What is a resting hand immobilization orthoses?
a statis orthosis that immobilises fingers and wrist - thumb may or may not be involved.
What is an advantage of a pre-molded commercial orthosis?
quick application with adjustable straps
what is the disadvantage of a premolded commercial orthosis?
Can't position joints at precise angles, less that optimal fit
Why do you avoid cutting through the perforations on thermoplastic>
the rough edges from holes can scratch skin
What are the components of a resting hand orthosis?
forearm trough, thumb trough, pan, and c- bar
Why use a volar resting hand orthosis?
when a great amount of forearm support is desired - use volar
Why use a dorsal resting hand orthosis?
When there are sutures, rashes, or needles to be avoided
Why is dorsal resting hand orthosis a beneficial design for hypertonicity?
Extends wrist and fingers in person with hypertonicity
What are the dimensions and considerations of the pan?
wide enough to house index, middle, ring and liitle finger ins slight abduction, 1/2 height curve to the sides to provide strength and prevent ulnar or radial slide of fingers
What are dimensions and considerations of the thumb trough?
Extend 1/2 inch beyond thumb, 1/2 circumference of thumb in palmar abducted position
What are the exact thumb position measurements?
CMC in 40-45 degrees abduction, extend IP and MCP
What is the purpose of the C-Bar?
keeps thumb web space in palmar abduction - to prevent contraction - looks like a C from radial side!
What is the purpose of a resting hand orthoses?
immobilize hand, position in functional alignment, retard further deformity (through rest and proper alignment)
How does resting hand orthosis relieve stress on joints?
by placing hand in functional or mid-joint position - some variations exist in this position
What is a common functional hand position?
wrist in 20-30 extension, thumb in 45 palmar abduction, MCP in 35-45 flexion, PIP and DIP in slight flexion
What is the anti-deformity position?
wrist in 15-20 extension, thumb 1/2 way b/w radial and palmar abduction, thumb IP full extension, MCP in 60-70 flexion, PIP and DIP in full extension
What are other names for anti-deformity position?
safe, protected - it maintains tension and distraction of anatomy to prevent contractures -this is also an intrinsic plus
Who wants a resting hand orthosis?
arthritis, post-op Dupuytren contracture release, burns, tendinitis, hemiplegic, hypertonic, tenosynovitis
What is complex regional pain syndrome (CRPS)
post traumatic pain that is insappropriate automatic activity and impaired extremity function
CRPS Symptom 1
Pain out of proportional intensity to the injury, often throbbing, burning, cutting searing, shooting
CRPS Symptom 2
Skin color changes - blotchy, purple, pale and red
CRPS Symptom 3
Skin temperature changes - warmer or cooler compared to contralateral side
CRPS Symptom 4
Skin texture changes - thin, shiny, sometime very sweaty
CRPS Symptom 5
swelling and stiffness
CRPS Symptom 6
decreased ability to move affected body part.
What is difference b/w CRPS Type 1 and Type 2?
Type 1 triggered by tissue injury and Type 2 is peripheral nerve injury
what is goal of CRPS Rehab?
eliminate pain, diathesis (suffering), and abnormal sympathetic reflex
What is the orthotic intervention for CRPS?
low force resting hand orthosis worn at all times - maintain a position of comfort within splint, avoid exacerbation of pain and skin irritation
What is Dupuytrens?
benign fibramotosis with formation of finger flexion contracture w/ thickened band of palmar and digital band.
What are some cormorbidities of Dupuytrens?
diabete, epilepsy, smoking, HIV -Aids, vascular disorders, alcoholism, family history,
Is Dupuytren's curable or treatable?
It is not curable - orthotics dont' prevent the contracture and surgery treats the disease but does not cure it.
When does orthotic intervention begin or Dupuytrens?
24 hours after surgery a dorsal static protective orthosis is provided, and worn for three weeks
Why is a dorsal orthotic used for Dupuytrens?
It is a no tension approach
What digits are included in Dupuytren surgery orthotic?
Usually only the fingers that had the release surgery