Orthotics and Prosthetics: Shoulder Immobilization Devices

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary goal of splinting in the C-rehabilitation phase?

To restore function and cosmoses

To apply pressure to scar tissue

To prevent deformity and maintain natural body contours (correct)

To protect anatomical structures from external forces

What is the importance of maintaining sustained stretch to scar tissue?

To promote wound maceration

To manage the ongoing process of scar development and contracture (correct)

To restore function and cosmoses

To achieve normal ROM

What is the purpose of splinting in function position?

To stabilize the joints (correct)

To promote skin graft integrity

To maintain R.O.M gained through exercises

To prevent rupture of tendons

Why is special attention given to moisten dressing to exposed tendon?

To prevent drying and promote skin graft integrity Signup and view all the answers

What is the purpose of revising splints in the C-rehabilitation phase?

To accommodate any change in R.O.M Signup and view all the answers

What is the indication of splinting in preserving skin graft integrity?

To prohibit motion of the joints which locate under or near the grafted area Signup and view all the answers

What is the purpose of serial splinting in the C-rehabilitation phase?

To maintain gained R.O.M Signup and view all the answers

What is the requirement for all splints?

Not specified in the text Signup and view all the answers

What is the primary purpose of applying splints in burn treatment?

To support burned extremities and maintain joint position Signup and view all the answers

What is a characteristic of thermoplastic splints that makes them a preferred material in burn treatment?

They can be remodeled multiple times according to their response to temperature Signup and view all the answers

In the acute phase of burn injury, when is splinting typically required?

When damage to tendons and joints is suspected Signup and view all the answers

What happens if a splint is too tight?

It invites pressure necrosis or nerve compression Signup and view all the answers

What is the significance of splinting techniques in burn treatment?

They preserve functional outcomes in combination with other treatment available Signup and view all the answers

Why should a splint avoid direct contact over a bony prominence?

To prevent pressure necrosis or nerve compression Signup and view all the answers

What should be taken into consideration when applying splints in the wound healing phase?

The need to avoid interfering with the healing process Signup and view all the answers

Why should a splint be removed periodically?

To allow for wound care and prevent joint stiffness and muscle atrophy Signup and view all the answers

What is the purpose of using non-conforming and non-constrictive securing methods in splinting?

To accommodate fluctuations in edema during the acute phase Signup and view all the answers

What is the purpose of daily checking and re-evaluation of a splint?

To ensure proper fit and prevent splinting problems Signup and view all the answers

What is the primary advantage of using thermoplastic splints over traditional materials like leather, wood, and metal?

They can be remodeled multiple times according to their response to temperature Signup and view all the answers

Why should a splint be cleansed with an antibacterial agent before re-application?

To prevent possible wound contamination Signup and view all the answers

During which stage of tissue healing are dynamic splints useful?

Proliferative stage Signup and view all the answers

What is the primary goal of treatment in severe burn cases?

To ensure patient survival and achieve optimal functional outcomes Signup and view all the answers

What type of splint is useful during the early inflammatory stage of tissue healing?

Static splint Signup and view all the answers

What happens if a splint is not secured properly?

It results in poor positioning and possible wound maceration Signup and view all the answers

What is the primary advantage of a shoulder abduction brace?

It maintains the shoulder in flexion, abduction, and horizontal adduction. Signup and view all the answers

What is a disadvantage of an axillary or air plane splint?

It puts pressure on the medial epicondyle of the humerus. Signup and view all the answers

What is the advantage of a clavicular strap?

It prevents protraction deformity. Signup and view all the answers

What is a disadvantage of a spinal support brace?

It cannot be worn under clothes. Signup and view all the answers

What is the primary anticipated deformity in the elbow and knee region?

Flexion with pronation. Signup and view all the answers

What is the purpose of a gutter or trough splint?

To support the elbow and knee region. Signup and view all the answers

What is the primary purpose of adding additional tubes to the 4-Watusi collar?

To increase the degree of neck extension Signup and view all the answers

What is a common disadvantage of using the Philadelphia collar?

It can cause pressure points on the clavicle Signup and view all the answers

What is the primary purpose of using ear donuts in the ear region?

To prevent folding of the helix Signup and view all the answers

What is the primary purpose of using the microstomia prevention splint in the mouth region?

To prevent microstomia Signup and view all the answers

What is the primary purpose of using the axilla or air plane splint in the shoulder and axillary regions?

To prevent shoulder adduction Signup and view all the answers

What is a common advantage of using the 4-Watusi collar?

It is easily adjusted Signup and view all the answers

What is the primary material used to make the 4-Watusi collar?

Thermoplastic material Signup and view all the answers

What is a common secondary problem associated with the use of the Philadelphia collar?

Pressure points on the clavicle Signup and view all the answers

Study Notes

Splinting Techniques for the Burn Patient

A splint is an external device that maintains joints in optimal length and supports burned extremities to prevent deformity.
Aims of applying splints:
- Support burned extremities
- Maintain joint position
- Correct and prevent deformities

Characteristics of Splints

Non-toxic
Light in weight
Made from non-absorbent material
Padded over bony prominence
Easy to shape
Firm enough
Fabricated from non-expensive material

Significance of Splinting Techniques

The treatment of severe burn cases focuses on:
- Patient survival
- End cosmetic appearance
- Functional outcomes
Splinting techniques play an important role in preserving functional outcomes in combination with different treatment available.

Uses of Splints in Burn Treatment

Acute phase:
- Splinting required only when damage to tendons and joints is suspected
- Immobilize and provide support of affected body parts
- Non-conforming and non-constrictive securing should be provided due to fluctuation of edema
Wound healing phase:
- Prevent development of contracture and disruption of newly skin graft
- Avoid interfering with healing as a result of improper fit or placement
Rehabilitation phase:
- Reduce contracture non-surgically, prevent deformity, and maintain natural body contours
- Combined treatment of splints, exercise, and pressure is required
- Maintain sustained stretch to scar tissue
Reconstructive phase:
- Splints applied following the release of contractures or reconstructive procedures for restoring function and cosmoses
- Splints are molded directly to the site and should be monitored for evidence of wound maceration or break down

Splinting Indications

Protection of anatomical structures:
- Stabilize joints to eliminate or reduce external forces
- Splint joints in functional position and tendons in slack position
- Special attention to moisten dressing to exposed tendon to prevent drying
Preservation of skin graft integrity:
- Establish circulation between underlying wound bed and transplanted graft
- Prevent motion of the joints which locate under or near the grafted area
Restore of function:
- Early non-operative resolution of contractures provided by sustained stretch and pressure
- Combine with serial splinting to maintain gained R.O.M

Requirements for All Splints

Proper fit:
- Not too loose or too tight
Secure application:
- Avoid pressure necrosis or nerve compression
Avoidance of pressure over a bony prominence:
- Dome the splint section over the prominence if possible
Periodic removal:
- Remove for wound care only
- Prolonged static immobilization can cause joint stiffness, muscle atrophy, or contracture
Daily checking and re-evaluation:
- Changes in edema and changes in the bulk or type of dressings may require daily splint correction
- Splint effectiveness also changes as the patient's status changes
Cleansing with each re-application:
- Prevent possible wound contamination

Types of Splints

Static or dynamic splinting depends upon the stage of tissue healing
During the early inflammatory stage, static splints are useful
During the proliferative stage of tissue healing, both dynamic and serial static splints may be indicated

Custom Design Halo Neck Splint

Made from thermoplastic material
Molded directly to the site

Watusi Collar

Series of cylindrical plastic tubes encircle the neck
To increase degree of neck extension, add additional tubes
Advantages:
- Applied good contact pressure on the scar tissue
- Easily adjusted
- Maintain extension and prevent lateral flexion
- Can be applied over simple dressing
Disadvantages:
- Occlusive monitoring needed for signs of maceration of wound
- Ridged effect in scar tissue
- Allergies to certain material as latex

Philadelphia Collar

Prefabricated circumferential foam or semi-rigid positioning material (orthosis)
Advantages:
- Commercially available
- Easily applied
Disadvantages:
- Temporary used
- Occlusive (pressure point on clavicle)
- Only minimal dressing can be worn under the collar

Ear Region

Anticipated deformity: Folding of helix
Secondary problems: Auricular chondritis, pressure on damaged ears
Splints:
- Semi-rigid oxygen mask
- Ear donuts

Mouth Region

Anticipated deformity: Microstomia, ectropion of upper and lower lips
Secondary problems:
- Decreased horizontal and vertical excursion
- Difficulty in mastication
- Altered speech
Splints:
- Microstomia prevention splint
- External traction hook
- Orthodontic pressure appliance

Shoulder and Axillary Regions

Anticipated deformity: Shoulder adduction, extension, and internal rotation
Secondary problems: Development of kyphosis
Splints:
- Axilla or air plane splint
- Shoulder abduction brace
- Clavicular strap or brace
- Spinal support

Elbow and Knee Region

Anticipated deformity: Flexion with pronation deformity
Secondary problems: Possible ulnar compression, possible peroneal compression
Splints:
- Gutter or trough splint
- Elbow or knee conformer
- 3 point splint
- Spiral extension splint
- Air splint

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the advantages and disadvantages of using axillary or airplane splints and shoulder abduction braces in orthotics and prosthetics. It discusses the benefits and drawbacks of each device in maintaining proper shoulder positioning.