Orthoses for Upper Extremity

    Spine:

    Spinal orthoses, includes neck braces and back braces, are used to support and stabilized from the jaw to the lower back. This type of orthoses can be used to realign the spine, immobilize the spine, and support weakened areas of the spine. The three main types of spinal orthoses are:

    • Lumbo-sacral orthosis (LSO): is a device that is used to support the lowest part of the spine and keep it from moving. This area includes the lumbar and sacral spine. It typically fits between the shoulder blades and the tailbone. These are used to treat degenerative disc disease, osteoporosis, and spinal fracture.
    • Thoracolumbar Spinal Orthosis (TLSO): The goal of a TLSO is to prevent the prgression of the scoliotic curve. This brace is fitted to the body and custom molded from plastic and to be worn 16-18 hours a day. It applies three-point pressure to the curvature to prevent its progression. It is typically worn under clothing and not noticeable, and can be taken off to swim, play sports, and participate in gym class during the day. A TLSO can be used to treat a variety of conditions like: compression fractures, laminectomies, and for after surgery use.
    • Cervical Thoracic Lumbo Sacral Orthosis (CTLSO): provides spinal stability when reducing spinal range of motion in the Cervical to Lumber spine (C2 – L5). They can be used when treating multi-level spinal injuries or related soft tissue injuries, post spinal surgery procedure, and to control/ support degenerative spinal complications. A CTLSO is usually used to treat scoliosis and kyphosis.

    Upper Limb:

    Upper Limb Orthotics are devices designed to improve the function and structure of various areas of the upper limb. There are two different types of orthoses that could be used depending on the injury or diagnosis:

    • Static orthoses: these devices do not allow any type of movement and are made from a rigid structure. They are most commonly used for fractures, tendon injuries, and nerve injuries.
    • Dynamic orthoses: these devices do allow some movement. The amount of movement is depending on the condition and are mainly used for weakness and spasticity.

    There are also orthoses made for more specific areas of the upper limb. Those are:

    • Shoulder Abduction Orthoses: this is used when a patient has injuries to their rotator cuff, shoulder capsule, clavicle, or soft tissue. They are also useful when one has a glenohumeral dislocation or subluxation.
    • Shoulder Stabilizer: similar to the shoulder abduction orthosis, but it can help to keep the shoulder in one place until it heals or is prepared for surgery. It can be used for the same issues as the Shoulder Abduction Orthoses, however it is also useful when treating mild sprains, strains, or fractures.
    • Fracture Brace: is used for patients that are recovering from a fracture. A fracture brace is typically used for patients with a mid-ulnar or radical fracture. A fracture brace can also be beneficial for wrist and hand fractures, distal humeral fractures, proximal radial injuries, or ulnar fractures.
    • Wrist-hand orthoses: these orthoses are most commonly used to treat carpal tunnel syndrome, tendonitis, or a sprain or strain. They are also helpful to those who have recently fractured their hands. It gives support to the limbs that are recovering from injury, struggling with a disorder, or preparing or recuperating from surgery. Depending on the extent of the injury a patient may have to wear it while resting or when participating in activities that could harm the hand or wrist.

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    Chest and Head:

    Chest orthoses can be used to treat abnormal shaping of the costal cartilage of the ribs, or pectus carinatum. This is most commonly found in boys when they begin puberty. It is also commonly found with other spinal abnormalities like kyphosis and scoliosis. Chest orthoses are designed to moderate pressure over the abnormal bone growth. This helps slow the growth of cartilage and with proper stretching and exercises can treat this condition.

    There are a variety of different head orthoses that are used to treat patients with head injuries or conditions. Those orthoses are:

    • Custom Burn Masks: is a clear orthosis that is modeled after a patient’s face and fits directly against the skin. This is used to mange scars and prevent hypertrophic (raised) scars and keloids. Aside from helping with healing, custom burn masks provide protection to the wound and allow for visual inspection of the wound site without having to remove the mask.
    • Protective Helmets: A customized safety helmet helps to reduce the risk of injury and helps to protect the head after surgery. These are most commonly used by athletes, people with special needs, and those who are recovering from an operation. Protective helmets provide protection and facilitate healing.
    • Cranial Remodeling Helmets: provides effective management and treatment of a wide variety of head shape abnormalities. Cranial remodeling treatment is only effective when there is adequate control over the areas bulging and enough room for growth in the flattened area.

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