Upper Limb Orthosis - Dr. Bhaskarananda Kumar
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Transcript of Upper Limb Orthosis - Dr. Bhaskarananda Kumar
![Page 1: Upper Limb Orthosis - Dr. Bhaskarananda Kumar](https://reader035.fdocuments.in/reader035/viewer/2022081716/542d1413219acd46518b4f0e/html5/thumbnails/1.jpg)
Definition • Derieved from Greek expression “making straight”
• An appliance used to support, align, prevent or correct deformity of a body part or to improve the function of a movable part of body
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Function
• Increase range of motion (ROM)
• Immobilise - promote tissue healing
• correct / prevent contractures / deformities
• Assist in providing enhanced function
• Block unwanted movement of a joint
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General Classification• Function
– Static / Dynamic
– Assistive / Substitutive / Protective / Corrective
• Duration of action – Temporary / Semi permanent / Permanent
• Site of Action – Hand orthosis / Wrist Hand orthosis
– Forearm and Elbow Orthosis
– Shoulder orthosis
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Protective SO - Single strap
Indications
• Support the arm or shoulder in Strain or sprain
– Fractures and dislocation• emergency management
• post-operative splinting
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Incorrect
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Incorrect
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Correct
• Flexion of the elbow > 90 degrees
• Aids in– limb elevation– decreases dependent edema
• Wrist also to be supported
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PROTECTIVE Multi-strap
• Figure-8 harness/clavicular brace
• stretch across the chest
• retract scapulae• restrict motion
• allow for tissue healing
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Multi-strap
Ordinary Shoulder immobiliser
Special shoulder
immobiliser
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Corrective Shoulder Abductor Orthosis
• Airplane Splint • After shoulder surgery
– rotator cuff rupture, acromioplasty,
– injury of the shoulder
-arm regions
• Axilla burn
• Paralytic Adduction
contracture
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Shoulder arm orthosis – protective
• Sarmiento Functional arm
brace
– Used in
humeral
shaft
fractures
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Elbow orthosis
• Protective – Static or dynamic splints
– Bands
– Braces
• Corrective – Turnbuckle Elbow orthosis
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Elbow Orthosis protectiveStatic and Dynamic splints
• Immobilization after traumatic/infective/arthritic conditions
• Olecranon/Epicondyle Fractures
• Ligament injuries• Instabilities
• 90 degrees flexion in mid-prone position
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Elbow orthosis – bands
• Tennis elbow band –– Prevents translation of extensor
tendon movements from the distal end to the proximal site of pathology
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Elbow Orthosis Corrective• Turnbuckle Elbow orthosis Treatment of elbow flexion and
extension contractures
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Wrist hand orthosis
• Protective – Cock up splint / carpal tunnel splint– Thumb spica splint
• Assistive– Dynamic cock up splint– Flexion / extension outrigger splints
• Corrective– Static splints – Flexion / extension outrigger splints
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Position of safe Immobilisation
• James position
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Wrist Hand Orthosis –cock up splint
• Provides proper support to the wrist
• Functional positioning splint• Post cast fracture
immobilization
• Post tendon transfer support
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Wrist hand orthosis –carpal tunnel splint
• Relieves the median nerve of excess pressure and subsequent ischaemia in persistent flexion posture
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Wrist Hand Orthosis - AssistiveDynamic splints
•Dynamic cock up splint:•Used in radial nerve palsy•Maintains passive range of movements at joints•Maintains length of the extensor tendons and allows time for recovery of the nerve
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Wrist Hand Orthosis – Corrective Static splints
• Splints to achieve correction of MCP joint stiffness
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Wrist Hand Orthosis corrective dynamic splints
• Stretches collateral ligaments in extension contracture of MCPjoints
• In flexor tendon injury post-operative mobilisation ( Klienert’s protocol)
Dynamic Flexion Outrigger Splint
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Wrist Hand Orthosis thumb opposition
• Sprains, fractures and strains
• Maintaining the thumb ROM• Restrict motion in patients with
arthritis• Stabilize the thumb in opposition in
patients with peripheral nerve injuries
• Tendon transfers/repairs
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Hand Orthosis
• Protective
• Assistive static / dynamic
• Corrective
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Hand orthosis – static splints - Mallet Splint
• Mallet Finger deformity due to trauma
• After Closed Fixation Of Fracture Fragment
• When Hyperextension of D.I.P. joint is necessary
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Hand Orthosis – static splints
Finger extension splints
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Hand Orthosis for Thumb static splints
• Thumb web spacer splint / thumb spica opposition splint
– Post surgery after 1st web space release
– Post fracture/ligament fixation
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Hand Orthosiscorrective static splints - straps
• Flexion straps – Serial correction of extension
contractures of the IP joints
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Hand Orthosis –corrective static splints
• Serial correction of flexor stiffness/ contractures of the IP joints
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Hand Orthosis IP Flexionassist –Knuckle Bender• Dynamic anticlaw deformity splint
• Flex MCP, allow active MCP extension
• correct hyperextension of MCP
• promote active IP extension
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Hand Orthoisis IP Flexion Assist
• Block PIP extension
• Swan neck deformity,
• Trauma - PIP volar plate injury
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Hand Orthosis IP Extension assist
• Dynamic Splint for Boutonnieredeformity
• Central slip avulsion injuries
• Extend PIP & DIP
• Allow active PIP flexion
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Summary
• Defintion and function of a splint
• Nomenclature
• Types of splints – Site of action
– Type of function• Protective / substitutive
• Assistive / corrective
• Dynamic / static