Orthotics & Prosthetics

Dr Munir Saadeddin
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 cobs 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
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
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
Restores function (Weight Bearing)


Restores Shape ( Cosmetic )



Is the part of the limb
remaining following
amputation
Weight bearing is
normally NOT at the
end of the 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 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
Functional
Fits well
Light in weight
Easy to use
Cosmetically acceptable
Easily maintained/repaired
Ideally locally manufactured