gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Comfortable Cast to restrict pronation and supination. Is it possible?

Meeting Abstract

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  • presenting/speaker Christian Kindler - Schoen Klinik Muenchen-Harlaching, München, Germany
  • Bernhard Lukas - Schoen Klinik Muenchen-Harlaching, München, Germany

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1700

doi: 10.3205/19ifssh1346, urn:nbn:de:0183-19ifssh13467

Published: February 6, 2020

© 2020 Kindler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: After TFCC Refixation limitation of pronation and supination (P/S) is necessary. About 7 years ago we switched from the upper arm splint or cast to the muenster cast. In this time we did 207 TFCC refixations, afterwards a muenster cast was applied. The exact application of this cast is not clearly described or varies in the literature. We optimized this cast concerning stability and comfort over the years. The aim of this study was to compare "our" muenster cast (MUC) with the upper arm cast (UAC) and upper arm splint (UAS).

Methods: 12 healthy volunteers were enrolled in the study. Each person obtained an upper arm cast, upper arm splint and a muenster cast. They had to wear the cast for one hour, doing activities of daily life and afterwards evaluate the cast with a questionnaire, which included: cast comfort, adaption to the cast, weight, keyboard use, drinking/eating, personal hygiene, overall satisfaction.

Range of motion of elbow, wrist and forarm was measured before and with all of the three casts.

Results and Conclusions: On average test persons ranked the muenster cast first (23,8 points out of 35), the upper arm brace second (23,3 points) and the upper arm cast third (20,1 points). Advantage of the upper arm cast was adaption to the cast, the upper arm splint was best rated in weight, keyboard use, the muenster cast in drinking/eating, overall satisfaction.

Measurement of range of motion showed, that the upper arm cast limits P/S slightly better than the muenster cast (27,78° SD 6,71 versus 36,11° SD 6,57). The upper arm splint does not limit P/S sufficient (98,89° SD 14,49). Elbow flexion is limited in the UAC to 17,78° (SD 6,28), in the UAS to 40,00° (SD 15,09) and in the MUC it is little limited, range of motion was measured with 99,44° (SD 11,65). Wrist extension and flexion results were: UAC 5,56° (SD 6,85), UAS 41,67° (SD 10,8), MUC 12,78° (SD 6,29).

The main technique of our muenster cast is to reinforce the cast at some important spots, this can be explained in demonstrating a video. If the cast has to be split, the split has to be stabilized with a special plaster technique.

Overall "our" muenster cast offers a very good patient comfort an satisfaction and limits P/S to a satisfying amount compared to the other cast or splints. The main advantage is the elbow extension and flexion which is nearly not compromised by this cast.