UPPER EXTREMITIES

ORTHESA

Upper extremities orthesa design

Static
No mechanical axis, no motion
Molded / applied directly to the hand that maintains the hand /
joints in one position
Indikasi orthosis statik:
1. Immobilize, stabilize, and support a joint in a desired position
2. Protect weak muscles from overstretch
3. Prevent contractures
4. Support structures following surgical repair
5. Facilitate the healing of soft tissue injuries and fractures
Dynamic
Provide a constant force to the joint. The force is generated either
by a stretched rubber band or a wire spring coil via an outrigger
attached to the base. The outrigger assures that the force is
directed at or close to a 90 angle to the long axis of the bone.
While the splint is worn by the px, there is a constant force applied
and even as motion improves, the splint force continous
Selain imobilisasi/membatasi pergerakan sendi, orthosis dinamik
juga berfungsi meningkatkan fungsi dengan menggunakan tuas,
katrol, sendi-sendi yang dapat bergerak & alat penyimpan tenaga
(per, pita, baterai, tangki berisi gas yang dikompresi)
Serial static
Molded in a stationary position with the tissue at max length. They
are changed frequently to accommodate the decreased resistance in
the tissues. Ideally the serial cast is changed every other day, or at

least 2x/week with brie periods of supervised exercise when out of

splint
Static progressive
May be identical with dynamic splints in contruction of the splint
base and outrigger, but the application of force is not dynamic.
The force may be applied via the same outtrigger and finger loop
system or by another means. Instead of a rubber band or spring,
tension is maintained once fitted ( commonly with velcro or
mechanical componenets which can be adjusted in small
increments )
The theory of static progressive splinting ( holding the joint at
easty maximum available length ) is the same as that for serial
static splinting. The primary difference is the way in which forces
are applied. When serial static casting is used, force is evenly
distributed over all surfaces. Static progressive splinting
concentrates the force through the surface area of splint part
applying the pressure

Algorythm for the use of splints

Fase inflamasi :
1 miggu
Immobilization splint
Segera setelah terjadi cedera
Fase proliferasi :
1 6 minggu

 Pembentukan scar , moveable tissue dengan tegangan

Dynamic type splint
Fase remodeling :
8 12/24 minggu
Jaringan padat, keras dan tidak elastis
Pemendekan jaringan
Serial static atau static progresiv splint

Biomechanic of splint ( mechanical principles )

Splint are 1st class lever

This wrist splint shows :
FA : force arm
RA : resistance arm
FLA : force line of action
RLA : resistance line of
action

a
longer
forearm
bar
decreases
the
resultant
pressure
transferred
by
proximally weight of the
hand to the anterior forearm