L4 UE Orthotics Flashcards

1
Q

Orthosis refers to

A

permanent device to replace or substitute for loss of function

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2
Q

Splint refers to

A

temporary device that is part of a treatment program

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3
Q

Medicare now requires…

A

any device applied by an orthotist or therapist to be called an orthosis

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4
Q

Therapist fabricated

A

typically work with low temp thermoplastics that can be directly applied to skin

faster to make, patients leave with device on same day, not as durable, easy to adjust

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5
Q

Orthotist Fabricated

A

work with high temp thermoplastics

requires casting, takes days to fabricate, durable, better for long term, less easy to adjust

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6
Q

Biomechanical Reference

A

using principles of kinetics and forces acting on the body, a unique combination of physics and physiology

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7
Q

Make sure to

A

minimize pressure!
avoid shear force and ischemia

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8
Q

Continuous force applied to extremity should not exceed

A

50 gm/cm2

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9
Q

Managing Pressure

A

-pressure is more critical in areas w/less tissue
-assess tissue tolerance to pressure or shear force
-provide max contour
-don’t add padding, create area of relief then pad

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10
Q

Forearm based orthosis should cover

A

2/3 of the forearm in length

width should be 1/2 the circumference

edge should be rounded/flared

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11
Q

Stabilizing force

A

prevents migration or rotation of the orthosis on the arm can be used to protect unstable system like a fx or serve as a base for mob as in static progressive orthosis

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12
Q

Manipulatory forces

A

static forces that direct or control internal and external forces to produce desired outcome

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13
Q

Actuating forces

A

require a system to generate a dynamic force

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14
Q

Sensorimotor approach

A

used for individuals having damaged central nervous systems to inhibit or facilitate normal motor responses

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15
Q

Rehabilitative approach

A

focusing on ability to facilitate return to max function

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16
Q

Finger based

A

dorsal or volar mallet and which joint

17
Q

Hand based

A

thumb spica vs flexion block or extension block

18
Q

Forearm based

A

wrist cock up, ulnar or radial gutter, thumb spica

19
Q

What pathology can benefit from an orthosis?

A

fractures
inflammatory processess
limiting motion while structures are healing
weakness/paralysis
promoting mobility active and passive

20
Q

Immobilization/static orthosis

A

immobilize for fracture healing

position to prevent deformity (like burned hand)

rest tissue to decrease inflammation

21
Q

Purposes of serial static or static progressive

A

sub for loss of motor function
correct an existing deformity
provide controlled motion
aid in fx alignmnet and wound healing

22
Q

restriction orthoses

A

allow controlled motion to facilitate safe mobility to keep tendons gliding and limit soft tissue contracture while protect healing structures

23
Q

Thermoplastic high temp

A

tolerates high force like weight bearing without failure

24
Q

Thermoplastic low temperature

A

heated in water between 135 to 180, can be draped directly on the skin

25
Properties of thermoplastic materials
memory drapability elasticity bonding/ self adherence self-finishing edges
26
Memory
ability to return to original shape
27
Drapability
ease with which the material conforms to the underlying shape
28
Elasticity
the material's resistance to stretch and tendency to return to previous shape after stretch material can be worked more aggressively useful for less cooperative patient
29
Creases of hand
mark where edege of the orthosis needs to end to allow motion distally
30
Longitudinal arch
formed by phalanges and mcp flexion and extension
31
Distal transverse arch
formed by carpal bones
32
proximal transverse arch
formed by MCP joint
33
Prehension Patterns
tip lateral tripod spherical power extension
34
Dorsal wrist cock up
used if palm needs to be free can be the base for dynamic orthosis less supportive due to weight of hand on small bar, but potential for pressure must relieve ulnar styloid dorsally
35
Volar Wrist Cockup
most commonly used two types; radial bar and thumb hole
36
Radial bar volar wrist cock up
easier to adjust bar, but frequently velcro comes off bar as it is such a small piece of velcro
37
Thumb hole volar wrist cock up
no hook velcro needed to attach distal loop velcro needs to clear thenars and CMC jt with hole for thumb
38
Why use a custom wrist orthosis?
radial nerve palsy zone 5 extensor tendon laceration tenosynovitis ganglion TFCC
39
Be cautious...
know your limitations refer out when possible consider off shelf when appropriate