THE
USE
OF
N.
LIVELY
SMYTHE
From
A problem
the
for
what
of
in
and
surgery
the
be
tendon
to use
lively
range
and
splints
for
There
are
to prevent
the
three
acute
stage
new
main
stage
splints
for
tendon
deformity.
splints
lost
muscle
This
muscle
the
recovery
attention
has
paper
attempts
surgery.
and
in detail.
described
consider
to
The
that
rather
the
patient
for
the
than
can
not
to
state
years
splints
the
after
employment.
training
long
difficult
a wide
many
reports
Bunnell
1949,
paralysis.
First,
position
nerve
and
of function
injuries
of this
primarily
opinion,
during
type
is the
encourage
use
function
to prevent
to the
stage
him
design
and
or correct
development
or as a permenent
Secondly,
lively
offer
and
flexion
of the
splints
only
elbow
transplanted.
splint
return
in
hospital
by
their
is required
but
described
the
to
replacement
in this
paper.
in
be
this
work
Many
by
many
under
a
months
treatment,
is not
may
produced
surgery
is paralysis
is paralysed
splints
fixation
possible.
necessitated
reconstructive
there
elbow
lively
as
period
essential
conditions.
where
major
trial
it was
until
is off
working
is when
to the
series
completed
a patient
and
pectoralis
the
of
illustrated
or semi-permanent
units
movement,
Although
place
are
a short
quickly
as
of this
to
cases
not
life
block
in
Centre
after
rehabilitation
longer
offered
and
employment
The
the
quickly
the
may
a bone
flexibility
half
offer
this
as a permanent
made
which
example
consideration
at
SPLINTS
and
nature
An
opinion
be
to normal
stability.
In our
prefer
to
return
their
useful
advantages
over
or injury.
to
for
found
LIVELY
can
programme,
disease
sometimes
lively
designed
been
certain
In
or
it is for
can
patients
limb
in the
to replace
recovery
OF
they
periods
original
more
as the
are
in our
have
offer
to
reconstructive
some
tendency
1952).
upper
limb
example
indications
that
Firstly,
the
the
usefully
restoration
described
1942,
Dunham
in
the
been
(Highet
of peripheral
the
the
splints
lively
start
afford
comprehensive
or
has
have
splinting
paid,
during
surgery.
return
patient
could
there
of the
Third,
in
is proceeding.
ADVANTAGES
We
1949)
and
usefulness
a combination
a growing
deformity-an
literature
been
function
results
splints
of splints
in
using
power.
reconstructive
solution
use
is no apparatus
approaches
(1946,
and
reconstructive
There
“
nevertheless,
Gazeley
contracture.
in the
is,
maintenance
correct
described
to encourage
the
between
:
remarkable
lively
and
or while
splints
Insufficient
of lively
for
decide
stated
surgery,
weakness,
1951,
in the
to
and
given
improved
example
Chessington
which
Capener
Nangle
Second,
lost,
of the
and
1951,
is to
(1952)
There
elbow
of poliomyelitis
is permanently
\‘Iost
and
Force,
shoulder
has
PARALYSIS
ENGLAND
Reconstructive
1952).
indications
as for
or
‘ ‘
of paralysis.
wrist
Eyler
of regeneration.
of stretch
for
types
hand,
and
deformity,
during
that
Irwin
elbow
Seddon
Air
paralysis
stabilisation,
1949,
describing
1948,
wrist,
I?oyal
Seddon
intervention.
joint
(Barr
limb
LIMB
CHESSINGTON,
Unit,
splints.
the
in certain
literature
Stewart
the
surgical
splints
of such
the
in
of
by
UPPER
PARRY,
of upper
control
arm
WYNN
of functional
transplants
IN
I?ehabilitation
treatment
achieved
of a functional
C. B.
Medical
provision
permanent
can
and
the
the
SPLINTS
or
too
so efficient
of biceps,
weak
be somewhat
by
to
be
functionally
bone
unwieldy,
blocks
and
arthrodesis.
Thirdly,
what
was
patient’s
VOL.
37 B,
E
it is not
originally
full
NO.
unknown
intended.
co-operation
4, NOVEMBER
for
reconstructive
Apart
are
1955
equally
from
important
surgery
technical
for
to
factors,
the
success
turn
out
the
of an
rather
differently
after-treatment
operation.
In
from
and
the
one
case
591
592
N. SMYTHE
a lively
splint
added
complete
paralysis
the thumb.
The
sometimes
We
difficult
have
period
found
to
usefulness
to
PARRY
of reconstructive
to appreciate
a splint
three
C. B. WYNN
surgery.
right
arm.
A bone block
was
of an opponens
splint
enabled
for patients
that
of two
the
of the
provision
AND
made
weeks
exactly
to imitate
the
give
the patient
will
This
performed
the results
results
and
patient
give
to write
him
what
to
had
him
more
almost
abduction
It is
of reconstruction
of such an operation
the doctor
a fairly
of
efficiently.
will be.
and worn for a
exact
idea of the
likely
end result.
In two of our patients
opponens
splints
were worn to imitate
the action
a transplant,
and
as a result
the patients
decided
on operation,
which
was successfully
carried
out.
Fourthly,
the patient
himself
may
be reluctant
to accept
such
a radical
measure
reconstruction.
Six
get further
recovery
patients
were much
as one
patient
put it,
for good.”
Finally,
the splints
of the
patients
despite
happier
the
to
clinical
accept
and electrical
lively
splintage
one
can
always
have
are
easy
“
with
to make,
severe
paralysis
one’s
were
evidence
at least
joint
require
convinced
only
to the contrary.
for the time
fixed,
the
that
but
once
simplest
materials,
adjustable
elbow splint,
for example,
costs about
three
shillings
and
sixpence
to make.
There
is undoubtedly
a place for lively
splintage
period
or while
nerve
regeneration
is awaited.
The splints
offer as near
and
thus
help
to lay
for the actual
rehabilitation
which
the weak triceps
can
down
correct
of muscle
work.
movement
groups.
DESCRIPTION
various
During
the last eighteen
types
of upper
limb
months
paralysis.
therapy
department
with the simplest
to be described
may be original,
but
have
found
to be helpful
The conditions
for
involving
wrist
plexus
biceps
OF
SPLINTS
They
spring
of elbow
also
patients
used
discussed
in a later
In two patients,
FOR
are
cheap.
can
also
provide
resistance
means
against
of materials
and at small expense.
Some of the splints
most
are modifications
of conventional
types
that
we
essential
in providing
efficient
were
provided
fall into
four
DISABILITIES
weakness
patients
was
INVOLVING
or paralysis
who
section.
one with
excised,
the disability
(Fig.
1) was eventually
This splint
was also
flexion
and extension
and
it is done
function.
groups
: 1) disabilities
; 3) disabilities
involving
lesions
were:
brachial
4, median
3, radial
5;
2.
had
for
Many
more
because,
splints
have
been
made
for twenty-six
patients
with
All the splints
have
been made
in the occupational
and sometimes
which
splints
SPLINTS
Nine
as
would
the opponens
splint
during
the recovery
normal
function
as
provides
elbow
alone ; 2) disabilities
involving
elbow,
wrist and hand
and hand;
4) disabilities
involving
hand
alone.
The causative
lesions
4; poliomyelitis
8; peripheral
nerve
injuries-ulnar
arthroplasty
were
patterns.
The
being
it is done
The
only
possible
they
of
had
confined
associated
arthroplasty
severe
discarded
weakness
when
THE
of the
ELBOW
ALONE
to the elbow.
The
or hand
weakness,
wrist
elbow
of the triceps.
the triceps
had
and
one
splints
to be described
but
whose
these
olecranon
had
In these
two patients
regained
control
over
provided
arm
a convenient
in a sling.
devised
which
provides
complete
support
for the shoulder
but avoids
on the cervical
region
(Fig. 2).
When
triceps
weakness
or paralysis
is permanent
in the presence
the elbow,
a different
type
of splint
is required
(Fig. 3).
This was
THE
JOURNAL
OF
been
of both
during
means
A sling
putting
be
the splint
the elbow.
used in two other
patients
with poliomyelitis
who had weakness
of the elbow.
The primary
aim was
to assist
them
in function
retraining
for their
employment,
but incidentally
it also
giving
resistance
to the weak triceps
for its rehabilitation.
During
treatment
it is often
necessary
to support
the
will
extra
has
of
been
weight
of normal
flexion
of
designed
for a patient
BONE
AND
JOINT
SURGERY
THE
with
severe
useful
USE
paralysis
movements
from
in
Elbow
strength
requires
the
OF
LIVELY
SPLINTS
poliomyelitis.
arms
were
Both
flexion
sling.
A piece
of canvas
7
of wiliCil is from
tile
elbow
alloy.
At the other
end are
aluminium
from
finger
chair.
chair
VOL.
the
shoulder
and
piece.
thumb.
The
splint
The
The
allowed
sling
absence
good
unaided.
37 B,
NO.
UPPER
legs
of the
LIMB
were
and
4,
NOvEMBER
1955
inches
wide
593
PARALYSIS
completely
elbows
splint
for weak
triceps.
The
strength
of the
spring
of the
triceps,
allowing
the
elbow
to obtain
full
maxilnal
power
to effect
full
extension,
constant
triceps
Shoulder
the
length
IN
paralysed
a pincer
is graded
extension.
use
is an
and
movement
according
As
efficient
to
the
the
only
of the
right
the
spring
form
of
re-education.
FIG.
2
and
64
to the
tip
of the
two
buckles
at either
is adjustable
and
is useful
of triceps
made
extension
of
inches
fingers.
side
for
has an envelope
piece
folded
back,
Into
this
is inserted
a piece
of curved
of the
hand
piece,
into
which
fit two straps
control
of oedema
of the hand
and forearm.
long
it impossible
the
right
elbow
for
and
him
to manipulate
enabled
him
his
to
move
wheel
his
594
N.
Two
and
patients
weakness
patients
of
with
poliomye!itis
triceps
(grade
is similar
aspect
of the
to the
bars
and
one
SMYTHE
AND
C.
suffered
3 on
just
tile
the
extension
splint.
lateral
aspect
of eacil
bottom
of the
spring
Elbow
flexion
3 except
Figure
The
power
of
the
(Fig.
4),
the
The
resistance
to
was
arm
refused.
of the
confined
A patient
of the
object
patients
the
weak
with
and
to
spring
splint
is in
of the
thereby
of the
flexion
and
supination
A splint
was
made
the
to
move
aiding
its
brachial
plexus
of the
to
to
provide
the
of the
bring
chair
of flexion
scale).
spring
forearm
The
of the
splint
is attached
to the
the
of
and
power
elbow
for
these
anterior
the
triceps
3
relation
power
is to
a wheel
triceps,
a lesion
the
This
splint
is the
same
hooks
are attached
to
the
of
that
weight
paralysis
Council
A duralumin
bar with
an elbow
moulded
leather
cuff.
A nylon
runs
down
in a groove
behind
hook
on tile forearm
cuff.
splint.
that
the
complete
except
to the
PARRY
Research
Li.
Elbow
WYNN
from
Medical
described,
is in relation
B.
hinge
thread
is fitted
attached
hinge
to
as that
illustrated
the front
of the
bars.
weight
the
to
to
of
the
the
in
forearm
and
triceps.
elbow
into
his
chair
mid-flexion,
and
unaided.
The
it enabled
splint
also
one
offers
rehabilitation.
involving
elbow.
C.5-6
had
A programme
supination
and
THE
flexion
JOURNAL
paralysis
of abduction
of reconstructive
of the
OF
BONE
surgery
elbow.
AND
The
JOINT
splint
SURGERY
THE
was
job
worn
as
inside
the
telephone
USE
jacket
type
of spring
A
patient
with
LIVELY
and
operator
(A new
OF
the
springs
and
allowed
mind
in
that
can
a total
SPLINTS
be
worn
brachial
IN
outside.
him
inside
plexus
palsy
constructed
h(’ short
with
Three
spring
p’c’
i’he
including
arthrodesis
tenodesis
of
elbow
he
the
patient
VOL.
fingers.
dropped
should
37 B,
into
have
to
No.
splint
of
the
again
that
elbow
splint.
upper
arm
piece
fix
4,
his
some
elbow
NOVEMBER
allows
the
and
to
tile
patient
and
the
From
of
fix
the
his
he
his
i)one
hone
holding
position
will
be
with
the
patient’s
in his left
hand
(Fig.
described
extellsive
5).
later.)
reconstructive
surgery,
earpiece
ill
his
left hand.
6
wrist,
full
extension.
constructed
earpiece
5
to
the
1955
jacket
This
splint
is controlled
through
a roller pulley
shoulder
in any
the
operate
Unfortunately
means
was
underwent
Fio.
.djustai)le
from
the
It
595
PARALYSIS
springs
are proided,
for the outer
tllir(l,
third
of flexion
respectively.
The
splint
the
springs
outside.
The
splint
was
jOi)
as telephone
operator
in Inin(l
and
inner
the
patkIlt’s
allowed
him
LIMB
to hold
the
FIG.
I,ivelv
elbow
Ilexion
splint.
the
nliddle
third
and
the
is worn
inside
the
jacket
UPPER
i)’
to
elbow
strap
passed
tile
forearm
in any
position
desired.
the
elbow
and
elbow
was
absorbed
of view
of his
work
flexed.
A splint
at
point
elbow
leather
on
blocks
block
desired
a
a buckle
(Fig.
to
the
6).
thumb,
it was
was
made
and
and
the
important
to
allow
596
N. SMYTHE
Adjustable
elbow
extension
consists
:
transverse
padded
lleadS
supports
the
graded
according
AND
splint
of
C. B. WYNN
witil
two
bars
of a padded
straps
fix
side,
one
the
chest
to
splint
to
prevent
with
wrist
a
extension.
hinge
at
shoulder
the
wrist.
is
8
subluxation.
The
kidney-shaped
on to buckles
in front
and
from
The
the
bar just
proximal
to tile metacarpal
hand.
l’he
strength
of the
spring
to the strength
of tile wrist
flexors.
FIG.
Adaption
lively
PARRY
piece
of hide
to which
is added
on the
upper
part
of the
elbow
one
bellind.
A supporting
fabric
back
of tile shoulder
piece
underneath
THE
JOURNAL
adaption
consists
two
splint
straps.
011 tile
These
medial
strap
passes
opposite
round
BONE
ANI)
tile
OF
arm.
JOINT
SURGERY
THE
USE
SPLINTS
Four
the
of
and
one
piece.
splint
wrist
Patiellts
elbow
splints
ELBOW,
for
of
of
the
(Fig.
nerve
except
tilat
aIld
tile
there
‘The
splint.
is
wrist
splint
l)iece
a metal
piece
the
ulnar
just
proximal
either
middle
to
of
tile
the
It
function.
to
8).
also
This
provides
a
proxinial
for
an
wearing
combat
the
patients
Five
the
paralysis
a gunshot
injury
posterior
patients
vol..
had
was
of
brachial
interosseous
is illustrated
37 B,
No.
4,
palsy
in
NoVEMBER
plexus
by
caused
Figure
1955
to
9.
tile
aIld
for
thumb
and
wrist
position
weakness
painful
in
fifth
tue
tile
and
of
hut
the
a serious
Figure
7
joints
metacarpo-
lingers.
ends
are
nerve
no
a hockey
patiellt
paky.)
no
been
extra
fitted
to
the
elbow
weight
to
the
splint.
weight.
HAND
fingers
all
the
attached
has
AND
wrist,
is
across
(l’his
forearm
WRIST
hamld
bar
fits
is virtually
nerve;
showed
of tile
(lOWelling
sprmngs.
the
of the
with
back
adaption
THE
radial
a blow
to
only
of tile
median
special
against
which
elbow
desired
addition
opposite
Ilexion
or small
and
of extensors
injury
by
the
a
INVOLVING
paralysis
caused
bar
splint
elbow
DISABILITIES
tile
dorsally
subluxation
at
piiii
this
any
extension
shown
metacarpo-j)ilalallgeai
tile
smooth
elastics
OPPOflIlS
the
in
extension
10
pllalangeS
by
included
is not
A Perspex
bar rests
on the
of the
fingers.
.
I-inch
the
palm.
A bar
of Perspex
dowel
prevents
counter
bases
across
of the
To
successfully
tile
si(le
ilinges
is also
(Fig.
splillt.
to
attaclled
drawback
nerve
as
transverse
11G.
Lively
of the
in
This
beyond
makes
and
action
9
same
just
on
l’his
joint.
wrist,
intrinsic
elbow
muscles
shoulder.
tile
extends
roller
i1tlangeal
is
HAND
the
7).
shoulder
of the
and
the
AND
elbow,
patients
holding
1:IG
Radial
WRIST
fingers
597
PARALYSIS
the
these
extension
subluxation
LIMB
controlling
made
into
paralysis
partial
UPPER
of the
means
brought
severe
show
muscles
Flexion
provided
be
to
with
often
The
IN
INVOLVING
of the
joints.
The
the
allowing
SPLINTS
DISABILITIES
powerful.
were
LIVELY
paralysis
metacarpo-phalangeal
fingers
in
FOR
had
patients
OF
and
recovered
recovery.
i)all.
thumb.
fully.
The
The
In
One
other
splint
three
cases
was
due
to
was
due
to
used
in
these
a
598
N.
SMYTHE
AND
C.
B.
WYNN
PARRY
11
FIG.
Opponens
Splint.
A piece
of flexible
rubber
is moulded
proximal
phalanx
an(l to lie across
the thenar
eminemice
in
of tile opponens
muscle:
this
is attached
to a cuff encircliIlg
Strip of stiff
hide
approximately
inch
wide,
attaciled
to
across
tile
metacarpo-phalangeai
this
means,
strip
the
is not
If full stability
joint.
a narrow
of metal
is nsd
to
tile
instead
of
enclose
tile
line
of
action
the
wrist.
rubber,
A
lies
obtained
by
hide.
tile
.,
FIG.
Thumb
stabihising
the extensor
encroaching
encircling
the
extensor
splint.
aspect
slightly
the
Tile
splint
12
consists
of tile metacarpo-phalangeal
on the palmar
aspect
proximal
aspect
phalanx.
of
metacarpal
A
the
moulded
of
a moulded
of
piece
of
for
writing.
metacarpo-phalangeal
to
give
stability
leather
joint
and
the
thumb
Perspex
joint
TIlE
tile
and
JOURNAL
piece
is fitted
and
OF
on
metacarpal,
completel’
the
BONE
over
first
ANI)
JOINT
SURGERY
THE
USE
LIVELY
OF
SPLINTS
DISABILITIES
Ulnar
nerve
This
the
lesions-Lively
splint
hand,
deformity
which
is
not
Splint
to
control
splint
is
like
stitcile(l
to
aspect
INVOLVING
splints
prevents
of
have
at
the
permitted
the
tile
by
the
of
silown
leather
been
UPPER
THE
made
LIMB
HAND
for
patients
in
the
piece
\Vitil
carpo-metacarpal
a
joint
12,
hut
the
slight
upward
moulde(l
pressure
encroaching
shighti
joint,
and
type
“
carpo-inetacarpal
Figure
with
joints
knuckleduster
“
of
of
tue
attaciled
each
to
bar
tile
and
tilen
metacarpo-phalangeal
1100k
into
springs
Experience
has
iittie
useful
the
during
permanent
brachial
plexus
is illustrated
Weakness
Figure
the
opposition-three
37 B,
thenar
with
No.
4,
NOVEMBER
attaciled
proved
that
recovery
recovery
was
cap
(ligit
eacil
fine
cllain
and
at
five
of
inches
terminal
is shown
the
successfully
of
splint
is
This
tile
on its paimar
aspect.
is
nerve
is
of
tile
tile
should
to
wrist.
exten(l
a
pilotOgraph.
but
using
patient
take
tile
crease,
to
cap
tile
The
under
front
wrist
proximal
ill
passs
in
first
tiny
Nion
is awaited,
One
to
and
are
Ilail
illto
only.
rimlgs
tile
tile
occur.
i’his
Perspex
extensor
imlcorporated
ring
of
tllaml
of
not
able
ring
tilrough
over
splint
a termninal
joints
farther
when
paralysis
in
of
stage
should
splint
opponens
termimlal
splint.
lesions.
function
14
Fio.
an
has
nerve
full
thumb.
piece
over
sphiIlt
for
paralysed
finger
flexors.
Plastic
rings
fitted
over
eacil
phalanx,
tile
terminal
ring
coverimlg
tue
but
heaving
tile
pad
of the
finger
free.
Eacil
ring
has
a
horizontal
metal
bar
illcorporated
on tile paimnar
surface.
is fitted
with
piece,
alid
it
ulnar
allows
Illterimll
tilumb
iland
599
PARALYSIS
ALONE
five
metacarpo-phalangeal
subluxation
that
IN
a course
it can
also
splint
for
tile
in
j)aint
spraying.
l)e used
as
a
a permanent
The
splint
10.
muscles-Splints
median
1955
ilave
nerve
lesions
been
and
made
three
for
with
six
patients
poliomvelitis.
paralysis
witil
The
aim
of
of
the
600
N.
splint
is to abduct,
All six patients
no
restriction
the
patient
Paralysis
the
able
In
C.
B.
thumb
WYNN
two
PARRY
at the
to write
for rotation.
and the
from
weakness
of all the
joint
(Fig.
metacarpo-phalangeal
with
patients
the need
poliomyelitis
the
pen
weakness
One
splint
joint
correctly
of the
gripped
thenar
of these
patients
used is illustrated
thenar
muscles
with
(Fig.
and
muscles
required
had weakness
in Figure
recurrent
1 1).
suffered
12.
of the
The
subluxation
of
13).
patient
ofallfingerfiexors-A
with
the
were
movement.
suffered
fitted
AND
control
splint
splint
without
brevis
from
carpo-metacarpal
was
and
this
of thumb
a stabilising
flexor
pollicis
other
rotate
using
SMYTHE
with
splint
shown
for the
use of lively
paralysis
in Figure
14.
of all the finger
The
splint
flexors
restored
from
poliomyelitis
a reasonable
grasp.
instead
of reconstructive
SUMMARY
1
.
The
indications
surgery
2.
are
splints
in upper
limb
paralysis
and
hand
discussed.
Examples
of lively
splints
used
for the
elbow,
We wish to thank
Mr H. Osmond-Clarke,
C.B.E.,
of this paper.
We wish
to acknowledge
the help
Air Force,
Coliaton
Cross,
in making
the
metal
tllank
also the Director
General
Medical
Services,
wrist
are described
and
illustrated.
for his encouragement
and valuable
advice
in the preparation
of the workshops
at the Medical
Rehabilitation
Unit,
Royal
hinges
incorporated
in some
of the splints.
We
wish
to
Royal
Air Force,
for permission
to publish
this
paper.
REFERENCES
J. S. (1949)
BARR,
at the
First
: The
Management
International
of
Poliomyelitis
Poliomyelitis
: The
Conference,
Late
p. 20i.
Stage.
Papers
Philadelphia,
and
London,
Discussions
Montreal
:
Bone
and
Presented
J.
B. Lippincott
Company.
S.
BUNNELL,
31-A,
(1949)
: Spring
Splint
(1946)
: Physiological
to
Supinate
or
Pronate
the
Hand.
Journal
of
Joint
Surgery,
664.
N.
CAPENER,
Manufacture
of
N.
CAPENER,
Postgraduate
Appliances.
(1949):
Medical
Rest
British
The
Use
with
Special
Medical
of Orthopaedic
Journal,
Shoulder.
W.
HIGHET,
B.
C.
IRWIN,
E.,
Poliomyelitis.
J.
E.
NANGLE,
(1942):
and
Splintage
Journal
of
(1951):
Instruments
to
Arthritis
and
Nerve
Lesions
and
to
the
761.
in
Appliances
of Peripheral
D.
EYLER,
ii,
the
Treatment
of
Anterior
Poliomyelitis.
25, 21.
W. E., and DUNHAM,
W. A. (1952): A New
Journal
of Bone
and Joint Surgery,
34-A,
GAZELEY,
Reference
Journal,
L. (1951):
Bone
and
Joint
and
Type
228.
Nerve
for
of Brace
Injuries.
Lancet,
Surgical
Rehabilitation
of
Surgery,
33-A,
Apparatus
in
the
Rehabilitation
of the
Weakened
1, 555.
the
Hand
and
Forearm
Disabled
by
825.
Orthopaedic
Surgery.
Oxford:
Blackwell
Scientific
Publications.
Second
Lippincott
WARD,
J.
Proceedings
E. (1948):
783.
G. E., BOHLMAN,
Paralyzed
WYNN
Reconstructive
International
Surgery
Poliomyelitis
of the
Upper
Conference,
Extremity.
p.
226.
Papers
and
Philadelphia,
Discussions
London,
Presented
J.
Montreal:
B.
Company.
STEWART,
30-A,
J. (1952):
H.
SEDDON,
at the
Muscles
PARRY,
C.
of the
of the
A
Plastic
H.
R., and
Arm.
B. (1953):
Royal
Opponens
Society
Discussion
for
the
R. V. (1948):
WOOD,
Journal
Splint
of
on
of Medicine
Bone
the
and
Joint
Future
(Section
Thumb.
A Device
Surgery,
of
Role
of
Physical
THE
Journal
in which
30-A,
of
Springs
and
Joint
Replace
the
Surgery,
Action
987.
Occupational
Therapy
Medicine),
JOURNAL
Bone
46,
OF
in
Rehabilitation.
185.
BONE
AND
JOINT
SURGERY
of