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P & O > Week 6 UE orthoses > Flashcards

Week 6 UE orthoses Flashcards

1
Q

FO

A

finger orthosis

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2
Q

HFO

A

hand finger orthosis

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3
Q

HO

A

orthosis

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4
Q

WHO

A

wrist hand orthosis

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5
Q

EO

A

elbow orthosis

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6
Q

EWHO

A

elbow wrist hand orthosis

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7
Q

SO

A

shoulder orthosis

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8
Q

Describing an UE orthoses

A

fabrication
articular vs nonarticular
location
direction
pupose

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9
Q

Articular

A

crosses a joint

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10
Q

Nonarticular

A

does not cross a joint or doesn’t have a mechanical joint

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11
Q

Purpise of UE orthoses

A

immobilize
mobilize/assist with movement
restrict motion

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12
Q

Immobilization

A

Stabilization joints/tissues
by preventing
excessive/abnormal
movements
Manage a deformity by
preventing a contracture
Protect structures from
harmful/excessive load
i.e., Stabilize
unstable/painful joints
to reduce inflammation,
prevent deformities,
facilitate healing of
injured tissues
(fracture, tendons,
ligaments

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13
Q

UE orthoses for specialized purpose

A

substitute hand grip/dexterity
exercise/therapy tool to assist function

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14
Q

Budding tapping

A

stronger digit assist with movement of impaired digit

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15
Q

Blocking splint

A

assist with AROM by blocking movement of more mobile joint

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16
Q

Anti-deformity positions of the UE

A

90° of shoulder
abduction with
external rotation
* Elbow extension
* Neutral to slight
supination forearm
20- 30°wrist
extension
70-90°MCP Flexion
IP extension
Thumb in palmar
abduction

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17
Q

increase wear time gradually vs full time wear depending on

A

diagnosis/ purpose of orthosis

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18
Q

Longer splints are more ______

A

comfortable and stable

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19
Q

Wider straps distributes force more evenly

A

more comfortable

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20
Q

Why contoured edges

A

pt comfort

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21
Q

Avoid pressure forces over

A

bony structures

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22
Q

in dynamic braces

A

angle of pull be 90 deg

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23
Q

apply tension only sufficient to take

A

the joint to comfortable end range

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24
Q

Design categories of UE orthoses

A

static
dynamic
functional

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25
Q

Static splint overview

A

Provide passive support
Commonly prescribed for immobilization
Provides protection through proper positioning

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26
Q

Positioning static splints

A

contracture prevention and/or healing
resting position

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27
Q

Resting position

A

holds tissues in elongated positions, but not at end range

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28
Q

Functional position of the hand and wrist for static splints

A

20° - 30° of wrist extension
40° - 45° MCP flexion
45° PIP flexion
Relaxed flexion of DIPs
Thumb abducted and in
opposition to fingers

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29
Q

Static splint indication - closed humeral shaft fracture

A

Healing time
non operative - 16 weeks
operative - 14/15 weeks

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30
Q

Static splint indication - elbow flexor spasticity

A

Due to upper motor
neuro pathology
May be worn at night to
maintain elbow
extension ROM &
prevent flexion
contracture

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31
Q

Airplane splint

A

static splint

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32
Q

Airplane splint purpose

A

immobilization position in shd abduction

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33
Q

Airplane indication

A

axillary burns
contracture prevention
humeral neck fx
brachial plexus injury

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34
Q

Abduction external rotation shoulder brace

A

statice splint
30 deg abd & 30 ER most comfortable

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35
Q

Abduction-external rotation shoulder brace indications

A

s/p rotator cuff repair
After shoulder
dislocation
s/p shoulder
arthrodesis

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36
Q

shoulder sling

A

static splint

37
Q

shoulder sling purpose

A

immobilization

38
Q

shoulder sling indications

A

post-trauma
post-surgery
AC or GH dislocation

39
Q

why should shoulder sling be used long term

A

lead to elbow flexion contracture

40
Q

sing vs abduction brace for rotator cuff repair

A

no diff in effectiveness - function, pain, healing. sling may be more cost effective

41
Q

Elbow forearm wrist orthoses

A

static splint

42
Q

elbow-forearm wrist orthoses stabilize injuries of forearm and wrist by

A

preventing supination and pronation
typically positioned in neutral

43
Q

Elbow-forearm wrist orthoses indications

A

Distal radius fracture
Forearm fractures
Triangular fibrocartilage injury
Terrible triad
Contracture prevention

44
Q

Terrible triad

A

elbow dislocation with associated radial head and coronoid fractures

45
Q

sugar tong splint

A

static splint

46
Q

Sugar tong splint limits

A

forearm supination/pronation, and wrist motion

47
Q

Sugar tong splint indications

A

carpal fractures
distal radius fracture
distal ulna fracture

48
Q

Indications for static wrist hand orthosis

A

Burns
Joint replacements
Rheumatoid Arthritis
Peripheral nerve injuries
Nerve and tendon repairs
Carpal tunnel syndrome
Wrist pain (prevention or
mgmt.)
Contracture prevention (i.e.
CVA or SCI or burns)

49
Q

Dorsal blocking splint

A

Block wrist & finger
extension
Protect repaired flexor
tendons
Typically positioned in 0°
or 30° of wrist flexion
– A neutral position may
result in less flexion
deformities,
complications, and earlier
return to prior activities

50
Q

Volar Blocking splint

A

block wrist and finger flexion

51
Q

Volar blocking splint indications

A

Contracture
prevention
Burns to the hand
* CVA, TBI, SCI
Spasticity control
Distal radius fractures

52
Q

Ulnar gutter splints indications

A

Soft tissue hand injuries to 4th
and 5th fingers
4th and 5th metacarpal fractures
(i.e. Boxer’s fracture)
4th and 5th phalange fractures
(extended)
Positioning for RA

53
Q

Radial gutter splint indications

A

Soft tissue injuries to the
2nd and 3rd fingers
Fractures of the 2nd and
3rd metacarpals
Fractures of the 2nd and
3rd phalanges
Positioning for RA
Laceration over the joints
of the 2nd and 3rd
phalanges or metacarpals

54
Q

Hand Orthoses

A

use when wrist motion can be unrestricted

55
Q

DeQuervain’s Tenosynovitis symptoms

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

56
Q

Gamekeeper’s or skier’s thumb symptoms

A

Pain with pinch grasp
Weakness of pinch grasp
Difficulty gripping objects
Swelling or bruising at
base of thumb

57
Q

Gamekeeper’s or skier’s thumb cause

A

sudden abduction of 1st MCP

can be a tear or sprain of the UCL

58
Q

Thumb spica splints

A

immobilizes the thumb and possibly wrist

59
Q

Thumb thica splint indications

A

Scaphoid fractures
Lunate fractures
Thumb phalanx fractures or
dislocations
Gamekeeper’s thumb or
skier’s thumb
DeQuervain’s tenosynovitis
Carpal tunnel syndrome (not
the standard of care)
CMC osteoarthritis

60
Q

Thumb opponens splints indications

A

CMC osteoarthritis
Spastic CP
Congenital deformity of
the thumb

61
Q

CPG CMC joint OA

A

Strong Recommendation for soft or
rigid hand orthosis

62
Q

CPG other hand joint OA

A

Conditionally recommendation
for orthosis such as finger splints, digital orthoses,
soft or rigid

63
Q

Mallet finger

A

DIP flexion

stack splint
aluminum splint

64
Q

Boutoniere deformity

A

PIP flexion with DIP ext

ring splint
dynamic splint

65
Q

Swan neck deformity

A

PIP ext with MCP and DIP

Commonly seen after trauma or in pt with RA

swan neck ring splint
Oval 8 finger splint

66
Q

Static orthosis

A

holds the the
affected finger in relative
extension or relative flexion
compared to the adjacent
fingers.

67
Q

Static orthosis protects or unloads

A

the injured or repaired tendon

68
Q

Static orthosis limits

A

excursion of the injured or repaired tendon

69
Q

Static orthosis is made of

A

firm thermoplastic

70
Q

Static orthosis is typically worn for

A

4-7 weeks
usually 3 or 4 finger design

71
Q

Relative motion flexor orthosis

A

15-20 degrees MCP flexion relative to the adjacent
fingers
Provides laxity in lumbricals, while increasing
tension on extensor hood

72
Q

Relative motion flexor orthosis indications

A

Central slip laceration
Boutonniere deformity (Acute or chronic)
Digital nerve repair
Flexor tendon repair
Interosseous tears
Lateral band sprain/tear
Post-PIP joint arthroplasty
Unexplained pain in palm of the hand
After metacarpal fracture (or other metacarpal
involvement)
Improve alignment of fingers with RA

73
Q

Relative motion extensor orthosis

A

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

74
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/Trigger finger
Unexplained pain about the MCP joints or dorsum of hand
Metacarpal head fracture
Improve alignment of fingers with RA

75
Q

serial static orthoses overview

A

Purpose:
Mobilization
Prolonged low load
Cast or brace with
ROM control
Worn full-time

76
Q

Serial static splint for PIP flexion contracture

A

Possible MOI:
Dislocation/Hyperextension
or Hyperflexion
Torsional Injury
Soft tissue injury

77
Q

comparison of orthoses for PIP flexion contracture

A

No difference in effectiveness
Factors to consider: total end range time, patient
comfort and compliance

78
Q

Static progressive orthoses overview

A

Single splint that is adjustable
Worn for at least 30 minutes, 3x/day
Joint held at current end range
Positioning readjusting each wear
Example Indications: PIP joint contractures, elbow
flexion contractures, knee flexion contractures

79
Q

Dynamic splints overviews

A

Purpose: Mobilization
Uses elastics, coils, or
spring tensioning
mechanisms to provide a
low long, prolonged
duration stretch in typically
one direction.
Should not produce pain
Not as effective as static
tension

80
Q

Specialized UE orthoses

A

act as substitute for irreversible functional loss

81
Q

Tenodesis splint

A

Intended to
enhance
tenodesis grip
Indications:
– C6-C7
quadriplegia

82
Q

To reduce UE spasticity

A

Use static splinting (low)
Use of dynamic splinting (low)

83
Q

To increase hand function

A

Use of static splinting (moderate)
Use of dynamic splitting (moderate)
Manual stretching (moderate)

84
Q

To improve functional task

A

Use of static splinting (moderate)
Use of dynamic splitting (moderate)
Manual stretching (moderate)

85
Q

Orthoses for extensors tendon repair

A

Zones IV-VIII: Surgical repair
* Post-op protocols:
– Immobilization
– Early Passive(Controlled)
Mobilization
– Early Active Mobilization
Prior evidence recommends early active
mobilization with orthosis (unspecified) or early
controlled immobilization over immobilization.

86
Q

Rationale for prescription, effectiveness of, upper
limb orthotic intervention for children with cerebral
palsy: A systematic review

A

There is a lack of evidence to support UE orthoses in
children with CP.

87
Q

Non-pharmacological interventions for spasticity in
adults: An overview of systematic reviews

A

Low quality evidence for non-pharmacological interventions
targeting spasticity, including splinting

88
Q

Splints/orthoses in treatment of Rheumatoid Arthritis

A

Insufficient support for use of wrist splints/orthosis for pain
mgmt. or to improve function in people with RA

P & O (4 decks)

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