Orthotics & Prosthetics

Dr Munir Saadeddin
Orthotics = Calipers
 Traditionally calipers
were the most known
form of orthosis
 Caliper is a device
which is applied to
lower limb to give
support or control a
joint
Prevention of Deformity : AFO
Prevention of deformity :
Drop Wrist In Radial N Palsy
 Seen in fractures
junction of mid and
lower 1/3rd humerus
 Radial N palsy makes
loss of wrist and MCP
joints dorsiflexion
 Nerve function recovers
with passage of time (if
not cut)
 Prevention of deformity
is important
Dynamic wrist splint = Wrist & MCP
Joints Orthosis in Radial N Palsy
Prevention of Deformity in
Brachial plexus Palsy
 Brachial Plexus Palsy
usually leads to loss of
shoulder Abduction and
External Rotation
 If not treated it leads to
Adduction & Internal
Rotation deformity
(taking a tip position)
 Abduction Orthosis is
used to prevent this
deformity
Prevention of Deformity in
Brachial Plexus Palsy
 Brachial Plexus injury is
usually a stretching injury
 Shoulder should be
splinted in functional
position awaiting nerve
recovery
 Also Active and Passive
exercises and electrical
nerve stimulation should
be done
Correction of Deformity : Foot
Orthosis= Shoe Raise& Heel Cup
 Shoe Raise is a
simple orthosis which
corrects limb length
asymmetry
 Heel cups inserted
into shoes may
prevent development
of varus or valgus
heel deformity
Correction Of Deformity : Spinal
orthosis

 Are used in deformities in excess of 25

degrees of cob’s angle
 Are used in Growing individuals
 To be effective they have to be used for
23 hours daily
 They have to be used till bone growth
cease
 Spinal Orthosis

 Many types :
 Can be Rigid or Semi-Rigid
 Most comprehensive form is Milwaukee
Brace= Cervico- Dorso - Lumbosacral
Orthosis
 Boston brace or Jewett brace is a type
of rigid Dorso-lumbosacral orthosis
Spinal Orthosis = DLS
 May be concealed
under the clothes
 Can control deformities
or injuries at lumbar
spine as well as dorsal
spine up to level D6
 Can control scoliotic or
kyphotic deformities
Spinal Orthosis = CDLS
 Milwaukee brace
Correction of Deformity :
Clubfoot
Maintenance of Correction of
Deformity: Clubfoot Orthosis
 Plaster of Paris is a type
of Temporary Orthosis
following surgical
correction of clubfoot
 Later it is replaced by
backslap foot-ankle
orthosis or Dennis brown
night boots
Maintenance of Correction of
Deformity: Dennis-Brown night boots

 They are used to

maintain correction
AT NIGHT following
surgical correction and
removal of Plaster of
Paris
 Once the child is
walking his body
weight will maintain
correction
Instability control :
Knee Orthosis
 Knee Orthosis is a knee
brace which controls of
knee instability following
Ligaments injuries like
collateral ligaments or
cruciate ligaments
 They stop lateral
instability and control
knee movements
between certain
degrees
Weight relief function of
Orthosis: e.g. Perth's disease
Weight Relief function of
Orthosis : Thomas Splint
 It is an orthosis which
transmits the weight
from the ground to
Ischial Tuberosity (so
weight is relived from
affecting the hip
 In Perth's disease a
similar orthosis has to
be used for up to 2
years
Weight relief function of
Orthosis
 Weight relief Foot-Ankle
orthosis may be used
following comminuted
fractures of lower tibia
( Pylon Fractures)
 Weight is transmitted
from the ground to
patellar tendon and
upper flare of tibia
Pain Relief function of Orthosis

 Lumbar corset, Lumbar

brace or soft, semi-rigid
or rigid Lumbar or
Lumbo sacral orthosis is
commonly used for
acute pain or following
injury
Pain relief Function of orthosis=
Cervical collar or Cervical Orthosis
Functions Of orthosis:
Facilitates Mobilisation
 Paralysed or weak
limbs Will be able to
support weight
bearing if fitted with
suitable orthosis
 This is very important
in cases of Polio or
other paralytic
disorders
Functions of orthosis:
Facilitates mobilisation
 Paraplegic patients
may be able to
mobilise if fitted with
adequate Orthosis
and received the
necessary training
Functions of Prosthesis

 Restores function (Weight Bearing)

 Restores Shape ( Cosmetic )

Stump
 Is the part of the limb
remaining following
amputation
 Weight bearing is
normally NOT at the
end of the stump
Stump
 In Above Knee
amputation weight
bearing is at Ischial
Tuberosity
 In Below Knee
amputation weight
bearing is at Patellar
Tendon and upper
flare of tibia
The Socket
 The socket is the
immediate part the
stump has to be placed
 It is usually made of
plastic material and
padded at pressure
points
 A venting opening is
made at the end to
ease getting stump in
Lower Limb Prosthesis

 May be Below knee or

Above knee
 It consists of the socket
and the additional part
 Picture shows above
knee artificial limb
( Above Knee
Prosthesis)
 Weight bearing is at the
Ischial Tuberosity
Ideal Orthosis / Prosthesis

Functional
Fits well
Light in weight
Easy to use
Cosmetically acceptable
Easily maintained/repaired
Ideally locally manufactured