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Upper Extremity Orthotic

Upper extremity orthotics are externally applied devices used to support, align, prevent or correct deformities, or to improve the function of the upper limb (shoulder, arm, elbow, forearm, wrist, hand, and fingers). They’re often used in rehabilitation, injury recovery, or neurological conditions to assist with movement or stability.

Upper extremity orthotics can be dynamic or static. Both types can be custom-fabricated or prefabricated and are selected based on the individual’s condition, functional goals, and stage of recovery.

Static Orthotics

Static orthotics: are designed to immobilize joints or maintain them in a fixed position, often used to prevent deformities, support healing structures, or provide rest in conditions like arthritis, fractures, or post-stroke spasticity. They are commonly used at night or during non-functional activities.

Dynamic Orthotics

Dynamic orthotics: incorporate movable components such as springs, elastic bands, or outriggers to allow or assist controlled motion while still providing support. These are typically used to improve joint range of motion, facilitate functional movement, or assist weak muscles in neurological conditions. Dynamic orthoses are particularly beneficial during daytime use and therapy, as they help retrain motor function while preventing contractures.

Shoulder

A shoulder orthosis is a device designed to support, stabilize, or restrict movement of the shoulder joint, the glenohumeral joint, to aid with healing, improve function, or prevent injury. These orthoses are commonly used following trauma, surgery, or in neurological conditions like stroke, where muscular control and joint integrity may be compromised.

One of the key applications of the shoulder orthoses is in managing shoulder instability, which can result from ligament laxity, dislocations, or muscle weakness. In these cases, shoulder orthoses limit excessive or abnormal movements, maintain proper alignment, and provide proprioceptive feedback to enhance joint control. Orthoses such as shoulder stabilizing braces or neoprene compression garments are commonly used in athletes or individuals recovering from shoulder dislocation to prevent recurrence and promote stability.

In stroke patients, especially those with hemiplegia or hemiparesis, shoulder subluxation (partial dislocation of the glenohumeral joint) is a frequent complication due to weakness or paralysis of the shoulder stabilizing muscles. This can cause pain, limit functional use of the arm, and impair recovery. A shoulder support orthosis often in the form of a humeral cuff slinghelps maintain glenohumeral alignment, reduce the gravitational pull on the shoulder, and minimize subluxation.

Elbow

Elbow braces are orthopedic devices used to support, stabilize, limit the motion, or manage contracture of the elbow joint. They are commonly prescribed for conditions involving injury, inflammation, nerve compression, or following surgery. The design and function of the brace depend on the underlying condition and therapeutic goals, ranging from rigid immobilization to controlled or assisted motion.

For example, night time elbow extension braces are used in case of cupital tunnel syndrome. Such brace prevents excessive elbow flexion to minimize ulnar nerve irritation during sleep.

In postoperative care, such as after ligament repair, fracture fixation, or tendon surgery, elbow braces are often used to control the range of motion (ROM). These braces have adjustable hinges that allow clinicians to set specific flexion and extension limits.

Overall, elbow braces are critical tools in both conservative and post-surgical management. They help protect structures, promote healing, reduce pain, and ensure a controlled return to function while minimizing the risk of reinjury or complications.

Finger

A finger orthosis is a device used to support, align, or correct finger deformities and improve hand function. Common types include ring splints, which stabilize joints without restricting overall finger use and are often used for conditions like arthritis or joint hypermobility. Specific deformities such as swan neck and boutonnière deformity. These orthoses aim to reduce pain, prevent or correct deformities, and restore function, often in conjunction with hand therapy.

Wrist

Wrist-hand orthoses (WHO) are devices designed to support, align, protect, or improve the function of the wrist and hand. They are commonly used in the management of neuromuscular or orthopedic conditions such as stroke, cerebral palsy, arthritis, carpal tunnel syndrome, and tendon injuries.

A WHO typically extends from the forearm to the palm, sometimes including the fingers, depending on the level of support needed. They can be static, holding the wrist and hand in a fixed position to prevent contractures or promote healing, or dynamic, allowing controlled movement to aid function and rehabilitation.The main goals of a WHO are to reduce pain, improve joint alignment, support weak muscles, protect healing tissues, and enhance functional use of the hand and wrist in daily activities.

For example, a static WHO is often used for carpal tunnel syndrome or wrist drop, it maintains the wrist in a slightly extended position to relieve the pressure exerted on the median nerve. More complex WHOs may include finger components to support grasp or prevent deformities like ulnar drift in rheumatoid arthritis.

Hand

CMC OA braces are the most common hand orthoses. These orthotic devices are designed to support the thumb’s carpometacarpal (CMC) joint, commonly affected by osteoarthritis. These braces help reduce pain, stabilize the joint, and maintain function during activities like gripping or pinching. They range from soft, flexible supports for mild cases to rigid, molded braces for more severe symptoms. Such braces provide firm stabilization while allowing full hand movement. Worn daily or during flare-ups, CMC OA braces are a key part of conservative treatment.

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