Lecture no : 12

Rehabilitation Engineering

Mr. Muhammad Moazzam

Lecturer(Biomedical Department)
University of the Lahore

Copy Right: Muhammad Moazzam

 Content
• Upper extremity orthoses
• Finger orthoses
• Hand orthoses
• Shoulder orthosis
• Shoulder–elbow–wrist–hand orthoses
 UPPER EXTREMITY ORTHOSES
• Upper extremity orthoses are mainly prescribed in order to provide
support, prevent deformities; maintain function; and/or restore
function of upper limb.
• Depending on the intended purpose, these orthoses are either static,
providing complete immobilization, or dynamic, allowing only
functional motion while restricting others.
• Typical conditions under which upper extremity orthoses are
prescribed are fractures
 FINGER ORTHOSES
• The first category in finger orthosis comprises the
immobilization orthoses
1. Static:
Boutonniere orthosis- A static splint corrects
hyperflexion at PIP (proximal
interphalangeal joints) joint by
3-point pressure principle.
 FINGER ORTHOSIS
2. Swan neck orthosis
A Swan neck deformity is a condition where the middle joint of the finger, known as the
PIP joint, hyperextends or bends backwards and the end joint near the fingernail, known
as the DIP joint, flexes or is bent downwards.
 HAND ORTHOSES
• The immobilization orthoses in this category limit motion at the
metacarpophalangeal joint (MP), proximal interphalangeal joint
(PIP), and distal interphalangeal joint (DIP) all together.
• These orthoses are also prescribed for prevention of MP joints
ulnar deviation, which is commonly seen in individuals with
arthritis.
• Two types of mobilization hand orthoses mainly used are: PIP
flexion mobilization orthoses and PIP extension mobilization
orthoses.
 DYNAMIC HAND ORTHOSIS
• To substitute for absent or weak extension.
• Wrist extension finger flexion reciprocal orthosis.
 HANDAND FINGER ORTHOSIS
1. Metacarpophalangeal flexion orthosis to prevent the
metacarpophalangeal extension.
 HANDAND FINGER ORTHOSIS
2. Metacarpophalangeal extension orthosis for finger drop
 HANDAND FINGER ORTHOSIS
3. PIPextensionstop
 HAND AND FINGER ORTHOSIS
4. PIP flexion stop
 DYNAMIC ORTHOSIS
1. Shoulder orthosis –
• Balanced forearm orthosis: It is the most useful device to assist
both elbow and shoulder function.
• It can be mounted on a wheel or on a table or occasionally on a belt
at the level of iliac crest. It contains of a trough in which the
proximal forearm rests.
Balanced forearm orthosis
1. Functional dynamic elbow flexion orthosis:
2. Functional dynamic elbow extension orthosis
 WRIST ORTHOSIS
• Dynamic wrist orthosis with dorsiflexion assist: It is a
modified long opponenssplint designed to assist wrist
extension and allowing normal flexion of wrist.
 SHOULDER–ELBOW–WRIST–HAND ORTHOSES

• The most common form of shoulder–elbow–wrist–hand orthoses

(SEWHO) is one given to patients after brachial plexus injury.
• This orthosis keeps the upper extremity in abduction, externally
rotated at the shoulder joint, extended and pronated at the
elbow, and extended at the wrist joint, thus preventing occurrence of
further deformity.
• This “airplane orthosis” is also useful after burns, especially to the
axillary region for prevention of contractures.
SHOULDER–ELBOW–WRIST–HAND
ORTHOSES
Questions ?