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Mom of Hannah
Posted Monday, June 08, 2009 1:29 PM


 

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My daughter is 3 and has JRA. She received steriod injections to her knee and wrist on May 28th.  The doctor wants her to wear a splint on her wrist and knee to help get back her range of motion.

I have tried an ace bandage and other things so that she won't take the splints off but she always finds a way to get them off. Any suggestions??

Thanks in advance

Mom of Hannah

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EastBay Mama
Posted Wednesday, June 10, 2009 12:40 AM


 

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Hi Hannah's Mom,
I can't address your question exactly because although my daughter has both had injections and splints, it hasn’t been at the same time, so I'll just speak to the issue of splints.  Our daughter was diagnosed at 1.5. She had learned to walk in pain and had developed a very protective stance, i.e. she walked with her knees bent in order to take the pressure off them and consequently her muscles had shortened to the point where she literally couldn't stand up straight.  The doctor prescribed NSAIDs, PT plus night splints to stretch her muscles and straighten out her legs.  We got rough "custom" ones from the PT (basically hard plastic molds of the back of her legs) and then took them to a good prosthetist/orthopedist to make sure they were really comfortable (he added a foam layer and smoothed out the edges) and made sure they could be securely attached to her legs (with hot pink velcro that he attached to both sides of the splint).  She fought wearing them at first, but grew accustomed to her "nighty night splints", which was amazing, given what an active sleeper she was/is. As her legs straightened out, we'd take them back to the orthopedist who'd straighten them out a bit, until eventually (many months later), her legs were straight. 

So....maybe you can try attaching some velcro straps OR see if you can get a good prosthetist/orthopedist to attach something (hopefully through your doctor or, if not, then out of pocket). Also if your daughter doesn't like keeping the splints on during the day, try putting them on her at night (if you're not already doing it).

Good luck!
Kim (mom of L – 6 PsA)
Post #4208086
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Mom of Hannah
Posted Wednesday, June 10, 2009 9:43 AM


 

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thank you so  much for the info.

I am picking up my daughters new splints tonight. They were custom made so they should be much more comfortable for her. I called around seeing if anyone made splints with buckles or something like that so my daughter could not take them off but I couldn't find anyone that did that. I will try to get her to wear them at night - she will have to get used to it but she is very stubborn.  I tried for months to get her to wear the other splint- it was  plastic and seemed uncomfortable  I would put it on over and over and she would just take it off. I would wrap it in sticky gauze stuff and ace bandages etc and she would still take it off.  Hopefully the new spints will be more comfortable and she will get used them.

Thanks again !!!

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East Bay Mama
Posted Friday, June 12, 2009 1:54 AM


 

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Hi Hannah's Mom,
I couldn't find my daughter's old splints to check (although I know they're somewhere), but we're pretty sure the orthopedist just glued/adhered velcro straps to the back of the plastic. If you can't find someone to do it and nothing else works, maybe just some glue, straps/velcro could work (making sure the velcro doesn't scratch her skin). If you have problems with the "design", let me know and I can find them and send a photo so you see how hers work.
My daughter's splints were meant to wear at night, so they were quite long, from the middle of her thigh to the middle of her calf. They had 3 or 4 straps on each (one or two above and one or two below the knee), so they were relatively hard to take off for a 1.5 year old. And we stayed with her until she fell asleep so she didn't take them off. I can't remember if we put them right on her skin or over some kind of leggings (memories I'm happy to forget), but I know that comfort has always been an issue with her so we must have figured out something comfortable.
I hope the new splints work out!
Best
Kim
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Mom of Hannah
Posted Monday, June 15, 2009 9:33 AM


 

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Sorry it took me so long to get back to you.

Thank you so much for offering to take a picutre of the splints. That's so thoughtful of you.

Hannah's old and new splints have velcro put because she's 3 and very resourseful she would just take them right off. Even when we cover the velcro straps with an ace bandage or a sock etc. she would still get them off.  They are supposed to be worn at night. The doctor recommended duct tape but when I take them off in the morning it hurts getting it off her skin. So I don't want to do that anymore.So we will just be persistant and keep trying.

Thanks!!!

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Suzanne321
Posted Monday, June 15, 2009 1:15 PM


 

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Duct tape sounds pretty extreme! I hope that was said half-jokingly. I think with time your daughter will get used to having it be a part of her life. My daughter started sleeping in a wrist splint at age two, and it is no big deal now. We had to figure out what bothered her about it, and for her it was not being able to feel her 'lovey'. So our wonderful OT adapted it so that could happen.

If this had been my older daughter, I think stickers would have worked. She would do anything for a sticker at that age. I would make a chart, like a calendar, and she would get a sticker for each day she did whatever it was I couldn't get her to go along with otherwise, and the end of the week/month, depending on what we were working on, she would get a surprise or a dollar store shopping spree.

Another thing that might help is seeing someone else with a splint. My daughter really liked it when we were visiting my mom and she had a brace on her wrist after surgery.



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Mom of Hannah
Posted Monday, June 15, 2009 4:27 PM


 

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Sadly they weren't joking- the PT and orthopedic doctor both suggested tapping the splints on.

Her rheumy suggested getting her casted and then removing the cast each week and putting on a new cast moving her wrist back a little farther each week. That sounded horrible to me also.

My husband has some old knee braces from when he had surgery and also some wrist splints from when he spranged his wrist (he's accident prone)  That's a good idea maybe if my husband wears his also it will make her more comfortable.  Thanks for the suggestion.

 Hannah's mom

PS I tried the stickers already - she wanted them but not bad enough to wear the splints

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Suzanne321
Posted Monday, June 15, 2009 5:12 PM


 

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Sometimes I think they have no clue what 'day-to-day life' is like when they suggest things like taping. Forcing an issue just makes it worse, I think. You need to find a way to make something that is going to be a daily, normal part of her life comfortable and easy for her - not a constant battle.

If she only needed it for a week, yes, maybe tape it on short term.

I had another idea - if she has a favorite doll or stuffed animal, you could make a splint for that, too. She could get the doll ready for bed with the splints, then you could get her ready. Both my girls like 'rituals' like that, so maybe that would help. Or helping her dad get 'his' on at bedtime!

Good luck - all this gets easier after awhile!
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Mom of Hannah
Posted Tuesday, June 16, 2009 9:29 AM


 

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I couldn't agree with you more about doctors not knowing what is reasonable for day to day life. I think that all the time.

Well we tried the whole family wearing splints and braces last night and that worked great- she actually kept it on for about an hour before she went to bed. I put her to bed with the splints on but when I checked on her a little while later she had taken them off- but it definately is a start.

I absolutely love the idea of making little splints for her doll - what a great idea. I'll try that one next.  Thanks so much!!

Hope you and your family have a great (painfree) day !!

Hannah's Mom

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