Evidence map›Paper›PMID 36937805›Full record

ArticleFoot & ankle orthopaedics2023

Surface Pressures in Lower Extremity Splints: A Biomechanical Study.

Kempland C Walley, Nicholas Farrar, Kameron Shams, Albert T Anastasio, Davin Gong, Kristopher Mell, James R Holmes, David M Walton, Paul G Talusan

Open access · goldAbstract read
In one paragraph

Article in Foot & ankle orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Lower Extremity Splint Application.Journal of the Pediatric Orthopaedic Society of North America · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Kempland C WalleyDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.ORCID https://orcid.org/0000-0003-4488-0663
Nicholas FarrarDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
Kameron ShamsDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.ORCID https://orcid.org/0000-0002-4117-4811
Albert T AnastasioDepartment of Orthopaedic Surgery, Duke University, Durham, NC, USA.ORCID https://orcid.org/0000-0001-5817-3826
Davin GongDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.ORCID https://orcid.org/0000-0002-7532-0346
Kristopher MellDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
James R HolmesDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
David M WaltonDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
Paul G TalusanDepartment of Orthopaedic Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
Michigan Medicine · USDuke University Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Though ubiquitously used in orthopaedic trauma, lower extremity splints may have associated iatrogenic risk of morbidity. Although clinicians pad bony prominences to minimize skin pressure, the effect of joint position on skin pressure and, more specifically, changing joint position, is understudied. The purpose of this biomechanical study is to determine the effect of various short-leg splint application techniques on anterior ankle surface pressure in the development of iatrogenic skin pressure ulcers. Methods: Various constructs of lower extremity, short-leg splints were applied to 3 healthy subjects (6 limbs total) with an underlying pressure transducer (Tekscan I-Scan system) on the skin surface centered on the tibialis anterior tendon at the level of the ankle. All subjects underwent anterior ankle surface pressure assessment when padding was applied in maximum plantar flexion and neutral position for conventional short-leg splints application in clinically relevant patient scenarios. Percentage change from initial contact pressure centered on the tibialis anterior with cast padding were calculated. Results: The percentage change in anterior ankle contact pressure when padding was applied in maximum plantar flexion (PF) and then definitively placed in neutral was increased at least 2-fold without the addition of plaster in lower extremity short-leg splints. Removing anterior ankle padding following final splint application in neutral reduced contact forces at the anterior ankle 46% and 59% in splints applied in maximum PF and neutral ankle position, respectively. Conclusion: The present study is the first of its kind to underscore and quantify clinically relevant technical pearls that can be useful in reducing risk of iatrogenic risk of skin breakdown at the anterior ankle when placing short-leg splints, mainly, that it is imperative to apply padding in the intended final splint position and to remove anterior ankle padding following splint application when able. Level of Evidence: Level IV, biomechanical study with clear hypothesis.

Indexed as

iatrogenic injuryimmobilizationpatient safetypressure woundssplintstrauma

Identifiers

PMID36937805
PMCPMC10014985
OpenAlexW4324122385

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.