Anterior Flexion Orthoses

Question 1

When are they used?

Answer 1

Compression fractures from T7/8 and L3/4

Less than >50% compression

Question 2

Types of Braces

Answer 2

Jewett- For higher activity, More ML stability,

CASH (cruciform anterior sternal hyperextension)- for little old ladies, lighter weight.

Question 3

Contraindications

Answer 3

Three columns fractures

compression fractures above T6

when trying to limit motion of lumbar spine

Question 4

Jewett Fitting Criteria

Answer 4

Inferior to sternal notch 1”

Superior to pubic symphysis 1”

Lumbar pad at apex

Question 5

CASH fitting criteria

Answer 5

Pubic pad is 2” superior to pubis

Sternal pad is just inferior to sternal notch and clavicles

Horizontal bars is 3” below ziphoid process

Lateral pads are 1/2” AWAY FROM BODY WITH PADS LOOSE.

Question 6

Trouble shooting-

Answer 6

Discomfort over dorsal pad- add padding or cushion

Discomfort over sternum or pubic bone- add sheepskin or padding.

Jewett does not adequately restrict lateral bending- add longer lateral pads