gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Design and Fabrication of a Static Progressive Elbow Extension Orthosis with a Turnbuckle

Meeting Abstract

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  • presenting/speaker Deborah Schwartz - Orfit Industries America, Leonia, United States

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1071

doi: 10.3205/19ifssh1540, urn:nbn:de:0183-19ifssh15406

Published: February 6, 2020

© 2020 Schwartz.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Clinical issue/s: One of the most common complications following injuries to structures of the elbow joint is elbow stiffness and/ or limitations to elbow active and passive extension. Conservative management of this complication is based on the fact that connective tissue is capable of being stretched due to its visco-elastic qualities. While under tension, it can respond by reaching an either elastic or plastic deformation state. Plastic deformation means the tissue will maintain its new length even when the force is removed, leading to a structural change in the tissue itself.

Clinical reasoning: Mobilization orthoses are used to reach plastic deformation of tightened and/ or shortened tissues. Multiple studies support the use of mobilization orthoses (dynamic or static progressive) to treat elbow flexion contractures. Clients are instructed to adjust the tension themselves, maintaining a pain free tolerable end range position. Static progressive orthoses work on the principle of stress relaxation, wherein the displacement is constant and the applied force varies. It is believed that the tissue will reach the plastic deformation state more quickly and the effects will last longer with stress relaxation.

Innovative, analytical or new approach: The static progressive orthosis with a turnbuckle described here is easy to fabricate. Prior to prescribing this orthosis, a functional assessment, active and passive range of motion measures and other relevant outcomes (pain, patient satisfaction) should be evaluated. The effectiveness of the orthoses should be re-assessed at regular intervals. The use of static progressive orthoses is based on providing a prolonged low-load stress on tissue over time to influence new cellular growth.

Contribution to advancing HT practice: Therapists need creative and easy orthotic fabrication techniques to help clients achieve full independence in all activities of daily living. This orthotic intervention is supported by multiple studies; its design offers a quick and easy fabrication method.