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