Moaz Elsaeed

ME 10 Upper Limb Orthotic Categories

Battery
powered
orthosis

■ 1- Non articular orthoses:

- Don’t passes any joint.
- Don’t limit any movement.
Humeral brace (fracture braces)
■ 1- Static progressive orthoses: ■ 4- Dynamic traction orthoses:
Face masks Are designed to correct contractures by a gentle -Permit a full active range of motion of the target joint,
prolonged stretch. (unlike serial static orthoses, here while applying a contrast distraction force to the joint.
there are adjustable hinge or screw) - Used for allow healing in intra articular fractures of IPJ.

Maintain normal
length of skin &
Control Scar tissue Correct elbow flexion contracture

■ 2- Static orthoses: ■ 2- Dynamic orthoses:

(Immobilize one or more joints in both directions)
Indications: - Maintain tissue length.
-Rest injured or inflamed tissue.
-Stabilize injured structure to promote healing.
-Reduce muscle tone (spastic muscle).
- Permitting active motion in one direction, followed by
passive pulling force in opposite direction (by springs).
- Substitute for weak or paralyzed muscle due to
peripheral nerve lesion e.g. radial nerve
■ 5- Tenodesis orthoses:
- Are Pseudo-dynamic orthosis that use active wrist
extension to bring about passive flexion of the MCP
joints & IP joints when the muscles of distal joints are
week or paralyzed.

De Quervain's
Tenosynovitis ■ 3- Dynamic motion blocking orthoses: b

wrist & finger orthoses Thumb spica - Permitting active motion in one direction, followed by
passive pulling force in opposite direction up to the limit
■ 3- Static joint-blocking: of blocking component. (e.g. flexor tendon repair)
(limit motion in one direction & allow motion in
opposite direction)
Mallet
finger
orthosis
Swan neck splint

Correct ■ 4- Serial static orthoses: Correct

elbow elbow
flexion
- Slow progressive increase ROM by repeated molding of splint. flexion
Boutonniere splint contracture - Correct contractures by applying a low load prolonged stretch. contracture
 Upper Limb Orthoses
Figure of 8 harness / clavicular brace:
- Used to restrict motion in
clavicular fractures to allow
for tissue healing and bone
remodeling.

1- Wilmer Shoulder orthosis: 3- Shoulder Abduction Orthosis / Airplane Splint:

* Shoulder Subluxation due to brachial plexus lesion or hemiplegia
* Aims: * After shoulder surgery (e.g. rotator cuff repair or acromioplasty).
1- Effective neutralization of shoulder subluxation
* Axillary burn
2- Suppression of edema
* Advantages: * Adduction contracture
1- Cosmetic appearance (under clothes)
2- Comfort of wearing (light weight easy donning and doffing)

4- Shoulder Guard / Humerus Fracture Brace:

2- Slings:
* Indication: Brachial Plexus injury, Humeral Fracture, Rotator Cuff Injury, other * For humeral fractures:
shoulder surgery. 1- Closed humeral shaft fractures.
* Purposes: - Immobilize UE - Decrease load on tissues - Prevent subluxation
- Prevent brachial plexus traction - Support associated joints/tissue 2- Postoperative Open humeral shaft fractures
■ a- Rolyan Humeral Cuff Sling / Rolyan Hemi Arm Sling: Adjunct to internal fixation.
( O-ring with dynamic straps & 1 humeral cuff) 3- After removal fixation.
- Moderately corrected vertical displacement of humerus.
- Allows external rotation & ROM.
- Can be worn under clothing. 5- External Rotation Splint:
* After Anterior Shoulder dislocation (to avoid Bankart lesion or recurrent
dislocation).
■ b- Cuffed Hemi Sling / Harris Hemi Sling:
* Shoulder in 45˚ of external rotation.
(2 cuffs, one for elbow & one for wrist) with (Figure 8 strapping)
- Arm in add. , internal rotation & elbow flex.
- Approximates Glenohumeral alignment.
- Helps prevent subluxation.
* Disadvantages: 1- Does not prevent pain.
2- Promotes shoulder subscapularis contracture
(because it maintains arm in adduction & internal rotation).
1- Static elbow orthosis: 3- Dynamic elbow orthosis:
(Immobilizes the joint in both directions) Used to improve ROM gradually while allowing soft tissue healing
* Indications: Indication:
1- Distal humeral fractures. 1- Soft tissue contracture.

2- Immobilization after surgery. 2- Limited ROM.

3- Olecranon/Epicondyle fracture. 3- Joint stiffness.

4- Ligament injuries.
5- Instabilities.
6- Elbow Arthroplasty.

2- Long arm splint (Cubital tunnel syndrome): 4- Epicondylitis Orthosis:

* Used in Cubital tunnel syndrome (Ulnar nerve compression).
* Upper limb is immobilized with elbow flexed 30 - 45˚.
* Usually used 3 months at night.
* It can be used full time if symptoms are persistent.
- Relieve the pressure on the tendon
- Relieve pain
Indication:
1- Medial epicondylitis (Golfer’s elbow).
2- Lateral epicondylitis (Tennis elbow).
1- Static orthoses (Carpal tunnel syndrome): 5- MCP ulnar deviation restriction orthosis:
* Used for 3 4 weeks in neutral position. * Used to limit ulnar deviation of MCP
* Used in Arthritic patients with ulnar deviation at MCPs

6- Antispastic hand orthosis: (e.g. in hemiplegia)

2- Wrist Hand Colles Splint: (For colles Fracture)

Temporary positioning and immobilization of wrist in ulnar deviated position

Ball Splint Hand Cone Splint

7- IP Flexion Assist :
* Swan neck deformity
(Block PIP extension)
3- Scaphoid Fracture:
The wrist and thumb in a glass holding position.
(Wrist in moderately extension & slight radial deviation)
8- IP Extension Splint :
* Boutonniere deformity
Metal bar
(Block PIP flexion)

4- Thumb Guard Spica: 9- Power Grip Assisted Grasp orthosis :

* De Quervain’s tenosynovitis
st
1 dorsal compartment: - Abductor pollicis longus (APL)
. - Extensor pollicis brevis (EPB)
* Electric Power Prehension Orthosis (EPPO).
* Providing the ability to Pickup, Grasp & Hold objects.
(Functional positions of the hand / ADL activity)