Orthosis plays an essential role in the world of hand therapy. Since our previous article shared 5 common static orthosis for hand injuries. What about Dynamic Orthosis ?
⭐ What is a Dynamic Orthosis ?
Unlike static orhtosis, a dynamic orthosis does not fully immobilize the affected joint. The main purpose of utilizing dynamic components is to provide a low-load, prolonged stretch (LLPS), which helps to prevent further inflammation, and evoke more plastic, permanent, as well as less painful change in tissue length.
⭐ Common Fabricating Components
⭐ General Fabrication Tips
1. The outrigger must be aligned perfectly with the finger.
2. The direction of stretching force must be perpendicular to the bone alignment.
3. It is essential to have a secured base of support from the orthosis.
4. The tension of dynamic component should be adjustable according to clients’ tolerance.
⭐ Dynamic Proximal Interphalangeal (PIP) Extension Orthosis
* Provides continuous passive extension to PIP joint, also allow active flexion for functional use of hand.
* Helps to treat early stage of flexion contracture or boutonniere deformity, to prevent further joint stiffness or soft tissue shortening.
* Maintains PIP joint in full extension after extensor tendon (zone III-IV) injury, to promote tendon healing and ensure protective finger motion.
⭐ Dynamic PIP Flexion Orthosis
* Provides continuous passive flexion to PIP joint, also allow active extension for functional use of hand.
* Helps to treat extension contracture for the affected joint, to regain joint flexibility.
* We use Phoenix® Outriggers as an example, other outriggers work fine as well.
⭐ Static-Progressive Joint Flexion Orthosis
* Static progressive orthosis is a great way to help stretching a stiff joint.
* A splint turner (pic 3) is utilized to provide adjustable stretch as tolerated, and the line guide (pic 5) is important in guiding the direction of stretching in perpendicular angle.
* We use thumb IP joint as an example, this orthosis can be applied to any other fingers.
In summary, fabricating a dynamic orthosis is definitely a more challenging task to hand therapists. It requires sophisticated fabrication skills and experience in all kinds of dynamic components to ensure a better fitting and functioning orthosis.
No matter what type of orthosis you are making, just remember Less is More. Always make sure to provide low-load, prolonged stretch (LLPS) to the stiff joint!
Andrew believes rehab-related knowledge should be easy to learn and follow at home, because "knowledge is power only when we can share it" !