Upper Limb Orthosis

Upper Limb Orthotics

• Upper limb orthotics are external devices designed to improve function and structure of various areas in the upper limb.

Types of Hand Orthoses

• Static orthosis: stiff, holds a specific part in a safe position, stabilizes and supports the injured part by immobilizing and restricting motion at a joint.
• Static progressive orthosis: provides consistent pressure or stretch at the maximum range the joint can reach, used to increase the range of motion.
• Dynamic orthosis: used to increase motion and for function, provides continuous stretch in one direction and allows movement in the opposite direction.

Benefits of Upper Limb Orthotics

• Help return to normal daily living activities
• Improve function of the upper limb
• Reduce limb pain
• Increase range of movement
• Prevent unwanted movement
• Protect area from re-injury
• Correct deformities
• Improve muscle strength
• Enhance tissue healing

Indications of Upper Limb Orthotics

• Stroke
• Paralysis
• Spasticity
• Fracture
• Tendinitis
• Trauma
• Spinal cord injury
• Burns
• Peripheral nerve injury
• Arthritis
• Deformity
• Post-surgery

Contraindications

• Open fractures (requires orthopedic referral)
• Do not delay orthopedic referral due to splint placement

Complications

• Inflammation and swelling of injuries
• Compartment syndrome
• Nerve impingement
• Pressure sores
• Skin breakdown
• Skin infection
• Vascular compromise
• Thermal injury from plaster reaction

Phalengeal Orthosis

• Dorsal Distal Phalanx Splints: metallic splint with sponge rubber padding on the dorsal aspect of the digit, spanning the fracture site.
• Hairpin Splint: thin piece of metal covering the distal phalanx, protects the distal end of the finger from further injury.

Ulnar Gutter Splint

• Soft cotton bandage from distal palmar crease to mid-forearm, plaster cut to same length and placed on medial side of hand.
• Immobilizes the fourth and fifth digits, with the MCP joint flexed 50 to 90 degrees and the DIP and PIP joints in extension.

Dynamic Finger Splinting

• Metallic splint with sponge rubber padding, splints the injured finger side by side with an adjacent uninjured finger.

Radial Gutter Splint

• Soft cotton bandage from distal palmar crease to mid-forearm, plaster cut to same length and placed on medial side of hand.
• Immobilizes the second and third digits, with the MCP joint flexed 50 to 90 degrees and the DIP and PIP joints in extension.

Dorsal Splint With Extension Hood

• Soft cotton bandage from DIP joint to mid-forearm, plaster placed to extend and cover the second, third, fourth, and fifth digits.
• Immobilizes the MCP joint in 50 to 90 degrees of flexion and the PIP and DIP joints in extension.