Upper Limb Orthotics

Upper limb orthoses are distinct from other orthoses because of the complexity of the human hand. There are many simultaneous joint movements that have to be considered for mobilization or immobilization (e.g. nine IP, five MCP, wrist, forearm, elbow, shoulder) short digital levers (Which translate to high forces, high pressures, and skin intolerance) and little soft tissues padding for bands and other components. Orthotic design for the upper limb must give equal focus to mechanical efficiency and precision of fit because comfort is critical for acceptance.

Upper limb orthoses are most likely to be accepted by patients if there is a well defined therapeutic purpose or if the orthoses provide a desired function that cannot be accomplished by any other means, such as substitute. Because even the best upper limb orthoses lacks mechanical versatility to grasp objects that vary in size, shape and weight with equal ease.
Upper limb orthotic design tends to be optimized for a specific purpose. Combine this mechanical shortcoming with impaired sensation, reduced skin friction, and poor subcutaneous contouring; an individual has to produce greater force than the normal hand just to accomplish routine activities. In addition, an upper limb orthoses is conspicuous and advertise the disability. Despite these limitations, upper limb orthoses can offer appealing advantages for the limb left
impaired by paralysis, deformity and pain.

Upper limb orthoses can be categorized in several ways, such as by pathology (e.g. spinal injury, arthritis, trauma, head injury) arthrosegmentally according to joint encompassed (e.g. shoulder, elbow, wrist hand fingers) or treatment objective(e.g. promote healing, direct growth, prevent deformity, correct deformity, enhance function) Specific orthoses are selected according to the patient physical need. It is helpful to organize upper limb orthoses into groups that reflect need. Therefore, the orthoses reviewed for orthotic management of the patient with upper limb paresis or traumas are grouped into therapeutic and functional categories.


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