Orfit Blog

What to Tell your Patient Regarding Their New Orthosis

29 June, 2015 | Tags: | Categorised in:

Once you have completed fabrication of any custom- made thermoplastic orthosis, it is very important to explain to your patient the purpose of the orthosis and the expected outcomes from wearing it. Whether the orthosis is designed to protect an injured extremity, alleviate pain, or help support a joint for functional activity, the patient should understand why the orthosis is needed and how it can be beneficial. Otherwise, he or she may not be inclined to wear it!

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Many hand therapy and rehabilitation clinics issue a prepared patient hand- out with instructions detailing the orthosis wearing schedule along with precautions and instructions for taking care of the orthosis. Written instructions should include contact information for the clinic just in case the patient needs adjustments on the orthosis or has questions about its use. The instructions should also clearly state when to wear the orthosis, if it is permissible to remove it (for bathing and showers, for example), and the expected duration of wear. The patient might also be asked to sign this document indicating they have received adequate instructions on their new orthosis. A copy of this document can then be placed in the patient’s chart as a record of the intervention.

Orfit Industries has created a document called “Wearing Instructions for Your Orthosis”. Please feel free to use this document for your clinic, or to use it as an example to set up your own document that meets your specific patient’s and/or clinic’s needs.

Suggestions to enhance patient compliance with orthosis wear might include the following ideas:

  • The patient has a good understanding of the purpose of the orthosis, the wearing schedule and the expected duration of wear;
  • The patient has some choice of the color of the thermoplastic materials or the color of the strapping materials;
  • The orthosis fits comfortably and securely on the patient and is easy to take on and off;
  • The orthosis has been personalized or decorated with markers, colored tape, colored scraps of material or fake jewels to give it a special and unique touch!

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Anti-bacterial coating of Orfit thermoplastic masks also resistent against the VRE bacteria

26 June, 2015 | Tags: , | Categorised in:

The Orfit range of thermoplastic masks are known since various years to have an anti-bacterial coating that is resistant against the following bacteria:

  • Escherichia coli
  • Staphylococcus aureus
  • Methicillin Resistant Staphylococcus aureus (MRSA)

We can now also claim that the coating of the masks is resistant against the Vancomycin-Resistant Enterococci (VRE) bacteria. It has been proven with the testing method ISO 22196:2011 that the bacteria can be reduced with more than 99.99% on the thermoplastic material with RT coating.

The VRE bacteria is dangerous because it can resist various forms of antibiotic therapy, including vancomycin.

“Enterococcal infections that result in human disease can be fatal, particularly those caused by strains of vancomycin-resistant enterococci (VRE). During 2004, VRE caused about one of every three infections in hospital intensive-care units, according to the Centers for Disease Control and Prevention.” (source: http://www.niaid.nih.gov/topics/antimicrobialResistance/Examples/vre/Pages/overview.aspx)

VRE is usually spread by the hands of the caregivers. Since they are the ones holding the masks and placing them on the patient, it is a great benefit that the thermoplastic material is resistant against this harmful bacteria.

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FESSH Congress in Milan, Italy (17 – 20 June 2015)

15 June, 2015 | | Categorised in:

 

During the week of June 17-20, Milan, Italy will host the annual meeting of The European Federation of Societies for Hand Therapy along with the European Federation of Surgeons (FESSH).  The EFSHT is a non- profit organization representing over 1800 hand therapists from 20 countries in Europe. The EFSHT was founded in 1989 to create an opportunity for European hand therapists to meet regularly and exchange ideas. The very first Congress of EFSHT was held in 1993, as a Hand Therapist satellite symposium along with the first meeting of FESSH in Brussels, Belgium.

The goals of the EFSHT (as stated on their website) are:

  • To increase the interest in and exchange of knowledge about Hand Therapy.
  • To coordinate activities among the European Societies to promote the exchange and development of knowledge.
  • To share scientific experience and research with colleagues, and also with Hand Surgeons and allied professionals dealing with hand patients.
  • To expand the practice of Hand Therapy so that an increasing number of patients with hand injuries may receive hand rehabilitation.

Orfit Industries is a committed partner and proud contributor to these efforts. Orfit Industries supports the practice of hand therapy world-wide, and offers therapists superior thermoplastic materials to create custom orthoses for their patients. We also offer practical knowledge in the form of splinting workshops for all levels of therapists, an Educational Corner on our website where we share splint designs and instructions, a very active Blog where we feature informative posts and articles on splinting and related topics, and a Facebook Group where you can join a worldwide community of like-minded hand therapists to share ideas and photos of splint designs.

Orfit Industries is delighted to be exhibiting at this gathering in Milan in June and we hope to see you there!  Please visit our booth display #11 and see what is new and innovative from Orfit Industries.  You can count on us to support your efforts to help patients recover from any type of disabling condition.

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029468_FESSH Floorplan (1)

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It’s Hand Therapy Week!

1 June, 2015 | Tags: | Categorised in:

The week of June 1-7, 2015 has been designated as Hand Therapy Awareness Week by the American Society of Hand Therapy to help promote the profession and support the hand therapists who work hard to improve their clients’ daily lives.

Orfit Industries supports the practice of hand therapy and offers therapists superior thermoplastic materials to create orthoses for their clients. We also plan educational programming to enhance clinical expertise in orthotic fabrication through our in-services and variety of beginner, intermediate and advanced splinting workshops.

What is Hand Therapy?

Hand therapy is the art and science of evaluating and treating injuries and conditions of the upper extremity (shoulder, arm, elbow, forearm, wrist and hand). Hand therapy uses a number of therapeutic interventions, including custom orthotic fabrication, to help return a person to their highest level of function.

Orthoses provide support and protection to injured extremities, position for function or against deformity, assist weak or absent muscles, and also can be used to regain range of motion when there are restrictions in movement.

Who Are Hand Therapists?

Hand therapists are licensed or registered occupational therapists or physical therapists who, through advanced study and experience, specialize in treating individuals with conditions affecting the hands and upper extremity.

To obtain the CHT credential, a hand therapist must practice as an OT or PT for a minimum of five years, accumulating at least 4,000 hours of hand and upper extremity experience. Hand therapists must also pass a rigorous certification examination to demonstrate their competency in the practice of hand therapy.

What Can Hand Therapists Do For Their Patients?

Hand therapists help patient after injury and lead them to a successful recovery, allowing the patient to function normally in their daily lives.

Hand therapy evolved from the need for a specialist with the knowledge and experience required to manage the challenging recovery of complex hand and upper extremity injuries.

What can Orfit Industries do for hand therapists?

Check out our online catalog or download our brochure so see our vast array of thermoplastic materials for every client’s condition.

Join our Facebook group to see a variety of orthoses from around the world.

Sign up for a workshop and learn exciting and easy orthotic fabrication techniques to enhance your practice.

Join Orfit Industries as we celebrate the profession of Hand Therapy worldwide!

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Abdominal compression mechanism developed with Orfit products by National Center of Oncology in Azerbaijan

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

Patient-MammoRx

One of Orfit Industries worldwide customers is the National Center of Oncology in Baku, Azerbaijan. They use a wide range of Orfit Immobilization devices during radiation therapy treatments. The NCO team has developed an abdominal compression mechanism by combining various Orfit products.

They position their patients on the MammoRx Breast Board, with the arms lifted above the head. Once the patient is positioned correctly, they make a 2-points Efficast breast mask over the upper abdomen. When the mask has hardened out completely, they place a small vacuum bag underneath the mask. The vacuum bag is placed between the mask and the patient. The combination of the vacuum bag and the mask form an abdominal compression mechanism that restricts the breathing of the patient.

The solution that NCO developed is a good solution for those hospitals that already have a MammoRx Breast Board. For hospitals that don’t, Orfit Industries offers standardized abdominal compression devices as well.

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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:

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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.

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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:

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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.

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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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