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The use of custom-made silverring splints in musicians Page 2 of 4 Dr.A.Boni.M.Rietveld, M.D., B.A. (mus.), orthopaedic surgeon, 8th European Congress on Performing Arts Medicine, Mainz, 13-15 October 2000. The Netherlands have 20.000 - 25.000 professional musicians and more than one million amateur-musicians. The complaints musicians present in the Medical Centre for Dancers and Musicians involve the upper extremity in 78 %. The subdivision of the complaints of the upper extremity is: shoulder 23 % elbow 16 %, wrist 22 %, hand 17 %. In some finger problems in musicians the use of a custom-made silverring splint can prevent operative therapy. These splints are light, strong and take little space, so usually they can be worn during music making, stabilizing and/or correcting the affected finger-joint. In Holland the splints are reimbursed by most healthcare insurance policies. For fitting a combined clinic with the orthopaedic instrument-maker is recommended. A common indication is hyperextension of the p.i.p.- joint after a mallet finger injury. Or hyperextension of the p.i.p.- and d.i.p.-joints in hypermobility syndrome. Clinical examples will be shown of a violinist and a guitarist. Another common indication is osteoarthritis (O.A.) of the fingerjoints, a common complaint in older musicians and especially in active amateurs: after retirement, at the very moment they get more time to enjoy it, their favourite time passing, i.e. music making, becomes impossible. The complaint is pain, joint instability and/or increasing joint-deviation. Clinical examples of O.A. of the distal finger joints will be shown in several instrumentalists, e.g. pianists and violinists. And a cello-player having too much pain in performing vibrato (left hand) and problems in holding the bow (right hand), due to O.A. of the distal index-finger joints in both hands. In these cases a splint gives a "quick fix" and may avoid arthrodesis. © Boni Rietveld, Heemstede, 30 april 2000
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