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P&O Exam 1 > Upper Extremity Orthoses > Flashcards

Upper Extremity Orthoses Flashcards

1
Q

How to describe an UE orthoses

A

-Fabrication: pre-fabricated vs custom
-Articular (crosses a joint) vs Nonarticular (doesn’t cross a joint or have a mechanical joint)
-Location
-Direction: applied focuses (flex, ext, radial, abduction)
Purpose: immobilize, mobilize/assist with movement, restrict motion

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2
Q

What is the purpose of immobilization UE orthosis?

A

-stabilizing joints/tissues by preventing excessive/abnormal movements
-manage a deformity by preventing a contracture
-protect structures from hamrful/excessive load
-stabilize unstable/painful joints to reduce inflammation, prevent deformities, facilitate healing of injured tissues (fracture, tendons, ligaments)

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3
Q

What is the purpose of mobilization UE orthosis?

A

-assist with motion
-manage deformity applying corrective forces
-assist with lost movement from nerve injury
-elongate shortened tissue

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4
Q

What is the purpose of restriction UE orthosis?

A

-protect structures from hamful/excessive load
-prevent joints from unsafe movements

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5
Q

UE Orthoses for Specialized Purposes

A

-Substitute hand grip/dexterity
-Exercise/therapy tool to assist function (buddy tapping or blocking splint)

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6
Q

Anti-Deformity Positions of the UE

A

-90 deg of shoulder ABD with ER
-elbow extension
-neutral to slight supination forearm
-20-30 deg wrist ext
-70-90 deg MCP flex
-IP ext
-thumb in palmar ABD
-consider burns

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7
Q

UE orthosis Design Principles

A

-increase wear time gradually vs full time wear depending on diagnosis/purpose of orthosis
-longer splints are more comfortable and stable
-wider straps distribute force more evenly
-contoured edges for patient comfort
-avoid pressure forces over bony structures
-in dynamic braces, angle of pull should be 90 deg
-apply tension only sufficent to take the joint to comfortable end range

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8
Q

Design categories of UE orthoses

A

-Static (static, serial static, progressive static)
-Dynamic
-Functional

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9
Q

Static splints

A

-provide passive support
-prescribed for immobilization
-provides protection through proper positioning
Articular vs nonarticular

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10
Q

Static splint positioning

A

-contracture prevention and/or healing
-resting position = holds tissues in elongated positions but NOT at end range
-Functional positions:
20-30 deg wrist ext
40-45 deg MCP flex
45 PIP flex
relaxed flex of DIPs
thumb ABD and in opposition to fingers

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11
Q

Static splint indications

A

-closed humer shaft fracture (non-articular)
-elbow flexor spasticity (non-articular)
-S/P RTC repair

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12
Q

What is the purpose of an airplane splint?

A

Static splint
-purpose: immobilization
-position in ABD
-Indications: axillary burns, contracture prevention, humer neck fracture, bracial plexus injury

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13
Q

What is the purpose of Abduction-External rotation shoulder brace?

A

Static Splint
-S/P RCT repair
-After shoulder dislocation
-S/P shoulder arthrodesis
-30 deg abd/ER most comfortable

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14
Q

What is the purpose of a shoulder sling?

A

Static Splint
-Purpose: immobilization
-Indications: post-trauma, post-surgery, AC or GH dislocation
-Long term use may lead to elbow flexion contracture

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15
Q

Elbow-Forearm Wrist Orthoses

A

Static Splint
-Stabilizes injuries of the forearm and wrist by preventing supination and pronation
-positioned in enutral
Indications: distal radius fracture, forearm fractures, tirangular fibrocartialge injury, terrible triad - elbow dislocation with associated radial head and coronoid fractures, contracture prevention)

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16
Q

Sugar Tong Splint

A

Static Splint
-limits forearm supination/pronation, elbow extension, and wrist motion
Indications: carpal fractures, distal radius and ulna fracture

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17
Q

Indications for Static Wrist Hand Orthosis

A

-Burns
-Joint replacements
-RA
-Peripheral nerve injuries
-Nerve and tendon repairs
-Carpal tunnel syndrome
-Wrist pain
-Contracture prevention

18
Q

Dorsal Blocking Splint

A

-blocks wrist extension and finger extension
-protect repaired flexor tendons
-positioned in 0 or 30 deg of wrist flex

19
Q

Volar Blocking Splint

A

-blocks wrist flexion and finger flexion
-indications: contracture prevention (burns to the hand, SCI, CVA, TBI)
-spasticity control
-distal radius fractures

20
Q

Ulnar Gutter Splints

A

-soft tissue hand injuries to 4th/5th digit
-boxer fracture: 4th/5th metacarpal fracture
-4th/5th phalange fracture (extended)
-positioning for RA

21
Q

Radial Gutter Splints

A

-soft tissue injuries to 2nd and 3rd fingers
-fractures of the 2nd and 3rd metacarparls
-fractures of the 2nd and 3rd phalanges
-positioning for RA
-laceration over the joints of the 2nd and 3rd phalanges or metacarpals

22
Q

DeQuervain’s Tenosynovitis

A

-pain or tenderness while moving thumb
-pain when grasping an object or making a fist
-radiating pain to forearm
-swelling at base of thumb
Special test: Finkelstein Test

23
Q

Gamekeepr’s or Skier’s Thumb

A

-pain with pinch grasp
-weakness of pinch grasp
-difficulty gripping objects
-swelling or bruising at base of thumb
-can be a tear or sprain of the UCL
Suddent ABDuction of 1st MCP

24
Q

Thumb Spica Splints

A

-immobilizes thumb and possibly wrist
-Indications for scaphoid, lunate fractures, thumb phalanx or thumb dislocation, gamekeeper’s thumb, deQuervain’s, CTS, CMC OA

25
Q

Thumb opponens splints

A

indications
-CMC OA
-Spastic CP
-congenital deformity of thumb

26
Q

Mallet Finger

A

-Dip flexion

27
Q

Boutonniere Deformity

A

-PIP flex
-DIP ext

28
Q

Swan-neck deformity

A

-PIP ext
-DIP Flex
commonly seen after trauma or with RA

29
Q

Elson’s test

A

-central slip laceration
-extend PIP with 90 deg flex over edge of table

30
Q

Finger orthoses for mallet finger

A

-stack splint
-aluminum splint

31
Q

Finger orthoses for boutonnierre deformity

A

-ring splint with PIP extension force
-dynamic splint

32
Q

Finger orthses for swan-neck deformity

A

-ring splint with PIP flex force
-oval 8 finger splint

33
Q

Relative motion flexor orthosis

A

-15-20 deg MCP flex
-provides laxity in lumbrical, while increasing tension on extensor hood

34
Q

Relative flexor orthosis indications

A

-central slip laceration
-boutonniere deformity
-digital nerve repair
-flexor tendon repair
-interosseous tears
-lateral band sprain/tear
-post PIP joint arthroplasty
-unexplained pain in palm of hand
-after metacarpal fracture
-improve alignment of fingers with RA

35
Q

Relative motin extensor orthosis

A

-10-15 deg of relative metacarpal joint extension for long extensor tendon repairs
-15-20 deg of relative extension for sagittal band injuries

36
Q

Relative extensor orthosis indications

A

-extensor tendon repairs zones IV-VIII
-sagittal band disruption
-intrinsic tendon transfer
-limit motion of split skin graft on dorsum of hand
-swan neck deformity
-mallet finger
-unexplained pain about the MCP joints or DORSUM of hand
-Metacarpal HEAD fracture
-improve aligment of fingers with RA

37
Q

Serial Static orthoses

A

Purpose: mobilization
-prolonged low load
-cast or brace with ROM control
-worn full-time

38
Q

Serial static splint indications

A

-elbow fracture/contracture
-s/p biceps tendon repair
-pip flexion contracture

39
Q

Static progressive orthoses

A

-single splint that is adjustable
-worn 30 mins 3x/day
-joint held at current end range
-positioning readjusting each wear
-Indications: PIP joint contractures, elbow flexion contractures, knee flexion contractures

40
Q

Dynamic splints

A

Purpose: mobilization
-Uses elastics, coils, or spring tension mechanisms to provide a low long, prolonged duration stretch in typically one direction
-should not produce pain
-not as effective as static tension

41
Q

Indications for Dyanimc splints

A

-radial nerve injury
-s/p flexor tendon repair

P&O Exam 1 (5 decks)

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