Upper-limb Orthoses
Uses
- neurological
- stroke
- traumatic brain injury
- multiple sclerosis
- cerebral palsy
- spinal cord injury
- peripheral nerve injury (e.g. brachial plexus)
- orthopedic
- trauma
- sports
- work-related injuries
- arthritis
Functions
- Increase range of motion (ROM)
- Immobilize an extremity to help promote tissue healing
- Apply traction either to correct or prevent contractures
- Assist in providing enhanced function
- Serve as an attachment for assistive devices
- Help correct deformities
- Block unwanted movement of a joint
Types
- Static
- rigid support
- fractures
- inflammatory conditions of tendons and soft tissue
- nerve injuries
- Dynamic
- assist movement of weak muscles
Classification
- Clavicular and shoulder orthoses
- Balanced forearm orthosis
- high-level tetraplegia or Brachial plexus lesion
- Supports the weight of the forearm and arm against gravity
- May be attached to a wheelchair or table for tabletop activities
- Arm orthoses
- sling - scapular or humeral fractures, hemiparesis with subluxation
Includes the figure-8 sling, cuff sling, and glenohumeral support
- Functional arm orthoses
- for proximal arm weakness involving the shoulder and arm
- shoulder saddle suspending a proximal forearm cuff by straps or a Bowden cable
- SCI. peripheral nerve lesions
- Elbow orthoses
- Posterior elbow splints - for elbow immobilization in elbow surgery or inflammation
- Serial cast - for prevention or correction of contractures by promoting soft tissue stretch and passive ROM
- Air splint
- maintains or increases elbow extension
- Form of circumferential inflatable sleeve, also used for contractures and elbow immobilization
- Dynamic elbow flexion orthosis - maintains the elbow in 90° of flexion in cases of elbow contractures, burns, and fractures
- Forearm/wrist orthoses - wrist sprain, wrist or forearm fractures, arthritis
- Wrist cock-up splint
- Wrist extension splint
- Ulnar gutter splint
- Long opponens thumb spica splint
- maintains thumb ROM in patients who have had burns
- restricts motion in arthritis
- for serial static stretching, such as in contractures and burns
- stabilize thumb in opposition for 3-point chuck pinch in peripheral nerve, quadriplegia & other UMN lesions
- Used in patients who have had tendon transfers/repairs, arthroplasty, and De Quervain tenosynovitis
- forearm-wrist-hand
- Immobilization for hand flexor and extensor tendinitis
- tendon, nerve, or fracture repair
- maintenance of passive ROM in patients with UMN lesions, burns & contractures
- Hand
- Static
- proximal interphalangeal (PIP) orthosis - Boutonniere & swan-neck deformities (rheumatoid arthritis)
- distal interphalangeal (DIP) orthosis - immobilize the DIP joints in extensor tendon and collateral ligament repairs
- Dynamic
- MP joint dynamic orthosis
- tenodesis splints
- wrist driven flexor hinge splint
- externally powered tenodesis
- Tone reduction
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