For nearly three decades, Jeffrey Deren, MD, an orthopedic surgeon at Orlando (Fla.) Health Jewett Orthopedic Institute, has treated the same quiet complication of hand injuries: the splint that was supposed to help.
Patients would arrive at his clinic days after an emergency department visit, wrists immobilized but hands stiff, swollen or positioned awkwardly. Sometimes the splint was too tight. Sometimes it was loose. Often, it held the hand in the wrong position entirely.
The result, Dr. Deren said, was that recovery sometimes began at a disadvantage.
“My motivation has really come from decades of seeing patients across Central Florida arrive from the emergency room to my office in splints that are fairly unregulated,” he said. “There’s no real standardization. They can be too tight, too loose, too long, too short or hold the hand in the wrong position.”
Those observations ultimately led Dr. Deren to invent a new device, SafeSplint, an adjustable splint designed to stabilize injured hands and wrists while maintaining the functional position specialists prefer.
Orlando Health recently launched a pilot study of the device across several emergency departments and at the Orlando Health Jewett Orthopedic Institute walk-in clinic in Alafaya/Waterford Lakes, Fla.
Each year, roughly 4 million Americans injure a hand or wrist. For many of them, the first stop is an emergency department or urgent care clinic, settings focused on rapid stabilization before a patient sees a specialist.
But in practice, that handoff can introduce problems.
When splinting creates new problems
Dr. Deren said splinting often passes through multiple layers of delegation in busy clinical settings. By the time the device is applied, the person placing it may have little standardization to guide them.
“A lot of times you would take the splint off and they would say, ‘Gee, it feels so much better,’ because each day the splint seemed to be making it more painful just because of the swelling,” he said. “Patients were told, leave the splint on, don’t change it.”
Those early days after injury, typically the first 24 to 72 hours, are also when swelling fluctuates most dramatically. A rigid splint applied during that window can quickly become too tight or ineffective, adding stiffness or discomfort before the patient even reaches a specialist.
That gap between initial stabilization and specialist care is exactly the problem Dr. Deren set out to solve.
“Three or four days of holding the hand in the wrong position can add months of morbidity,” Dr. Deren said.
Designing a splint that adapts to patients
SafeSplint aims to address that problem through a combination of hinges, air bladders and adjustable straps that allow the splint to maintain a functional hand position while adapting to swelling. “It’s inflatable and it has hinges in it, so that the hand can be customized to each patient,” Dr. Deren said. “The hand could be placed in a position of what we call maximum function.”
That position, with the wrist slightly extended and the finger joints flexed, helps prevent stiffness and preserves function during early healing.
The device also allows patients or clinicians to adjust pressure as swelling changes. “If the swelling goes up, they can let air out. If the swelling goes down and it becomes loose, they can add more air,” Dr. Deren said. “The two main goals are patient comfort by providing rigidity across the fracture, but also keeping the hand in a functional position.”
From garage prototype to health system pilot
Like many physician-driven innovations, the device began humbly. Dr. Deren first began experimenting with designs in 2017 using materials in his garage. “I literally started with clay and balloons in my garage trying to fashion something that was usable,” he said.
After several years of independent prototyping, he brought the concept to Orlando Health Strategic Innovations, the health system’s internal innovation accelerator. The group works with clinicians and team members to refine, develop and commercialize promising ideas.
For Anthony Mango, senior manager of strategic innovations at Orlando Health, the partnership reflects a broader shift in how health systems approach medical innovation. “A lot of the time they just patent the idea and hope for the best, that a manufacturer or someone else will license it,” Mr. Mango said. “That model has drastically shifted over the years.”
Instead, Orlando Health often develops technologies internally through to regulatory approval and early deployment.
“Our office took the next step and said, ‘If we can’t just patent the idea, why don’t we do the full development in-house,’” Mr. Mango said. “We can handle the full regulatory process, the FDA filing and the design of the product.”
The team worked with Dr. Deren to refine SafeSplint from a rudimentary prototype into a final device ready for pilot testing and commercialization.
“As a surgeon with no business experience, I had no idea what this involved,” Dr. Deren said. “There’s no possible way I could have done this without the team I’m working with.”
Potential impact beyond the hospital
Pilot studies are now beginning across four Orlando Health sites, where clinicians will evaluate ease of use and patient satisfaction.
Because SafeSplint is designed to be simple and standardized, Mr. Mango said it could eventually be used in settings ranging from nursing homes and athletic training rooms to schools and even military environments.
“The whole goal is anyone can apply this,” he said. “It’s not a highly technical skill that orthopedic residents or others only possess.”
For hospitals, the device may also carry operational benefits. Adjustable splints could reduce patient discomfort and potentially prevent return emergency visits caused by swelling or overly tight immobilization. But for Dr. Deren, the goal is simpler: improving the starting point for recovery.
“I hope it becomes a common tool that people reach for,” he said. “Every physician and provider has tools they rely on in certain situations, and I hope this becomes one of those tools to safely deliver patients from the emergency room or urgent care to a specialist.”
In medicine, the smallest improvements can change the course of healing. Sometimes, they start with a surgeon noticing that the standard solution isn’t quite good enough, and deciding to build a better one.
