Orthotics 2

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Author:
alannaheeres
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204666
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Orthotics 2
Updated:
2013-03-03 20:57:22
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Orthotics
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Orthotics 2
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  1. 10 Principles of Proper Fit
    • 1. Maintains the arch
    • 2. Proper positioning
    • 3. Dual obliquity respected
    • 4. Freedom of movement - based on skin creases
    • 5. For dynamic splints, traction is applied at 90 degrees to the rotational access
    • 6. Follow contours of the extremity
    • 7. Minimize friction; round, smooth and flared edges
    • 8. Adequate length for a lever arm
    • 9. Trough splints extend about 1/2 around circumference¬†
    • 10. Assess splint in all forearm positions
  2. Education of the patient must include instruction on what 4 precautions?
    • 1. Skin breakdown
    • 2. Numbness
    • 3. Joint stiffness
    • 4. Follow-up
  3. Skin breakdown precautions (3)
    • Wash the skin and splint regularly
    • Redness, blanching and pain are all indicators of excessive pressure
    • Educate family and caregivers if cognition is an issue
  4. Numbness precautions (3)
    • Results from pressure on the nerve
    • Common problem areas are the base of the 1st and 5th metacarpals (CMC joint)
    • The numbness will resolve quickly if the splint is replaced quickly
  5. Joint stiffness precautions (2)
    • Maintain mobility of all joints unless contra-indicated
    • Restrictions to ROM: pain and swelling
  6. Follow-up precautions (3)
    • Determined by the type of splint provided, pathology being treated
    • What is the patient's responsibility?
    • Edematous tissue must be monitored closely
  7. Every patient who has been provided a splint should be given specific instructions on what 6 areas?
    • 1. What is the purpose of the splint
    • 2. How to care for the splint
    • 3. What is the wearing schedule
    • 4. What precautions to take
    • 5. Any exercises that may be performed to facilitate functional return
    • 6. Adjunct treatments (aids; activity modification)
  8. 5 factors that impact your choice of splinting material
    • 1. The patient's needs (ie plaster vs. plastic)
    • 2. The type of splint required (ie rigid vs. semi-flexible
    • 3. The available of different materials and their properties
    • 4. The amount of time available to make the splint
    • 5. Cost of the material
  9. What are the 4 physical properties of splinting material?
    • 1. color
    • 2. texture
    • 3. light penetration
    • 4. radio-transparency
  10. What are the 7 mechanical properties of splinting material?
    • 1. plasticity
    • 2. resistance to surface "folding"
    • 3. resistance to surface scratches
    • 4. resistance to fatigue
    • 5. Resistance to shock
    • 6. Memory
    • 7. Recycling potential
  11. What are the thermal properties of splinting?
    • 1. specific temperature
    • 2. cooling time
    • 3. surface temperature
    • 4. resistance to traction (ability to stretch)
    • 5. shrinkage
    • 6. bonding (ability to stick to itself)
    • 7. conformability (drape)
  12. Refers to the ideal amount of heat required for a material to become moldable
    specific temperature (65-80 degrees)
  13. Cooling time:
    The amount of time the material remains moldable after heating
    setting time
  14. Cooling time:
    The amount of time required for the material to return to its original rigidity
    Curing time
  15. What are the 3 chemical properties of splinting material?
    • 1. Toxicity
    • 2. Skin reaction
    • 3. Reaction to acids, bases and solvents
  16. Other characteristics of splinting material to consider (4)
    • 1. Price
    • 2. Dimensions
    • 3. Suppliers
    • 4. Precuts
  17. Classification according to heat temperatures:
    What is 'high temperature'?
    140 Celsius or 280 Fahrenheit
  18. Classification according to heat temperatures:
    What is 'low temperature'?
    50-82 celcius or 122-180 fahrenheit
  19. Three categories of heat temperature
    • 1. High temperature
    • 2. Low temperature
    • 3. No heating
  20. What are the 4 types of straps?
    • 1. Velcro
    • 2. Soft strap pile (Velfoam)
    • 3. Webbing
    • 4. Tensor wrapping
  21. 6 Methods of strap attachment
    • 1. Velcro hook with adhesive backing
    • 2. Velcro hook attached with thermoplastic material
    • 3. Rivets
    • 4. Chicago screws
    • 5. Glue
    • 6. Duct tape
  22. 7 Factors to consider when choosing a strap
    • 1. Condition of the skin
    • 2. Comfort
    • 3. Edema
    • 4. Maintenance of the strap
    • 5. Ease of application and removal
    • 6. Splinting material cost
    • 7. Cost
  23. Resting hand splint - position of rest:
    Diagnosis examples (4)
    • Arthritis
    • Hemiplegia
    • Comatose state
    • Inflammatory conditions (pathological)
  24. Resting hand splint - position of function
    Diagnosis examples (2)
    • Spinal cord injury
    • Progressive neuromuscular diseases
  25. Resting hand splint - position of protection
    Diagnosis examples (2)
    • Acute hand trauma
    • Burns
    • Infections
  26. Why is perforated material better?
    May breathe better
  27. Why is non-perforated material better?
    Presence of open wounds that may be draining
  28. Is dorsal or volar better?
    more soft tissue coverage on volar

    Dorsal enhances proprioceptive stimulation of the extensor muscle groups and frees the palmar hand and forearm surfaces for tactile pressure
  29. What can be used to better align the digits in the presence of a deviation deformity (eg. arthritis) and also allow the digits to breathe preventing inter-digital skin maceration?
    Finger separators
  30. What type of strap is most suitable for frail skin, bony prominence or the elderly?
    Velfoam
  31. What type of wrap can be used in the presence of excessive post-traumatic edema?
    Tensor wrap or coban
  32. Material:
    A thermoplastic which combines features of both plaster and thermoplastics
    It can be re-molded and you can add on pieces easily
    It is very lightweight and cool to wear
    It does not retain heat
    Hexcelite
  33. Who made the long thumb spica?
    Caitlin
  34. Who made the Thumb guantlet splint?
    Me
  35. Who made the wrist cock-up splint?
    Kiersti
  36. Acute phase splint:
    Static splint - generally to rest tissues
  37. Rehab phase splints:
    Static as you will change over time eg. as person regains ROM
    Serial static splint
  38. Rehab phase splint:
    Client can change
    Static-progressive
  39. Rehab phase splint:
    Block range in one direction but allows in another direction
    Drop-out splint
  40. Rehab phase splint:
    Has hinges, mainly done by orthotist
    Articulated
  41. Rehab phase splint:
    Force (eg. elastics)
    Dynamic
  42. What are the components of the problem set?
    • 1. Tissue status
    • 2. Components of function (eg. ROM)
    • 3. Scar
    • 4. Pain
    • 5. Function (ADLs)

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