Braces and splints are useful for chronic and acute conditions alike. They can also be used for prevention of injury. There is much scientific evidence that supports the use of braces and splints.
The unloader (valgus) knee brace is often used for pain reduction in people with osteoarthritis of the medial compartment of the knee. These braces are designed to apply an outside (external) force to reduce the load on the medial (central) knee compartment, which reduces pain. Improved joint proprioception also helps to relieve pain. In a study involving 120 patients with knee osteoarthritis and varus deformity, researchers found that the unloader knee brace helped relieve pain and improve functional status. The benefits of this brace were found to be greater than a hinged brace.
For patellofemoral pain syndrome, the patellar brace is used for anterior knee pain. This brace was developed for malalignment of the patellofemoral joint. The brace is made of neoprene, or another elastic material, and has straps for patellar support. The buttress is often circular, but it may be C- or J-shaped. This helps maintain tracking of the kneecap in the femoral groove. In two systematic reviews of studies, researchers found that this brace offers some support for patellofemoral pain syndrome, but should only be used short-term. A small study of military recruits found a decreased incidence of anterior knee pain with patellar bracing.
The knee immobilizer is used for many acute traumatic knee injuries. Complete immobilization of the knee is contraindicated for extended timeframes, due to stiffness, muscle atrophy, and chronic pain that could result. A knee immobilizer may be useful for management of quadriceps rupture, medial collateral ligament rupture, and patellar tendon rupture. Prophylactic knee immobilizers are used to limit/prevent knee injuries.
The functional ankle brace is recommended for immobilization and treatment of acute ankle sprains. These ankle braces decrease the risk of future ankle sprains in patients with a history of ankle sprain. Rigid braces immobilize the entire ankle, but functional ankle braces will allow for some plantar and dorsiflexion of the ankle. However, the brace can offer support of the medial and lateral malleoli bones. The braces are often made of canvas and have been shown to improve proprioception, which can reduce the occurrence of ankle sprains.
In a systematic review of treatment of acute ankle sprains, researchers found that functional ankle braces offer better and shorter outcomes. Patients reported greater overall satisfaction, less swelling, more stability, and faster return to work. Another study found that these braces improved joint function after a moderate-severe inversion injury.
A neutral wrist splint is worn full-time improves symptoms of carpal tunnel syndrome, which is a compression neuropathy. The neutral wrist split has proved useful for improving symptoms and function after four weeks, according to one large review of studies. In another randomized study, researchers found that wrist splits offered significant improvements at a six-week follow-up in the group that wore the device full-time. There are options when using a wrist split. Some people opt just to wear it at night, whereas others use it full-time. Custom splints are also available, which offers more comfort to the wearer.
Neutral wrist splints come with a dorsal or volar compartment, where metal or thermoplastic inserts are placed. The mold is often made of prefabricating metal, and when fitting the split, the doctor observes the wrist position to decide if the splint needs to be rigid or flexible. Patients wearing the splint have the option to adjust the angle to a neutral position when necessary.
