Our Project
Doctor Linda X. Wu, a Clinical Instructor in Pediatrics at Washington University School of Medicine in St. Louis, is looking for an arm splint that covers from the forearm to just above the elbow that is adjustable for pediatric patients ages ranging from 18 months to 13 years old. Splints are orthopedic devices that support the injured area of the body and promote healing by protecting damaged bones, tendons, ligaments, and other tissues, primarily responsible for immobilizing bone fractures to let them heal and put patients’ pain under control. Also called ‘half-casts’, splints treat various injuries including broken or dislocated bones, sprains, and tendon ruptures. Depending on the injury, splints are either the only healing support applied, or sometimes applied before the cast when patients have a lot of swelling. Frequently, the splint is on as a temporary fix before the patient can see an orthopedic surgeon to set, secure, or cast a break properly.
Existing preformed splints for adults come in sizes small, medium, and large, which are not enough to cover the spectrum of children’s sizes. Sometimes, the pre-formed splints that are made in the ER are not up to standard – they fail to support the elbow at 90 degrees in many cases, which result in poor healing of the injured area. The sizes of pediatric patients come in large variations, which makes it impossible to make a splint for each age. Due to such limitations of the pre-existing splint designs, the client- Dr. Linda X. Wu, is in need of preformed splints that are adjustable in size by either expanding or contracting the material. Coming up with such splints will significantly reduce the client’s time spent on creating distinct splints for each and every pediatric patient. Her key question is whether the preformed splints that can adjust in size can have a better fit and comfort than the current custom splints to children through individualization while keeping key components intact such as the elbow being held at the desired angle and a certain amount of stiffness for the splint.
Existing Solutions
Our focus is primarily on emergency room and pediatric physicians’ use of elbow splints, however other solutions such as casts and at-home solutions could be seen as existing options. A solution in function is a full arm cast, the challenge with the use of the cast under the same circumstances as a new break is that a splint is a temporary removable option. When a cast is applied to a break too early on, the swelling is too significant for the cast to be properly fitted immediately. Additionally, the patient often comes in overnight with a break, and an orthopedic surgeon is not working and able to properly assess the cast needs. With the added swelling, the doctors cannot easily see fractures at times, and without a removable option like a splint, the patient could have their break set wrong.
There are additionally at-home splints that the patient can purchase themselves that come in a variety of materials and sizes. These splints come in materials similar to braces, ace bandages, and even plastic tubes that are inflated with air. These solutions, although beneficial later in the healing process do not allow for physicians and hospital staff to ensure that the arm is set at the proper angle and that the stiffness and sizing requirements are sufficient to fill a patient’s needs.
For custom long-arm orthopedic splints, fiberglass such as fiberglass and plaster are the most popular materials utilized. Immobilization is provided to both the forearm and elbow and can be extended to the wrist as well depending on the patient’s need. In most soft tissue injuries, a sling provides adequate support. The preparation of the long arm splint is involved and requires the practitioner to measure the length of the patient’s arm and gather mold material and sugar tong to adequately form and support the cast. The posterior splint that goes under the patient’s arm is pre-measured before the application begins. For fiberglass for adults, the splints come pre-sized, but with pediatrics, the fiberglass must be cut to properly fit the pediatric patient. With plaster, up to ten layers are used in order to properly splint the arm. Prior to the splint and overwrap with an elastic bandage, the arm is wrapped in a web roll such as cotton gauze. (Walthall). With this method, the precut fiberglass is available for adult patients and is not readily available in a variety of sizes suitable to pediatric patients. Fiberglass when cut has sharp edges and produces microfilaments when cut making it dangerous in use. Plaster, as described, takes up to ten layers to properly secure a splint, which is considerably more time-consuming. These current methods take around twenty minutes as described by our client, and if done incorrectly consume more time.
The current patents that reasonably exist within the scope of our product are primarily for adults. One current elbow splint patent maintains a portion of the splint that supports the palm and is only adjustable in the context of the angle the joint is held to for the purpose of carpal-tunnel patients and is not adjustable in size. (Heiter, 2016). Other patents cover casts as well as certain materials used in the casts. No current solutions for size-adjustable temporary elbow/forearm splints.