protective wrist/forearm splint that can be used during skiing

[weeanniemcd]

Hello everyone,

I am looking for advice regarding a suitable protective wrist/ forearm splint that could be used during skiing.

I am currently treating a 14 year old boy who fractured his left radius/ulna in 3 places when he fell playing football on 22/9/09. He was treated with ORIF and conservative treatment (below elbow cast). His cast was removed on 6/11/09 and since then his ROM has steadily improved. He has full elbow and wrist ROM except wrist extension where he is achieving approx 2/3 ROM. He struggles with supination where he achieves approx 50 % ROM. Previously he has fractured his humerus x 1 and his wrist x 2 on same arm - separate incidents. This has been investigated and was put down to sheer ‘bad luck’. Apparently his supination was restricted prior to this current injury. Additionally his thumb power has been affected at the IP joint – he now has 3/5 flexion and extension power. Two weeks ago this was only 1/5.

At the moment he is continuing his ROM exercises. In addition he is carrying out some gentle strengthening exercises and I have encouraged him to swim. He is very active and still attends his karate class but does not participate in any sparring or contact activities during the class.

His family wish to take him skiing in Jan/Feb 2010 and have enquired about a suitable protective splint for him to wear to limit the possibility of him re-fracturing. I was wondering if anyone has any ideas on something that would be suitable?

Many thanks!

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[pudding_bowl]

It's been internally fixated so the chance of him re-fracturing in the same area is very unlikely, though it'd be painful for him to land on it thats for sure. I suggest doing some fall training with him however - slowly building up height so that he becomes comfortable with it. And a very good idea to help strengthen that bone.
Rigid splints will mean when he falls he'll take more force in the areas that aren't in the splint... so more likely to break a bone in the hand for example. a more moveable splint would be ok to limit extreme's of ROM but won't prevent him breaking it too much. The proprioreceptive benefit of wearing a simple wrist brace from the chemist may be sufficient to help him prevent a break.
Do some fall training with him and maybe someone else who ski's (as I don't) will have a better idea on bracing for you.

[msk101]

Hi There...
Further to this (having spent 2 seasons as a physio in the ski slopes of Canada and also breaking my own wrist in the process)... the snowboarder type wrist guards are a good start. they just protect the wrist from hyper extension when falling. it's not worth the $$ to get anything bigger or fancier because it really won't do much more. It's also important to explain to your patient that if he's falling to clench his fists and tuck elbows into his side at 90 degrees-ish which really reduces the chance of falling onto an outstretched hand and hyperextended elbow, and the bracing for the impact is also heightened with muscle activity to clench the fist. i would also strongly suggest he get a helmet (sounds accident prone) but that would also help with teaching him side impact fall/roll (downhill skis will release to enable this) and protect his head.

hope that makes sense!

msk101

[weeanniemcd]

Thanks for your advice! I've had a look on the net at different types that are used specifically in skiing/snowboarding. I have found one called a 'Flexmeter Wrist Guard'. It prevents wrist hyperextension and absorbs forces - seems to be quite a good make. For some reason the forum will not permit me to post the link to show you the splint but if you google it, it should appear.


Any comments?

[msk101]

The flexmeter look pretty good. i'm not personally familiar with them, Dakine are also worthwhile checking out as they make gloves with inbuilt guards or separate guards too. if you don't find something where you are, most of the ski resorts have a ski shop which will sell the basic product for boarders and skiiers.

msk101