joint function.
- To assess the effectiveness of the modified splint in enhancing flexor tendon gliding and overall joint mobility.
Main Methods:
- Analysis of patient mobilization patterns using the Kleinert splint.
- Biomechanical analysis of flexor tendon excursions in unembalmed specimens.
- Design and implementation of a modified Kleinert dynamic splint.
- Clinical evaluation of the modified splint in 37 patients.
Main Results:
- The original Kleinert splint was found to impede the necessary sliding movement between deep and superficial flexor tendons.
- The modified Kleinert dynamic splint was developed based on observations of tendon excursion and splinting mechanics.
- Clinical experience with 37 patients demonstrated improved DIP joint function with the modified splint.
Conclusions:
- The modified Kleinert dynamic splint effectively addresses the limitations of the original design.
- Improved DIP joint function is achievable through modifications that allow for essential tendon gliding.
- This modified splint represents a significant advancement in post-operative rehabilitation for flexor tendon injuries.