Orfit Blog

Splint in the Spotlight – Ulnar Drift Splint

20 May, 2015 | Tags: , | Categorised in:

 

Splint-in-the-Spotlight

Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Ulnar drift splint

ulnar-drift-splint

Objective of the splint:

This splint design can be used to improve the alignment of strongly deviated fingers, which is in many cases caused by rheumatoid arthritis. An ulnar drift deformity is characterized by ulnar deviation and volar subluxation of the metacarpal phalangeal (MCP) joints. In rheumatoid arthritis, chronic inflammation of the MCP joints and many other contributing factors cause damage to the joint capsule and surrounding ligaments resulting in this deformity. This deformity has functional and esthetical implications and is often accompanied by wrist deviation and other extremity deformities as well. As the ulnar shift must be corrected, it is highly recommendable to use a lever system (see figure below).

drawing 1

In addition, it is also advisable to pull rather than push in order to obtain a comfortable correction, which explains the position of radial bar at the level of the MCP and first phalanx. Therefore it is very important that this part of the splint is moulded correctly (correct position and covering enough surface) and that extra padding (Luxofoam) is provided to prevent overpressure. The piece/bar which covers a small part of the palmar surface must also be shaped and moulded in such a way that it conforms to the anatomy of the distal border of both the thenar and hypothenar musculature. These crucial points contribute to overall patient comfort. Continue reading

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Splint in the Spotlight – Lever Splint System for Hemiplegia

4 May, 2015 | Tags: , | Categorised in:

 

Splint-in-the-Spotlight

Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Lever System for Hemiplegia

Objective of the splint: Prevention of tissue shortening.

1Pathology: Hemiplegia, spastic phase

One of the main problems we face with hemiplegia is tissue contractures. There are several causes, beginning with edema leading up to articular stiffness, and eventually muscle shortening.

The concerns are localized differently during each phase: during the flaccid phase, the concern is geared towards the level of the hand which we very often position flat, for example on a pillow. This is the reason why an orthosis that supports the hand in the intrinsic position can be useful during the night.

During the day, the dorsal wrist cock-up splint could be used to avoid wrist flexion. This design is better than the volar one because it preserves more sensitivity.

In the spastic phase, the concern shifts to the entire upper limb, from the elbow up to the fingers.

This is one of reasons why the Bobath association recommends the arm swinging during walking, eliminating the need of wearing a supportive sling.

A strictly volar orthotic design might not be the best solution in this case, because it can cause friction which could prevent the optimum articular positioning. Furthermore, there are risks of hyper pressure which can cause wounds or bedsores: the maximal amount of tissue compression at the fingertips, without risk of tissue damage, is 50g / cm2.

The lever system is a good solution because it is easier to don and doff the orthosis. Also biomechanically it is more interesting: if you provide a force of 100 grams on the proximal side of the extremity, you obtain approximately 200 grams of force at the distal part of the extremity (as the momentum is influenced by the distance from the center of rotation). In addition, there is no risk of friction on finger length either.

The splint pattern consists of two parts: the first pattern is for splinting the wrist and long fingers and the second one is an additional piece to position the thumb. But most of the time, you may be able to eliminate the additional material to position the thumb.

The thenar muscle is a key spot which can be used to inhibit spasticity as you can obtain excellent results providing pressure on it for example with a Velcro tape. You can stick the Velcro strap in front of the arch of the hand, which is located at the third MCP joint. Afterwards, orientate it toward the MC joint, base of the first metacarpal, as shown in the below picture:

2
As you can see, the loop tape is securely fastened at the internal part of the orthosis. By using a small piece of very sticky thermoplastic (like Orfit Classic Soft 1.6 mm) you can make sure it will stay on permanently. Press it firmly together to prevent it from becoming a local pressure point. As an alternative, you can also use a piece of Orficast, which is thinner than regular splinting materials.

3

4

Product Recommendations

A non-elastic splinting material is highly recommended for this type of anti-spasticity orthoses to avoid fingerprinting. These materials will also stay in place while obtaining the correct position during molding.

Orfit Eco and Orfibrace  are excellent choices. If you choose Orfit Eco Black NS or Orfibrace, you will have to scrape off the NS coating in order to attach the Velcro straps.

You can also use our Orfit Classic stiff precut (in sizes Small, Medium and Large), which eliminates the need to make a pattern. Instructions are provided in our online Educational Corner.

By adding a thumb piece, you will obtain this orthosis:

1

As it is recommended to provide pressure rather than to provide traction, the thumb piece is positioned externally and the Velcro strap will provide pressure on the thenar (first metacarpal) and onto the first and second thumb phalanges.

Try to position the extremity in the intrinsic position as much as possible, but avoid overcorrections as they might cause local pressure points (Zancolli scale).

Wearing protocol:

Typical wearing schedules for this type of orthosis are during the night.

If the patient wears it day and night, the risk of having a hemi-neglect syndrome will increase.

Daytime should be saved  for rehabilitation and mobilization exercises.

Questions?

If you have a question or comment, please post it in the Orfit Splinting & Rehabilitation Group on Facebook, or send an email to welcome@orfit.com.

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Splint in the Spotlight – the Circumferential Wrist Orthosis

14 April, 2015 | Tags: , | Categorised in:

 

 

Splint-in-the-Spotlight

Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Circumferential Wrist Orthosis

Objectives of the Splint: Immobilization of the wrist joint for restriction of motion, pain relief, joint alignment, functional support, and/or positioning for healing.

Circumferential-Wrist-Orthosis

Pathologies

A variety of acute and painful wrist and hand pathologies may require immobilization with a circumferential wrist immobilization orthosis.

Consider patients with the following diagnoses:

  • Acute wrist fractures
  • Acute TFCC ligament injuries
  • Acute arthritic flare-up and inflammation
  • Complex Regional Pain Syndrome (CRPS)
  • Post-operative tendon transfers, arthroplasties, and osteotomies
  • Stiff finger joints requiring dynamic and/or static progressive traction

The circumferential wrist orthosis, enveloping both volar and dorsal surfaces of the forearm, can be extremely rigid and strong, allowing for excellent fracture stabilization, post-operative protection, and extreme support. The therapist can utilize a 1.6mm (1/16)” or 2.0mm (1/12”) thermoplastic material because there is stabilization on both volar and dorsal wrist joints as well as lateral protection. A circumferential splint is typically not as heavy or as bulky as a clam shell design, which includes both a volar designed splint and a dorsal splint placed on top. And it is much easier to don and doff than the clam shell design.

The circumferential design may also help with edema management, providing even compression all around the swollen extremity, along with circumferential strapping, and this can be further enhanced with a compression sleeve worn underneath the orthosis. A circumferential orthosis makes an excellent base for all outrigger attachments, (either on the volar and/ or dorsal side) because it does not migrate distally with force directed on the fingers.

Product Recommendations

Circumferential splints to support the wrist on both volar and dorsal forearm surfaces are typically fabricated from thermoplastic material of 2.0mm, or 2.4mm (1/12” or 3/32”) thickness. This easily provides adequate support for most adults, and creates a lighter weight and more comfortable splint. But 3.2mm or 1/8” thick materials can be used when needed (due to size of extremity, etc).

Continue reading

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April is Occupational Therapy Month!

1 April, 2015 | Tags: | Categorised in:

April Occupational Therapy Month

Orfit Industries celebrates the profession of Occupational Therapy worldwide.

Occupational Therapy Month began in 1980 to correspond with the American Occupational Therapy’s Annual Conference and Expo.

Occupational therapists and occupational therapy assistants help people across all ages participate in the actions and tasks they want and need to do through the therapeutic use of everyday activities. Occupational therapy practitioners provide a customized and individualized approach to the evaluation and intervention process, and help patients with disabilities participate in everyday activities; whether it is helping children in school, assisting patients recover from injuries to regain skills, or even aiding older adults to stay as independent as possible.

When necessary, Occupational therapy practitioners fabricate customized thermoplastic supports and splints that enable body limbs to heal properly, or move independently to allow greater range of motion and function. Orfit Industries provides therapists with a wide selection of thermoplastic materials to choose from. These high quality thermoplastic materials will meet every client’s individual needs.

Together, Orfit Industries and Occupational therapists worldwide are contributing to greater independent functioning for patients of all ages and helping them to live life to its fullest by promoting health, and enabling better living regardless of injury, illness, or disability.

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10 tips to comfortably position and immobilize children or adults with anxieties

26 March, 2015 | | Categorised in:

When positioning and immobilizing a patient for a radiation therapy treatment, anxieties like claustrophobia can occur when the immobilization is performed with a thermoplastic mask. Here are a couple of measures you can take to prevent this from happening and to make the patient feel as comfortable as possible.

10tipstomimmobilize

1) Prepare your patient

Obtaining a good result starts with a good preparation. Your patient needs to know exactly what he or she can expect and why the mask is so important: It will help keep them in the same position each time for each treatment session. You can show them a moulded mask as an example and you can show the different moulding steps on a poster. If they know in detail what will happen, it will be less likely they are frightened. Gaining trust and allowing them to ask questions are crucial steps before applying the mask.

2) Help them relax

Talk them through the mask moulding process by helping them to breathe in a relaxed manner. You have to assure them that they can keep on breathing through their nose even with the mask on their face.

The mask feels like a hot wet towel similar to what you receive during a facial treatment in a spa. This can be given as an example so they feel more at ease and know what to expect.

For some patients it helps to meditate or do relaxation exercises. For inspiration, we recommend this article: http://whatisradiationtherapy.com/simulation-details/

3) The Orfit Open Face Hybrid Mask 

The Orfit Open Face Mask may become the standard in radiotherapy as it leaves most of the face uncovered, thereby reducing the discomfort and high anxiety experienced by claustrophobic (and other) patients undergoing head and neck Radiation Therapy.

Open Face Mask Radiation Oncology

If treating all patients with an Open Face Mask is not yet an option for your Radiation Oncology Department, remember that Orfit Industries offers different versions of almost all masks, leaving either eyes, mouth and/or nose free.

4) Choose the right head support

Orfit has different sizes of head supports available. Choose the one that fits nicely around the patient’s head and neck. If necessary you can use blocks and wedges for additional support. You want to avoid having pressure points at the back of the head or somewhere in the neck.

The more comfortable the patient is feeling, the less he or she will move.

head supports2 Continue reading

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Splint in the Spotlight – the Dorsal Wrist Cock-up Orthosis

18 March, 2015 | | Categorised in:

 

Splint-in-the-Spotlight

Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Dorsal Based Wrist Cock-Up Orthosis

Objectives of the Splint: Immobilization of the wrist joint for restriction of motion, pain relief, joint alignment, functional support, and/ or positioning for healing.

dorsal-wrist-cock-up-splint

Pathologies

Many of the same wrist pathologies treated with a custom fabricated volar based wrist cock-up orthosis can be treated with a dorsal based orthosis as well. The most common pathologies of the wrist that benefit from this orthosis include:

  • Fractures
  • Nerve compressions (Carpal tunnel syndrome)
  • Wrist sprains
  • Post-surgical conditions
  • Spasticity
  • Cerebral palsy

Some distinct advantages of the dorsal design are that it leaves the volar palm free for sensory input, and it acts as a strong lever to help lift a spastic flexed wrist into a more functional and beneficial position. The dorsal design allows for functional activities to be performed easily without interference of the orthosis.

Product Recommendations

The dorsal wrist cock up orthosis should be fabricated from a thermoplastic material that has a moderate to high degree of conformability to ensure a close fit, yet is strong enough to support the desired wrist position. Orfit Industries offers the following thermoplastic materials with high conformability which ensures that they fit comfortably on the dorsal forearm and allow for molding around bony prominences. They are available with perforations or in solid sheets.

Continue reading

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Join the ‘Orfit Patient Immobilization & Positioning Group’ on Facebook

9 March, 2015 | | Categorised in:

Test3

Orfit Industries recently launched the Orfit Patient Immobilization & Positioning Group on Facebook. This group provides a platform for professionals in Radiation Oncology who use Orfit Patient Immobilization and Positioning Solutions.

https://www.facebook.com/groups/Orfit.Radiotherapy/

We invite Radiation Therapists, Physicians, Medical Physicists, Mould Room Technicians, Nurses and selected industrial partners to join the group and stay informed, share ideas, discuss and ask questions about positioning and immobilizing patients who receive radiotherapy treatments. The group will also be a platform where you can learn more about the broad range of solutions that Orfit Industries offers.

We look forward to receiving many contributions to make this an interesting and informative place!

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Splint in the Spotlight – the Volar Wrist Cock-up Orthosis

4 March, 2015 | Tags: , , | Categorised in:

Splint-in-the-Spotlight

Our Orfit blog shares information and instructions in matching our thermoplastic materials to orthotic designs.
Please check back frequently to gain inspiration and ideas in orthotic fabrication for all of your
patient’s needs.

Splint Design:  Volar Based Wrist Cock-Up Orthosis

Objectives of the Splint: Immobilization of the wrist joint for restriction of motion, pain relief, joint alignment, functional support, and/ or positioning for healing.

knipsel

Pathologies

Many pathologies of the wrist are treated with a custom fabricated volar based wrist cock-up orthosis. The most common pathologies of the wrist that benefit from this orthosis include:

  • Fractures
  • Nerve compressions (Carpal tunnel syndrome)
  • Wrist sprains
  • Tendonitis
  • Ganglion cysts
  • Arthritis
  • Post-surgical conditions

Positioning of the wrist varies according to the diagnosis; however, the wrist is usually maintained in either neutral or slight extension. This allows the patient to comfortably perform functional activities with the wrist fully supported and properly positioned.

Product Recommendations

The volar wrist cock-up orthosis should be fabricated from a thermoplastic material that has a high degree of conformability to ensure a close fit.  Orfit Industries offers the following thermoplastic materials with high drape and excellent conformability, perfect for a well-fitting and comfortable volar wrist cock-up splint. They are available with perforations or in solid sheets. Continue reading

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Choosing the most suitable Orfit masks for head and neck

2 March, 2015 | Tags: , | Categorised in:

Orfit Industries has a wide range of thermoplastic immobilization masks, both for head and neck and for extra cranial immobilization. The complete range of masks can be found on the Orfit website.

The below information is a guideline to help you find the most suitable head and neck mask that fits your needs.

various-masks

How to choose the most suitable Orfit masks for head and neck?

Step 1: Which kind of base plate do you have in your department?

  1. Orfit HP base plate: The Orfit HP base plates have slots that accept our L-shaped profiles.
    32110
  2. Push-pin base plate: This base plate is compatible with masks with push-pin profiles.
    32148
  3. S-Type base plate: this base plate accepts the Orfit DUON masks.
    INT-3
  4. U-Frame base plate: This base plate accepts the Orfit UON masks.
    32097

Step 2: Now that you have determined the type of base plate you have in your department,
and the type of profile(s) the mask should have, you can continue your search in a certain mask range: Continue reading

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How to use the Orfit SBRT Solution with a short baseplate: an instructional video

17 February, 2015 | Tags: , , | Categorised in:

The Orfit SBRT (Stereotactic Body Radiation Therapy) Solution allows for the treatment of lung and abdominal tumors while keeping control over the breathing movement of the patient. It provides the stability and reproducibility needed for high dose and high precision treatments.

The SBRT solution comes with a long or a short baseplate. The advantage of the long base plate is that it can be combined with various All-In-One cushions and extra cranial masks. The advantage of the short base plate is that it is easy to handle thanks to its smaller size.

We have two instructional movies available for viewing. One for the SBRT solution with long base plate (watch it here) and one for the SBRT solution with short baseplate. Watch the video below to learn how to use the short base plate in combination with a mechanical pressure system or a pneumatic pressure belt, while combining it with either an AIO arm set-up or a MammoRX Arm set-up.

The mechanical pressure system consists of an arch, a compression plate and a screw that pushes down the compression plate to create the desired abdominal pressure. The pneumatic pressure belt is strapped around the patient’s waist. An inflatable bag is attached to this belt and inflation with a manual pump will create pressure on the abdomen.

Two positioning devices are available for arms and hands. The first one is a cushion and grip poles system, similar to the AIO Breast- and Lungboard. The second one are the MammoRx arm and hand supports.

More information can be found on our website. If you have questions, you may get your local Orfit distributor or ask your question in our Orfit Patient Immobilization & Positioning Group on Facebook!

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