12 Tips and Tricks for Working with Orficast

Popular Orficast questions answered!

Here are the answers to some questions that we get asked all of the time about using Orficast. If you have a tip of your own to share or an additional question, let us know!

How to remove an orthosis made from Orficast?
How to apply Velcro adhesive backed hook and loop straps?
How to know when the product is ready to use?
How to know when the orthosis is ready?
How to finish the edges?
Should I include the DIP joint in a finger orthosis?
Should I include the IP joint of the thumb in a thumb orthosis?
How does the patient wash the Orficast orthosis?
Can the Orficast orthosis get wet in the shower?
Can I reuse the material from an Orficast orthosis to make a new one?
Can I play sports with my orthosis?
Can I accelerate the drying process?

 

 

How to remove an orthosis made from Orficast?

Once you get the Orficast wrapped around the patient’s finger or hand in a circumferential manner, the easiest method for removal is to cut a straight seam using small surgical scissors or plaster cast scissors. Afterwards, you can close the seam with straps.

If you prefer to leave a finger orthosis as a circumferential design, simply slide it off the finger – this will work if there is only a minimal contracture and the knuckles are not enlarged.

In case of a thumb immobilization orthosis you can press and pull proximally with your finger on the thenar eminence to help remove the orthosis.

 

How to apply Velcro adhesive backed hook and loop straps?

The Orficast stays damp for a while, nevertheless you will need to apply straps right away. Using a heat gun, directly on the spot where you want to attach the Velcro adhesive backed hook, to heat up the Orficast until it turns a bit darker in colour and gets sticky. Heat up the glue a bit to activate it and adhere together firmly. Use another small piece of Orficast and heat it up with the heat gun. Apply this as edging around the hook to reinforce the bonding.


An alternative is to use a piece of dry Orficast as an intermediate layer between the Velcro loop or hook and the orthosis. Simply heat the dry Orficast with a heat gun and stick it onto the back of the Velcro. Reheat the orthosis and the dry Orficast and stick together. This way you can prepare several pieces in advance and save time while fabricating.

 

How to know when the product is ready to use?

When you place the Orficast material in water, heated to 149°F or 65°C, it will become activated almost instantly. You do not need to leave it in for very long.

Lift up one edge with the spatula to see how floppy it is. Remove from the water and pat dry 1 to 2 times on a towel, removing the excess water so it doesn’t drip on your patient.

It will not stretch or wrap easily if the water is too cold. You will know after a few practice times.

 

How to know when the orthosis is ready?

Once you have wrapped the Orficast on the patient and placed them in the desired position, the material will start to harden. It stays wet but after one minute, it will be firm enough so that you can remove your supporting hands. Give it another 1 or 2 minutes before removing to trim.  Once again, you will know after a few practice times.

To make sure that the Orficast has hardened sufficiently, gently tap with your fingernail on the surface of the orthosis. If it makes a dry noise, the orthosis is ready for removal.

 

How to finish the edges?

Use a sharp scissors and cut smooth long strokes to make nice edges of the material. You can also heat up and roll the edge or use our soft edging velvet strip for a softer border.

 

Should I include the DIP joint in a finger orthosis?

This depends on the purpose of the orthosis. For PIP joint flexion contractures, it is often desirable to leave the DIP joint free to perform active flexion exercises and stretch the ORL ligament (Oblique retinacular ligament which when tight contributes to the flexion contracture)  Night time orthoses may be more effective with longer lever arms so include the DIP joint. The correct orthosis design will depend on the diagnosis and purpose of the orthosis.

 

Should I include the IP joint of the thumb in a thumb orthosis?

Most orthoses for the thumb are used to offer support and stabilization of the CMC and MP joints and leave the IP joint free for function. You may need to add a hyperextension block if the patient’s thumb sits in IP joint hyper extension, interfering with the ability to pinch.

 

How does the patient wash the Orficast orthosis?

It is not recommended to soak the orthosis in warm soapy water as it will be impossible to remove all of the soap, and this will irritate the skin. Rather, offer the patient a stockinet sleeve to wear underneath and over the orthosis to keep it clean, spot clean with a little warm water and a cloth, or wear under gloves. The black Orficast may hide the dirt more effectively.

If the patient still wants to wash the orthosis use lukewarm water and non-aggressive soap. Wash the orthosis and rinse it in the shower. The waterjets will remove the soap, due to the open-cell structure of Orficast. The orthosis will remain wet for a while.

 

Can the Orficast orthosis get wet in the shower?

An Orficast orthosis will not lose its shape in a shower, but it will remain wet and damp and be uncomfortable. It will eventually dry.

Simply have your patient place a bag over the orthosis when bathing, or remove for this activity.

 

Can I reuse the material from an Orficast orthosis to make a new one?

Although Orficast material has memory and is re-useable to a certain degree, once the orthosis is completely formed either by wrapping or pinching, it is not easy to unwrap or un-pinch it. Small adjustments might be possible by spot heating, but it is desirable to simply make a new orthosis when the old one is no longer fitting well.

 

Can I play sports with my orthosis?

Depending on the pathology an orthosis made out of Orficast can be worn during sports. Due to its open cell structure sweat will be transported to the surface and evaporate, preventing skin irritation. In case of a team sport always check with the referee if you are permitted to wear an orthosis out of a more rigid material. Make sure the edges are nicely finished to prevent irritation or skin laceration. Do not forget to clean the orthosis regularly, maybe even keep one separate only for sport.

You can swim with the orthosis, but the orthosis and Velcro straps will however stay wet for a while.

 

Can I accelerate the drying process?

You can help the drying process by carefully tapping the orthosis dry with a towel. Do not put it in the sun or on a heating device, or use a hair blower on a hot setting or a heat gun to dry. This may cause the orthosis to lose its shape. If available at your facility you can use compressed air or a hair blower on a cool setting to accelerate the evaporation of the water in the orthosis.

 

Co-written by Debby Schwartz, OTD, OTR/L, CHT

Physical Rehabilitation Product and Educational Specialist at Orfit Industries America.

Debby is a hand therapist with over 33 years of clinical experience. She completed her Doctorate of Occupational Therapy at Rocky Mountain University of Health Professions in 2010.

She is also an adjunct professor at the Occupational Therapy department of Touro College in NYC and has written many articles for hand therapy journals, including the ASHT Times and the Journal of Hand Therapy.

Co-written by Björn Le Roy

Physical Rehabilitation Product and Educational Specialist at Orfit Industries.

 

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