Scientific/Clinical Article| Volume 19, ISSUE 4, P384-392, October 2006

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Comparison of Range-of-Motion Constraints Provided by Splints Used in the Treatment of Cubital Tunnel Syndrome—A Pilot Study


      Nocturnal splinting of the elbow is commonly used to treat cubital tunnel syndrome (CBTS). Rationales are based on several studies, which suggest that proper nocturnal positioning of the elbow during sleep contributes to decreased cubital tunnel symptoms. Currently there is limited scientific evidence supporting the rationale for specific splinting protocols. Splints may be custom or prefabricated. The purpose of this article is to assess the range-of-motion constraints of five nighttime elbow orthoses commonly used in the treatment of CBTS. This preliminary study was conducted using a cadaveric model, using three arms to represent three human arm sizes, and compared five different splints, and no splint. Range-of-motion testing was performed using gravity alone and then testing was repeated using gravity plus a 1-pound weight in a standardized fashion. Results showed that all splints restricted elbow flexion significantly more than the unsplinted extremity. Of the five splints, the AliMed splint allowed the most elbow flexion both in the gravity assisted, and gravity plus a 1-pound weight assisted conditions. The only splint that restricted elbow extension was the Hely & Weber splint. The Pil-O-Splint Elbow Support with stay, Hely & Weber and the Folded Towel all restricted elbow flexion to less than 90° under all study conditions. The information provided may be helpful in making clinical decisions regarding splinting for CBTS.
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      JHT Read for Credit

      Quiz: Article #040

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue. There is only one best answer for each question.
      • #1.
        The purpose of the study was to assess
        • a.
          the cubital tunnel pressures while wearing five different elbow splints.
        • b.
          the effectiveness in treating CBTS with five different elbow splints.
        • c.
          the ROM constraints of five different elbow splints.
        • d.
          the role of five different ROM settings on CBTS.
      • #2.
        CBTS is
        • a.
          the second most common peripheral compression neuropathy in the upper extremity.
        • b.
          the second most common peripheral compression neuropathy affecting the ulnar nerve.
        • c.
          the most common compression neuropathy in the upper extremity.
        • d.
          as common as carpal tunnel syndrome
      • #3.
        The null hypothesis was
        • a.
          that the custom made splint would be the most effective in restricting elbow flexion.
        • b.
          that the Hely & Weber splint would be the most effective in restricting elbow flexion.
        • c.
          that the AliMed splint would be the least effective in restricting elbow flexion.
        • d.
          that the five splints would restrict elbow ROM equally.
      • #4.
        The only custom splint evaluated was
        • a.
          a posterior plaster shell flexed at about 30°.
        • b.
          a thermoplastic bivalve flexed at about 45°.
        • c.
          a large towel circumferentially applied and taped about the elbow.
        • d.
          an anterior block splint with a 40° flexion stay.
      • #5.
        The_____________splint allowed the least elbow flexion.
        • a.
        • b.
          Hely & Weber
        • c.
          Folded Towel
        • d.
      When submitting to the HTCC for recertification, please batch your JHT RFC certificates in groups of three or more to get full credit.