Ch 6 - Prosthetic and Orthotics: Upper Limb Orthoses

Question 1

What are the 3 categories of upper limb orthoses?

Answer 1

1. Static orthoses
2. Dynamic orthoses
3. Tone-reducing orthoses

Question 2

What is an Opponens orthosis used for?

Answer 2

Immobilize the thumb to promote tissue healing and/or protection or for positioning of the weak thumb in opposition to other fingers to facilitate three-jaw chuck pinch

Question 3

Describe an Opponens orthosis.

Answer 3

Hand-thumb orthoses consist of a dorsal and a palmar bar encircling the hand, with a thumb abduction bar and C-bar to stabilize the thumb

Question 4

Describe a Long Opponens orthosis with wrist-control attachments.

Answer 4

Stabilizes first MCP while forearm bar maintains wrist in extension and prevents radial and ulnar-deviation deformities

Question 5

What does an Opponens orthosis with lumbrical bar prevent?

Answer 5

MCP joint hyperextension

Claw hand deformity

Question 6

What is an Opponens orthosis with finger extension assist used for?

Answer 6

Interphalangeal flexion contracture
Boutonnière deformity
Postsurgical release of Dupuytren’s contracture

Question 7

Describe a Swan neck ring splint.

Answer 7

Prevents PIP joint hyperextension through a three-point pressure system but allows full IP flexion

Question 8

Describe a Boutonnière ring splint.

Answer 8

Immobilizes the PIP in extension and prevents flexion through a three-point pressure system

Question 9

What are uses for thumb-web space stabilizers/thenar web spaces/ c-bar splint?

Answer 9

Burns
Postsurgical revision of scar
Webspace contractures

Question 10

What is an intrinsic plus position?

Answer 10

MCPs flexed 70° to 90°
IPs in full extension
Thumb CMC in palmar abduction
Thumb MCP/IP in full extension

Question 11

How are resting wrist-hand orthoses typically aligned?

Answer 11

Wrist in neutral to slight extension and the digits in an intrinsic plus position

Question 12

What are thumb mobilization orthoses used for?

Answer 12

Contactures in flexion, extension or abduction

Question 13

Describe a cock-up splint.

Answer 13

Wrist-hand orthoses in which the palmar section is extended (usually 0° to 20°)

Question 14

Describe an Oppenheimer splint.

Answer 14

Prefabricated from spring steel wire and padded steel bands to assist wrist extension by tensing the steel wire, thus aiding finger flexion through tenodesis effect

Question 15

When should a wrist-driven prehension orthosis be used?

Answer 15

C6 complete tetraplegia with 3+ or better wrist extensors to use body powered tenodesis

Question 16

Describe a RIC tenodesis splint.

Answer 16

String lax w/ wrist flexion and tightens w/ extension, bringing the fingers close to the immobilized thumb, accomplishing three-jaw chuck prehension

Question 17

Describe a balanced forearm orthosis.

Answer 17

Shoulder-elbow-wrist-hand orthosis (SEWHO) that consists of a forearm trough and a mount

Question 18

What does a balanced forearm orthosis help with?

Answer 18

Support forearm and arm against gravity to move the arm horizontally and flex the elbow to bring the hand to the mouth

Question 19

What is required for use of a balanced forearm orthosis?

Answer 19

– MMT >2 of biceps and pectoralis
– Trunk stability and balance
– Endurance in a sitting
– Preserved ROM of the shoulder and elbow joints

Question 20

How are tone reducing splints worn?

Answer 20

2 hours on and 2 hours off throughout the day