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A NEUTRAL ROTATION SPLINT FOR USE AFTER CAPSULAR SHRINKAGE



Abstract

Thermal shrinkage of the shoulder capsule requires postoperative joint immobilisation with the humeral head centred in the glenoid fossa for optimal proprioceptive recovery. Routinely applied commercial slings hold the arm internally rotated and lengthen the posterior capsule. The aim of our study was to develop and test the clinical effectiveness of a splint that would maintain the shoulder in an optimal position of neutral rotation after posterior capsular shrinkage.

To our knowledge, no splint has been described for this purpose. We developed a new design fabricating the splint using thermoplastic material. The design was then modified to ensure ease of fitting and patient comfort.

The custom-made splint is fashioned preoperatively and fitted in the operating room after the dressings are applied. Our study group consisted of 18 cases of multidirectional or posterior shoulder instability who were splinted for a period of three weeks after thermal capsular shrinkage. The comfort and compliance of the splint were assessed using a patient questionnaire. Constant scores for the study group were retrospectively compared with a similar patient group managed with a ‘polysling’.

The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN