orthotics and prosthetics ug lecture
TRANSCRIPT
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ORTHOTICS & PROSTHETICS
Dr Dhananjaya Sabat MS, DNB, MNAMS
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DEFINITIONS
Orthotics - The science that deals with orthoses designed to provide external control, correction, and support. (orthoses = braces)
Orthosis is an appliance used to support part of a body or perform certain function.
Splint is an appliance used to support / immobilize part of a body.
Caliper is a device which is applied to lower limb to give support or control a joint
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FUNCTION OF ORTHOSES
Prevents deformity Corrects deformity Maintains correction Corrects instability Relieves pain Relieves weight bearing Facilitates ambulation
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General classification
❖ Static orthoses: As the word static implies, these devices do not allow motion. They serve as a rigid support in fractures, inflammatory conditions of tendons and soft tissue, and nerve injuries.
❖ Dynamic/functional orthoses: These devices do permit motion on which its own effectiveness depends. These types of upper extremity orthoses are used primarily to assist movement of weak muscles.
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COMMON SPLINTS & BRACES AND THEIR USES
Name Use
Cramer-wire splint Emergency
immobilization
Thomas splint Fracture femur -anywhere
Bohler-Braun splint Fracture femur -anywhere
Aluminium splint / stack splint/ Frog splint
Immobilization of fingers
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THOMAS SPLINT
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FIXED TRACTION
SLIDINGD TRACTION
PIERSON’S ATTACHMENT
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BOHLER BRAUN SPLINTFOOT DROP
UPPER TIBIAL, DISTAL
FEMORAL
LOWER TIBIAL,
CALCANEAL
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Name Use
Volkmann's splint I Turnbuckle
Volkmann's ischaemic contracture (VIC)
Toe-raising spring For foot drop
Cock-up splint Radial nerve palsy
Kunckle bender splint Ulnar nerve palsy
Aeroplane splint Brachial plexus injury
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Name Use
Von Rosen splint, Pavlik harness
CDH
Dennis Brown / Steenbeck splint
CTEV
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Name Use
Cervical collar Neck immobilization
Philadelphia collar Neck immobilization
Four- post collarSOMI Brace
Cervical spine injury
Halo vest Cervical spine injuryTB cervical spine
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Name Use
Lumbar corset, LS belt Backache
ASHE (Anterior spinal hyper extension) brace ,
Taylor's brace
Dorso-Iumbar spinal injury
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Name Use Milwaukee brace, Boston brace
Scoliosis
Patellar tendon bearing (PTB) brace Fracture both bone leg
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Prosthetics - The science that deals with functional and/or cosmetic restoration for all or part of a missing limb. (prostheses = artificial limb).
Prostheis is an appliance used to replace part of a body ( an amputated / removed part).
Prosthesis can be: Exoprosthesis ( common orthopaedic
prostheses) Endoprostheesis ( Austin Moore prosthesis,
Cardiac valve prosthesis)
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INTERNATIONAL Nomenclature
Common name
AFO KAFO HKAFO THKAFO LSO TLSO CTLSO Surgical shoe
Below knee caliper Above knee caliper
LS belt / corset
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Usual Shoe modifications
Heel Raise Total Raise Arch Support Thomas Heel Reverse C&E
Heel Sole Wedge MT Bar Toe wedge
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Floor Reaction Orthosis
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FootJaipur foot Sach foot
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Type of Lower Limb Stumps
End Bearing stump
Side bearing or Total
Contact
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B.K. Prosthesis
Components Suspension Socket Shank/Shin piece
Ankle and foot Assembly
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Suspension
Flexible A. Supracondylar Cuff
B. Sleeve C. Suction
Brim Contour A.
Supracondylar B. Supra
Pateller Thigh corset consists of
- 2 Metal Bars with knee joints
- Corset- Leather/Plastic
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Socket
Hard socket for ideal B.K. Stump Hard Socket with inner lining Weight Bearing Anteriorly - Lower 3rd of patella
- Ligamentum patellee, tibial tuberosity
Posteriorly - Pop. Fosa
Laterally - Lat. condyle of tibia and head of fibula
Medially - Med.condyle of tibia
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Shank/Shin Piece
Exoskeleton - Plastic resin and wood
Endoskeleton - Metal/PVC tube
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Ankle Foot Assembly
Non Articulated Articulated
Single Axis Multiple Axis
SACH SAFE STEN CARBON COPY II
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Above Knee Prosthesis
Components Suspension Socket Knee Joint Shank/Shin piece Ankle foot assembly
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Suspension
Suction Silesian belt Pelvic belt with hip joint Shoulder suspendor
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Socket
Quadrilateral - Commonly used
Total contact
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Knee Joint Assembly
Conventional single axis knee -
commonly used
Polycentric knee joint
Constant friction knee
Constant friction with friction lock
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Syme Prosthesis Conventional End weight bearing : -
Leather/plastic socket attached to SACH foot
P.T.B. Syme prosthesis : -When heel pad is not sufficient for weight bearing than P.T.B. type Syme prosthesis is given.
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Upper Limb Prosthesis Components
Socket Suspension system Elbow mechanism for A.E. Forearm Wrist Unit Hand Terminal device Power transmission system
Contd..
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Source of Energy Stump Shoulder shrug Shoulder elevation
External Energy Sources Pneumatic Electrical Electronic
Myoelectric prosthesis (BIONIC HAND)
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Ideal Orthosis / ProsthesisFunctionalFits wellLight in weightEasy to useCosmetically acceptableEasily maintained/repairedIdeally locally manufactured