Complex Orthoses Made Simply and Effectively (Recorded Webinar)

1. The Muenster Orthosis: An Orthosis That Limits Forearm Rotation

Certain clinical diagnoses require the stabilization of the forearm bones and prevention of forearm rotation in order for injured structures to heal. Distal radial ulnar joint injuries, TFCC injuries, and complex forearm bone fractures are typical diagnoses in which immobilization of the forearm in neutral is specified. The Muenster orthosis, as demonstrated here, can be made effectively and quickly from an innovative material that contributes to overall client comfort and compliance.

2. Thumb Orthoses: Short Opponens and Long Opponens Orthoses

Multiple clinical diagnoses require thumb immobilization for healing after injury or for improved function. The most common conditions that benefit from the use of a short thumb opponens orthosis might be osteoarthritis and/or rheumatoid arthritis. Thumb sprains, tendinitis, fractures, and arthritic conditions involving the thumb and the wrist might require a long opponens orthosis. There are multiple design options for these two orthoses. In this chapter, a quick and effective method using an innovative material will be featured.

3. Proximal Interphalangeal Joint Orthoses

Due to the complex anatomical structures of the proximal interphalangeal joint, complications are typical after injury. Edema, stiffness, and loss of motion are common. Early detection of injury, appropriate treatment protocols, and use of the correct orthosis can help restore function. Orthoses can also help when there are range-of-motion deficits in the joint or limited joint stability.

4. The Relative Motion Orthosis

The relative motion orthosis offers an easy orthotic intervention for a variety of clinical issues involving the fingers. By placing one or two MCP joints in relatively more or less extension than adjacent fingers, force can be transmitted distally for improved PIP joint range of motion. Or the tension on repairs of extensor tendons and/or sagittal bands is decreased. Patients report less pain and improved function while wearing this simple finger-based orthosis.

5. Thermoplastic Hinges in Mobilization Orthoses

Thermoplastic hinges can easily connect distal and proximal components of an orthosis, allowing motion in desired directions at the joint in between. When placed appropriately, these hinges can block wrist flexion and extension but allow motion in the dart thrower’s plane, a motion that occurs at midcarpal range and eliminates movement of the proximal carpal row. Hinges can also be used with a long thumb opponens orthosis by allowing flexion and extension but blocking ulnar and radial deviation, and in this way play an important role in the treatment of de Quervain’s syndrome.

6. Question and Answer Session

This section is a viewer-submitted question and answer session facilitated by Deborah Schwartz.