Orthotics Prosthetics Dr Munir Saadeddin Orthotics Calipers Traditionally

Orthotics & Prosthetics Dr Munir Saadeddin

Orthotics = Calipers § 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 1/3 rd 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 cob’s 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

Spinal Orthosis = DLS § May be concealed under the clothes § Can control deformities or injuries at lumbar spine as well as dorsal spine up to level D 6 § Can control scoliotic or kyphotic deformities

Spinal Orthosis = CDLS § 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

Functions of Prosthesis § Restores function (Weight Bearing) § Restores Shape ( Cosmetic )

Stump § Is the part of the limb remaining following amputation § Weight bearing is normally NOT at the end of the stump

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 § 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

Ideal Orthosis / Prosthesis Functional Fits well Light in weight Easy to use Cosmetically acceptable Easily maintained/repaired Ideally locally manufactured