Upper Extremity Orthoses Flashcards
An orthotic device that crosses a joint is considered ________, while one that does not cross a joint is called ________.
Articular, Nonarticular
Which of the following is not a direction of applied forces for orthotic devices?
A) Flexion
B) Extension
C) Radial Deviation
D) Rotation
Rotation
Orthotic devices can be classified by their
Location
What is the purpose of immobilization in upper extremity (UE) orthoses?
Immobilization helps stabilize joints or tissues by:
Preventing excessive or abnormal movements
Managing deformities by preventing contractures
Protecting structures from harmful or excessive loads
Mobilization orthoses are used to assist with _______ and manage deformities by applying corrective force.
Movement
What is the primary purpose of mobilization in UE orthoses?
Mobilization orthoses assist with movement and help manage deformities by applying corrective forces.
Example: Assist with lost movement from nerve injuries or elongate shortened tissues.
Which of the following is not a purpose of restriction in UE orthoses?
A) Prevent joints from unsafe movements
B) Elongate shortened tissues
C) Protect structures from harmful or excessive loads
D) Limit joint movement
B) Elongate shortened tissue
One of the main goals of immobilization is to reduce _______ in injured tissues.
Inflammation
What is the purpose of UE orthoses designed to substitute hand grip or dexterity?
-Example:
provide support for individuals with limited hand function, allowing them to perform tasks like holding utensils.
Patients with C5-C6 spinal cord injuries (SCI).
UE orthoses can be used as an exercise or therapy tool to assist function, such as using a ________ to enhance the movement of an impaired digit.
Budding Tapping
What is the function of a blocking splint in UE rehabilitation?
A) To substitute hand grip
B) To assist with active range of motion (AROM) by blocking movement of more mobile joints
C) To provide stabilization for painful joints
D) To prevent contractures
B) To assist with active range of motion (AROM) by blocking movement of more mobile joints
The anti-deformity position of the shoulder includes ________ degrees of abduction with external rotation.
90
What is the recommended position for the elbow in an anti-deformity posture?
A) Flexion
B) Extension
C) Hyperextension
D) Slight flexion
Extension
The forearm should be positioned in ________ to slight supination in an anti-deformity posture.
Neutral
What is the recommended wrist position in an anti-deformity posture?
20-30 degrees of extension to prevent flexion contractures.
In the anti-deformity position, the metacarpophalangel (MCP) joints should be flexed to ________ degrees.
70-90
Label A, B, C
-name
-location
-position
A) HFO, MCP and IP immobilization
B) MCP flexion mobilization splint + resist ext, free movement of IP joint
C) MCP ext restriction splint (move more vs. A)
In the anti-deformity position, the interphalangeal (IP) joints should be in:
A) Flexion
B) Extension
C) Abduction
D) Adduction
B) Extension
The thumb should be positioned in ________ abduction in the anti-deformity posture.
palmar
Why is the anti-deformity position important, especially in burn cases?
prevent contractures and preserve functional range of motion in the affected areas following burns.
What does the wear time of an orthosis depend on?
purpose of the orthosis,
Longer splints are generally more ________ for patients.
Comfortable
Why are wider straps preferred in UE orthosis design?
A) They are easier to apply
B) They distribute force more evenly
C) They look better
D) They are less expensive
B) They distribute force more evenly
What is the purpose of using contoured edges in orthosis design?
enhance patient comfort by reducing irritation and pressure
When designing an orthosis, it is important to avoid pressure over ________.
Bony prominences (i.e. ulnar head)
In dynamic braces, the angle of pull should ideally be:
A) 45°
B) 90°
C) 180°
D) 135°
B) 90°
Static splints are commonly prescribed for ________.
Immobilization
Static splints primarily provide ________ support to joints or limbs.
passive
The resting position of a static splint holds tissues in ________ positions but not at end range.
elongated
What is the functional position of the hand and wrist in a static splint?
A) 10° wrist extension, 90° MCP flexion
B) 20° - 30° wrist extension, 40° - 45° MCP flexion
C) 45° wrist extension, 20° MCP flexion
D) 30° wrist flexion, 45° PIP extension
B) 20° - 30° wrist extension, 40° - 45° MCP flexion
Hand & Wrist Static Splint Pos:
In the functional position of the hand, the PIP joints should be in ________ degrees of flexion.
45
Hand & Wrist Static Splint Pos:
What is the recommended position for the distal interphalangeal (DIP) joints in a functional splint position?
relaxed flexion
Hand & Wrist Static Splint Pos:
In the functional position of the hand, the thumb should be ________ and in opposition to the fingers.
Abducted
These are functional positioning for what type of splint?
Wrist Extension: 20° - 30°
MCP Flexion: 40° - 45°
PIP Flexion: 45°
DIP Position: Relaxed flexion
Thumb Position: Abducted and opposed to fingers
static splint of hand and wrist
When may static splints be worn to manage elbow flexor spasticity?
A) Only during physical therapy sessions
B) During the day to assist with activities
C) At night to maintain elbow extension ROM
D) Throughout all waking hours
C) At night to maintain elbow extension ROM
What is the primary purpose of an airplane splint?
immobilization of the shoulder and arm.
In an airplane splint, the positioning of the arm is in ________.
Abduction
Which of the following is NOT an indication for using an airplane splint?
A) Axillary burns
B) Contracture prevention
C) Wrist fracture
D) Brachial plexus injury
C) Wrist fracture
Which of the following is NOT an indication for using an abduction-external rotation shoulder brace?
A) After shoulder dislocation
B) s/p shoulder arthrodesis
C) s/p total knee replacement
D) s/p rotator cuff repair
s/p total knee replacement
The most comfortable position for the shoulder in the abduction-external rotation brace is ________ degrees of abduction and ________ degrees of external rotation.
30°; 30°
Which of the following is NOT an indication for using a shoulder sling?
A) AC or GH dislocation
B) Post-surgery
C) Chronic shoulder pain
D) Post-trauma
C) Chronic shoulder pain
Long-term use of a shoulder sling may lead to ________ flexion contracture.
Elbow
Which of the following is true regarding the cost effectiveness of a sling versus an abduction brace?
A) The sling is generally more expensive.
B) The abduction brace is more cost effective.
C) The sling may be more cost effective.
D) Both are equally expensive.
C) The sling may be more cost effective.
What is the primary purpose of elbow-forearm wrist orthoses?
stabilize injuries of the forearm and wrist by preventing supination and pronation.
Elbow-forearm wrist orthoses can be used for a terrible triad, which involves elbow dislocation with associated radial head and ________ fractures.
Coronoid
Elbow-forearm wrist orthoses are typically positioned in a ________.
neutral position
What is the primary purpose of a sugar tong splint?
limit forearm supination/pronation, elbow extension, and wrist motion.
The sugar tong splint is indicated for ________ fractures, distal radius fractures, and distal ________ fractures.
Carpal; ulna
What are the key indications for using a static wrist hand orthosis?
Burns
Joint replacements
Rheumatoid arthritis
Peripheral nerve injuries
Nerve and tendon repairs
Carpal tunnel syndrome
Wrist pain (prevention or management)
Contracture prevention (e.g., CVA, SCI, burns)
What is the primary purpose of a dorsal blocking splint?
block wrist and finger extension to protect repaired flexor tendons.
The dorsal blocking splint is typically positioned in ________ degrees of wrist flexion.
0° or 30°
What is a benefit of positioning the dorsal blocking splint in a neutral position?
A) Increased wrist extension
B) Less flexion deformities and complications
C) Enhanced finger extension
D) Longer recovery time
B) Less flexion deformities and complications
Dorsal blocking splints are used to protect repaired ________ tendons during the healing process.
Flexor
What is the primary purpose of a volar blocking splint?
block wrist and finger flexion.
Which of the following is an indication for using a volar blocking splint?
A) Shoulder dislocation
B) Spasticity control
C) Elbow fracture
D) Carpal tunnel syndrome
B) Spasticity control
What are the key indications for using a volar blocking splint?
Contracture prevention (e.g., burns to the hand, CVA, TBI, SCI)
Spasticity control
Distal radius fractures
What is the primary purpose of ulnar gutter splints?
immobilize the 4th and 5th fingers
Which of the following conditions is NOT an indication for using an ulnar gutter splint?
A) Boxer’s fracture
B) 4th and 5th phalange fractures (extended)
C) Scaphoid fracture
D) Positioning for rheumatoid arthritis (RA)
C) Scaphoid fracture
Which fingers are primarily indicated for Radial Gutter Splints?
The 2nd and 3rd fingers
Only use HO when wrist motion can be restricted. True or False
False: unrestricted
What is the special test used to diagnose DeQuervain’s Tenosynovitis?
Finkelstein Test
What symptom might indicate DeQuervain’s Tenosynovitis when grasping an object?
Pain when grasping an object or making a fist.
Where might the pain radiate in someone with DeQuervain’s Tenosynovitis?
Radiating pain to the forearm.
An injury to the ulnar collateral ligament (UCL) of the thumb, often caused by sudden abduction of the first metacarpophalangeal (MCP) joint.
Gamekeeper’s or Skier’s Thumb?
What difficulty might a person experience when handling objects with Gamekeeper’s thumb injury?
gripping objects
What is the primary function of a Thumb Spica Splint?
To immobilize the thumb and possibly the wrist.
Is a Thumb Spica Splint considered standard care for carpal tunnel syndrome?
No, it is not the standard of care for carpal tunnel syndrome.
What condition is indicated for using a Thumb Opponens Splint?
Spastic cerebral palsy (CP)
CMC (carpometacarpal) osteoarthritis.
Congenital deformity of the thumb.
What is the recommendation for using hand orthoses in CMC Joint OA?
Strong recommendation for soft or rigid hand orthosis.
List the finger deformities:
mallet finger
boutonniere deformity
swan neck
What is Elson’s test used to diagnose?
A laceration or injury to the central slip of the extensor tendon in the finger.
What finger deformity can result from an untreated central slip laceration?
A boutonnière deformity.
Finger Orthoses:
mallet finger:
boutonniere deformity:
swan neck ring deformity:
stack splint, aluminum splint
ring splint, dynamic splint
swan neck splint, oval 8 finger splint
A ___________ holds the affected finger in relative extension or relative flexion compared to adjacent fingers.
Relative Motion Orthosis
How long is a Relative Motion Orthosis typically worn?
What are the common designs of a Relative Motion Orthosis?
For 4-7 weeks
Usually 3- or 4-finger designs.
What type of orthosis is this?
The affected finger is placed in 15-20 degrees of MCP flexion relative to the adjacent fingers. It provides laxity in the lumbricals while increasing tension on the extensor hood.
Relative Motion Flexor Orthosis
How is the affected finger positioned in a Relative Motion Extensor Orthosis for long extensor tendon repairs?
10-15 degrees of relative metacarpophalangeal (MCP) joint extension.
What degree of extension is recommended in a Relative Motion Extensor Orthosis for sagittal band injuries?
15-20 degrees of relative extension.
What is the primary purpose of Serial Static Orthoses?
What type of device is typically used in Serial Static Orthoses?
Mobilization through prolonged low load stretching of tissues.
A cast or brace with range of motion (ROM) control.
What is a common indication for using a Serial Static Splint?
PIP flexion contracture
biceps tendon repair
elbow fracture/contracture
How does a Static Progressive Orthosis hold the joint?
How often should a Static Progressive Orthosis be worn?
It holds the joint at its current end range and is readjusted with each wear.
At least 30 minutes, 3 times per day.
What is the primary purpose of a Dynamic Splint?
Mobilization through a low-load, prolonged duration stretch.
Should a Dynamic Splint produce pain during use?
No, it should not produce pain.
What specific motion is a Dynamic Splint commonly used to increase?
Increasing extension.
What is a common indication for using a Dynamic Splint?
Post-surgery (s/p) Flexor Tendon Repair.
radial nerve injury
What specific splinting technique is used after flexor tendon repair?
A dorsal blocking splint to limit MCP extension.
What is the primary purpose of a Tenodesis Splint?
What type of patients is a Tenodesis Splint typically indicated for?
To act as a substitute for irreversible functional loss and enhance the tenodesis grip.
Patients with C6-C7 quadriplegia.
