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What About a Thumb Orthosis?

presented by Virginia O'Brien, OTD, OTR/L, CHT

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Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Thumbs may require support from an orthosis as the thumb is in "rehabilitation" to regain its stability. The choices for thumb support range from custom to prefabricated, from thumb-based to forearm-based. Thumbs may require stabilization support to reduce pain initially. How do you choose whether or not to use an orthosis, which type of orthosis to use, and what amount of support is necessary? This chapter will discuss how to select the appropriate orthosis, taking into account activity and/or rest requirements, immobilization and stabilization, and deformity reduction. Five different custom orthoses will be presented in video format. This course will present the anatomical reasoning behind making the appropriate choice for your patient, and for the individual thumb. In case you do decide to prescribe an orthosis for your patient, we'll also discuss wearing schedules, dosages of wear, and a weaning program.

CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).

  • Evaluation of the Thumb (1 hour)
  • Why is Thumb Pain Such a Pain? An Introduction to Dynamic Stability of the Thumb (2 hours)
  • Saving Your Thumbs: Elastic Taping, Customizing Orthosis, Joint Protection Techniques, and Adaptive Equipment (1 hour)
  • o What About a Thumb Orthosis? (2 hours)
  • Meet Your Instructor

    Virginia O'Brien, OTD, OTR/L, CHT

    A graduate of the University of Wisconsin-Madison and Rocky Mountain University of Health Professions (Provo, Utah), Virginia first became interested in hand architecture during her fieldwork days. She is actively involved in clinical and biomechanical research of the thumb and the wrist, is a member of the AOTA Evidence Exchange committee and a member of…

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    Chapters & Learning Objectives

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    1. Types of Orthoses

    Even before and in the midst of retraining for dynamic stability of the thumb, the thumb may need support. How is this choice made? Principles are reviewed to help the therapist help the patient make the best choice or choices.

    2. Orthotic Fabrication: CMC Stability, Le’Belt and Figure 8 Orthoses

    Orthotic fabrication of three different orthoses for thumb stability is presented. They are the CMC Stabilization orthosis, MP and IP free; the Le'Belt abduction orthosis, soft support for MP Adduction assist; and the Figure 8 gardening orthosis for use in a garden glove or for other stabilizing needs.

    3. Orthotic Fabrication: “Strap” by A. Wajon and Game-Keepers’ Orthoses

    Orthotic fabrication of three additional orthoses for thumb stability is presented. They are the "Strap" orthosis by A. Wajon, the Game Keepers' Orthoses, and Game Keepers' UCL Orthosis.

    4. Reverse Zig-Zag and Other IP and MP Deformities: Orthoses and Treatment Options

    Some thumbs require minimal support for transfer of muscle and tendon force for grander functional gain. Reverse zig-zag deformity and instability or hyperextension at the distal and metacarpophalangeal thumb joints can impact function. Different orthoses options are presented.

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