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DPT 771 - Ortho, Prosthetics & Assistive Tech > Upper Extremity and Spinal Orthoses > Flashcards

Upper Extremity and Spinal Orthoses Flashcards

1
Q

Which orthosis is used for Gamekeeper’s thumb?

A

Thumb Spica Splint

  • Thumb Spica Splint stabilizes the thumb in a functional position
  • Preventing ulnar collateral ligament damage
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2
Q

What is the purpose of a resting hand splint?

A

Wrist Hand Orthosis (WHO)

Purpose = Prevent contractures

  • It maintains the wrist, hand, and fingers in a neutral/static position, commonly used for immobilization.
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3
Q

Which orthosis is used for carpal tunnel syndrome?

A

Cock-Up Splint

  • Maintains the wrist in slight extension to reduce pressure on the median nerve and alleviate symptoms.
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4
Q

What type of splint is used in cervical SCI patients to assist with grasp function?

A

Tenodesis Orthosis

  • It facilitates opposition/prehension by approximating the thumb and fingers during active wrist extension.
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5
Q

Which splint is used for extensor tendon repair?

A

Static Volar Splint:

  • Wrist immobilized in 30° extension
  • MCP joints in 0–15° flexion
  • IP joints in full extension.
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6
Q

What is the splinting protocol for flexor tendon repair?

A

Dorsal Blocking Splint (DBS):

  • The wrist is immobilized in 45° flexion
  • MCP joints in 40° flexion
  • IP joints are allowed full extension to protect the repair
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7
Q

Which splint is used for mallet finger?

A

Stack Splint:

  • Maintains the DIP joint in neutral or slight hyperextension for six weeks to support extensor tendon healing.
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8
Q

Which injury requires referral to a hand surgeon due to forced extension during active flexion?

A

Jersey Finger

  • This injury involves the flexor digitorum profundus tendon and requires specialized surgical treatment.
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9
Q

What splinting technique is recommended for boutonniere deformity?

A

PIP Extension Splint:

  • Maintains the PIP joint in full extension for six weeks to prevent flexion contractures.
  • Aluminum splint
  • oval 8 or ring splint
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10
Q

Which orthosis is used for hyperextension injuries involving the volar plate?

A

Custom PIP Splint:

  • Protects the joint and supports stability to prevent deformity caused by ligament damage.
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11
Q

What is the purpose of a soft cervical collar?

A

Soft Cervical Collar:

  • Provides a kinesthetic reminder to limit motion.
  • Commonly used for mild soft tissue strains and sprains.
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12
Q

Which orthosis is used for anterior cervical fusion recovery?

A

Aspen or Miami J Collar:

  • Semi-rigid collars that limit motion, providing immobilization post-surgery.
  • Indicated for anterior cervical fusion or Type I C2 fractures.
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13
Q

Which orthosis provides the most rigid cervical immobilization?

A

Halo Orthosis:

  • Rigid frame with screws anchored to the skull.
  • Used for unstable cervical fractures to limit all cervical motion.
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14
Q

What is the indication for a SOMI (Sternal Occipital Mandibular Immobilizer)?

A

SOMI

  • Used for stable cervical fractures or moderate to severe soft tissue injuries.
  • It limits flexion/extension and provides support into the thoracic region.
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15
Q

Which orthosis is typically prescribed for scoliosis with a Cobb angle of 25–35°?

A

Boston TLSO:

  • Semi-rigid brace worn 23 hours/day
  • Most commonly used for scoliosis management with Cobb angles between 25–35°.
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16
Q

What is the purpose of the Charleston Bending Orthosis?

A

Charleston Bending Orthosis:

  • A low-profile TLSO worn at night for scoliosis management.
  • Designed to apply corrective forces during sleep.
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17
Q

What type of spinal orthosis is used for herniated nucleus pulposus or moderate soft tissue sprains?

A

Semi-Rigid TLSO:

  • Increases intra-abdominal pressure and limits ROM to reduce symptoms and promote healing.
  • Commonly referred to as a “body jacket.”
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18
Q

Which orthosis is used to manage anterior compression fractures?

A

Jewett Hyperextension Orthosis:

  • A rigid brace that limits flexion, used for stable anterior compression fractures in the thoracic or lumbar spine.
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19
Q

What is the purpose of a Boston Overlap Orthosis?

A

Boston Overlap Orthosis:

  • Semi-rigid LSO used for herniated nucleus pulposus or mild-to-moderate soft tissue injuries.
  • Increases intra-abdominal pressure and limits ROM.
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20
Q

What is the purpose of the three-column concept in spinal fracture management?

A

Three-Column Concept: A diagnostic framework dividing the spine into:

(1) Anterior column:

  • Made up of the anterior longitudinal ligament and the anterior one-half of the vertebral body, disc, and annulus.

(2) Middle column:

  • Made up of the posterior one-half of the vertebral body, disc, and annulus, and the posterior longitudinal ligament.

(3) Posterior column:

  • Made up of the facet joints, ligamentum flavum, the posterior elements and the interconnecting ligaments.
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21
Q

Which cervical orthosis allows tracheal access while maintaining moderate ROM restriction?

A

Philadelphia Collar - A semi-rigid cervical collar providing moderate ROM restriction and tracheal access.

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22
Q

A patient with a stable Jefferson fracture needs an orthosis. Which one is most appropriate?

A

SOMI Orthosis - Provides rigid support, limiting flexion and extension. It extends inferiorly into the thoracic region for greater control, suitable for stable cervical injuries like a Jefferson fracture.

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23
Q

A patient with a Type I C2 dens fracture requires immobilization. What orthosis would you recommend?

A

Miami J or Aspen Collar - These semi-rigid cervical orthoses provide moderate motion restriction, ideal for Type I C2 fractures.

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24
Q

Which orthosis is appropriate for a patient with scoliosis and a Cobb angle of 30°?

A

Boston TLSO - This semi-rigid brace is the most common scoliosis orthosis for Cobb angles of 25–35°, worn 23 hours/day to prevent curve progression.

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25
Q

A patient recovering from a flexor tendon repair in the hand requires a splint. Which one would you use?

A

Dorsal Blocking Splint (DBS) - Immobilizes the wrist in 45° flexion, MCP joints in 40° flexion, and allows IP joints full extension to protect the tendon repair.

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26
Q

What orthosis would you recommend for a patient with mallet finger?

A

Stack Splint - Maintains the DIP joint in neutral or slight hyperextension for six weeks to ensure proper healing of the extensor tendon.

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27
Q

A patient with a herniated nucleus pulposus complains of low back pain. Which orthosis would be effective?

A

Semi-Rigid TLSO - Limits motion and increases intra-abdominal pressure to relieve symptoms and support the spine. Commonly referred to as a “body jacket.”

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28
Q

A patient has a scaphoid fracture. What orthosis would you use?

A

Thumb Spica Splint - Stabilizes the thumb and extends up to the forearm, providing support and immobilization for scaphoid fractures.

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29
Q

What orthosis would you recommend for a hyperextension injury with a stable anterior compression fracture?

A

Jewett Hyperextension Orthosis - Limits flexion to prevent worsening of the fracture and provides appropriate support for stable injuries.

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30
Q

Which orthosis is indicated for a cervical SCI patient needing assistance with prehension and grasping?

A

Tenodesis Orthosis - Facilitates thumb and finger approximation during active wrist extension, enhancing prehension for functional use.

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31
Q

A patient with a boutonniere deformity presents. What is the appropriate splinting technique?

A

PIP Extension Splint - Maintains the PIP joint in full extension for six weeks to prevent contractures and promote tendon healing.

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32
Q

A patient presents with cervical strain after a car accident. Which orthosis would you use?

A

Soft Cervical Collar - Provides minimal support but serves as a kinesthetic reminder to limit motion, suitable for mild soft tissue strains.

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33
Q

A patient requires immobilization following an anterior cervical discectomy. What orthosis is appropriate?

A

Aspen or Miami J Collar - Semi-rigid cervical orthoses designed to immobilize the cervical spine following procedures like anterior cervical discectomy.

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34
Q

A patient with a distal radius fracture needs wrist stabilization. Which orthosis is recommended?

A

Cock-Up Splint - Maintains the wrist in slight extension to immobilize the distal radius and promote proper healing.

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35
Q

Which orthosis is used for a patient with a posterior ligamentous spinal injury?

A

Halo Orthosis - Provides rigid immobilization, limiting all cervical motion, and is indicated for unstable injuries involving posterior spinal elements.

36
Q

A patient recovering from a stable C1 fracture needs support. Which orthosis would you recommend?

A

Philadelphia Collar - Offers moderate support while allowing tracheal access, ideal for stable cervical fractures like C1 injuries.

37
Q

A patient with a PIP joint hyperextension injury has collateral ligament damage. What orthosis is used?

A

Custom PIP Splint - Protects the joint by stabilizing it, preventing further damage or deformity.

38
Q

A patient with a thoracic spine burst fracture requires support. What is the best orthosis?

A

Rigid TLSO - Provides immobilization for thoracic spine fractures, limiting motion and protecting the spine during healing.

39
Q

Which orthosis is indicated for a patient recovering from a mid-shaft humerus fracture?

A

Humerus Fracture Brace - Stabilizes the mid-shaft of the humerus, allowing controlled movement while supporting the fracture site.

40
Q

A patient has DeQuervain’s tenosynovitis. What orthosis should be used?

A

Thumb Spica Splint - Provides immobilization and support for the inflamed tendons at the base of the thumb.

41
Q

A patient with adolescent idiopathic scoliosis has a Cobb angle of 40°. What treatment is needed?

A

Referral for Surgery - A Cobb angle of 40° is beyond the scope of orthotic management and requires surgical intervention.

42
Q

Which orthosis is used for a patient with mild mechanical low back pain?

A

Lumbosacral Orthosis (LSO) - A soft or semi-rigid LSO provides support and restricts excessive motion to alleviate low back pain.

43
Q

A patient presents with hyperextension deformity from a volar plate injury. Which orthosis is needed?

A

Custom Finger Splint - Stabilizes the joint to prevent further hyperextension and deformity, supporting ligament healing.

44
Q

A patient recovering from a lumbar discectomy needs stabilization. Which orthosis is appropriate?

A

Semi-Rigid LSO - Restricts trunk motion, provides lumbar support, and increases intra-abdominal pressure to promote recovery.

45
Q

A patient presents with a stable thoracolumbar compression fracture. What orthosis should be used?

A

Jewett Hyperextension Orthosis - Limits flexion, providing effective support for stable compression fractures in the thoracolumbar region.

46
Q

A patient with a boutonniere deformity involves an avulsion fracture of less than one-third of the joint. What is the best splinting method?

A

PIP Extension Splint - Splints the PIP joint in full extension, preventing deformity and promoting healing for small avulsion fractures.

47
Q

What is the primary purpose of a spinal orthosis?

A

Spinal orthoses stabilize the spine by restricting motion, relieving pain, and supporting healing in conditions like fractures, degenerative diseases, or deformities.

48
Q

Why is a three-column model used to evaluate spinal fractures?

A

The three-column concept divides the spine into anterior, middle, and posterior columns to assess fracture stability and guide treatment based on the extent of column involvement.

49
Q

How does a Jewett Hyperextension Orthosis limit spinal motion?

A

It restricts spinal flexion by using a rigid frame with pads anteriorly and posteriorly, preventing further injury in stable anterior compression fractures.

50
Q

Why are tenodesis orthoses beneficial for cervical SCI patients?

A

Tenodesis orthoses leverage active wrist extension to approximate the thumb and fingers, restoring functional grasp in patients with paralysis of prehension.

51
Q

What is the difference between a semi-rigid and rigid TLSO?

A

A semi-rigid TLSO provides moderate motion limitation and is used for mild-to-moderate injuries, while a rigid TLSO offers maximum stabilization for severe fractures or degenerative conditions.

52
Q

How does a Thumb Spica Splint support DeQuervain’s tenosynovitis?

A

It immobilizes the thumb and wrist, reducing inflammation and strain on the tendons in the first dorsal compartment.

53
Q

What are the indications for a Halo Orthosis?

A

Halo Orthoses are used for unstable cervical fractures requiring maximum immobilization, including posterior ligamentous injuries or unstable odontoid fractures.

54
Q

Why is a PIP Extension Splint used for boutonniere deformity?

A

It maintains the PIP joint in extension, preventing flexion contractures and allowing the central slip extensor tendon to heal properly.

55
Q

How does a semi-rigid Lumbosacral Orthosis (LSO) alleviate low back pain?

A

It restricts excessive motion, provides lumbar support, and increases intra-abdominal pressure to offload the spine, relieving pain in conditions like mechanical low back pain or disc herniation.

56
Q

What are the primary goals of scoliosis orthotic management?

A

Scoliosis orthoses, like the Boston Brace, aim to prevent curve progression in moderate scoliosis by applying corrective forces and maintaining spinal alignment.

57
Q

How does a Cock-Up Splint help carpal tunnel syndrome?

A

It positions the wrist in slight extension, reducing pressure on the median nerve and alleviating symptoms of carpal tunnel syndrome.

58
Q

Why is the Charleston Bending Orthosis worn only at night?

A

It applies corrective forces while the patient is sleeping, targeting scoliosis curves in a relaxed state without interfering with daytime activities.

59
Q

What role does a dorsal blocking splint play in flexor tendon repair?

A

It protects the repaired flexor tendon by positioning the wrist in flexion and allowing controlled movement at the MCP and IP joints to prevent strain.

60
Q

What is the advantage of a SOMI orthosis over a soft cervical collar?

A

A SOMI provides greater immobilization, extending support into the thoracic spine and limiting flexion/extension, making it suitable for more severe injuries or stable fractures.

61
Q

How does the Milwaukee Brace differ from the Boston TLSO?

A

The Milwaukee Brace is a traditional rigid scoliosis orthosis that extends to the cervical spine, used for higher thoracic curves, while the Boston TLSO is low-profile and focuses on lower spinal curvatures.

62
Q

Which splint is used for mallet finger, and why?

A

Stack Splint - Maintains the DIP joint in neutral or slight hyperextension for six weeks, preventing extensor tendon lag and allowing healing.

63
Q

What is the appropriate treatment for jersey finger?

A

Referral to an orthopedic or hand surgeon - Jersey finger involves a flexor digitorum profundus tendon avulsion and requires surgical intervention to restore function.

64
Q

What splinting technique is used for boutonniere deformity?

A

PIP Extension Splint - Maintains the PIP joint in full extension for six weeks, preventing further deformity and promoting central slip tendon healing.

65
Q

Which injury involves hyperextension or dorsal dislocation of the PIP joint?

A

Volar Plate Injury - Typically caused by hyperextension; splinting stabilizes the joint to prevent deformity and promote ligament healing.

66
Q

What is the difference in treatment for DIP injuries (e.g., mallet finger) versus PIP injuries (e.g., boutonniere deformity)?

A

DIP injuries (e.g., mallet finger) are splinted in neutral or slight hyperextension with stack splints, while PIP injuries (e.g., boutonniere deformity) require full extension with PIP extension splints.

67
Q

Which splint is used for collateral ligament injuries of the finger?

A

Custom PIP Splint - Stabilizes the joint, providing support to damaged collateral ligaments while maintaining mobility in non-injured joints.

68
Q

What is the primary splint used for central slip extensor tendon injuries?

A

PIP Extension Splint - Prevents flexion deformity and promotes healing of the central slip extensor tendon.

69
Q

How are volar plate injuries typically managed?

A

Splinting the affected finger in a neutral or slightly flexed position to stabilize the joint and protect the healing volar plate.

70
Q

What splinting technique is recommended for a swan neck deformity?

A

Oval 8 Splint or Ring Splint - Prevents hyperextension at the PIP joint and corrects the deformity caused by volar plate laxity.

71
Q

What is the key evaluation step for suspected ligament or tendon injuries of the finger?

A

Perform a thorough physical examination, assessing joint stability, range of motion, and tendon function. Use specific tests like the Bunnell test for joint stiffness and flexibility.

72
Q

Which injury typically results from forced DIP extension during active flexion?

A

Jersey Finger - The flexor digitorum profundus tendon avulsion caused by this mechanism requires immediate surgical referral.

73
Q

What is the role of the Tripoint Splint for PIP joint injuries?

A

Provides controlled motion and support for ligament and tendon injuries while maintaining alignment and preventing contractures.

74
Q

How should hyperextension injuries to the PIP joint be treated?

A

Immobilize in a PIP splint with slight flexion to stabilize the joint and allow healing of the volar plate and collateral ligaments.

75
Q

What is the Cochrane review’s conclusion on mallet finger splinting methods?

A

All available splints achieve similar clinical outcomes for mallet finger. Surgical fixation does not significantly improve results compared to splinting alone.

76
Q

What type of splint is used for PIP joint flexion contractures?

A

Dynamic Extension Splint - Provides continuous extension force to overcome contractures and restore joint mobility.

77
Q

Volar Plate Injuries: mechanism? Evaluation? Treatment?

A

Volar Plate Injuries Mechanism: Hyperextension or dorsal dislocation of the PIP joint. Evaluation: Joint stability tests and imaging for avulsion fractures. Treatment: Splint in a neutral or slightly flexed position to stabilize the joint and protect the healing volar plate.

78
Q

Collateral Ligament Injuries: mechanism? Evaluation? Treatment?

A

Collateral Ligament Injuries Mechanism: Side impact or joint dislocation causing lateral instability. Evaluation: Stress testing for instability; imaging for severe injuries. Treatment: Splint for immobilization, followed by controlled motion exercises.

79
Q

Central Slip Injuries: mechanism? Evaluation? Treatment?

A

Central Slip Injuries (Boutonniere Deformity) Mechanism: PIP joint trauma or forced flexion. Evaluation: Elson’s test for central slip integrity. Treatment: PIP splinting in full extension for six weeks to prevent deformity and allow healing.

80
Q

Swan Neck Deformity: mechanism? Evaluation? Treatment?

A

Swan Neck Deformity Mechanism: Laxity or injury to the volar plate, leading to PIP hyperextension. Evaluation: Physical examination for PIP hyperextension and DIP flexion deformity. Treatment: Oval 8 or ring splint to prevent PIP hyperextension and restore alignment.

81
Q

Jersey Finger: mechanism? Evaluation? Treatment?

A

Jersey Finger Mechanism: Forced DIP extension during active flexion, causing avulsion of the flexor digitorum profundus tendon. Evaluation: Inability to flex the DIP joint actively; imaging to confirm avulsion. Treatment: Immediate referral to a hand surgeon for surgical repair.

82
Q

Mallet Finger: mechanism? Evaluation? Treatment?

A

Mallet Finger Mechanism: Extensor tendon injury at the DIP joint due to forceful flexion. Evaluation: Inability to extend the DIP joint actively. Treatment: Stack splint to maintain DIP joint in neutral or slight hyperextension for six weeks.

83
Q

Volar Plate Avulsion Fractures: mechanism? Evaluation? Treatment?

A

Volar Plate Avulsion Fractures Mechanism: Hyperextension or dislocation causing an avulsion at the volar plate. Evaluation: Imaging to confirm fracture; joint stability tests. Treatment: Splinting in a slightly flexed position to stabilize the joint and protect the fracture site.

84
Q

PIP Joint Dislocations: mechanism? Evaluation? Treatment?

A

PIP Joint Dislocations Mechanism: Trauma causing dorsal or lateral displacement of the PIP joint. Evaluation: Physical examination and imaging to assess ligament and bone involvement. Treatment: Reduction followed by splinting to maintain alignment.

85
Q

DIP Joint Injuries: mechanism? Evaluation? Treatment?

A

DIP Joint Injuries Mechanism: Trauma or hyperextension causing joint instability or tendon damage. Evaluation: Examination for range of motion and ligament integrity. Treatment: Stack splint for tendon injuries; immobilization for joint instability.

86
Q

Flexor Tendon Injuries: mechanism? Evaluation? Treatment?

A

Flexor Tendon Injuries Mechanism: Laceration or avulsion affecting tendon function. Evaluation: Inability to actively flex the finger; imaging for avulsion. Treatment: Dorsal blocking splint and referral for surgical repair.

DPT 771 - Ortho, Prosthetics & Assistive Tech (21 decks)

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