1. Orthotics & Prosthetics
Dr Munir Saadeddin

6. Orthotics = Calipers
Traditionally calipers were the most known form of orthosis
Caliper is a device which is applied to lower limb to give support or control a joint

11. Prevention of Deformity : AFO

12. Prevention of deformity : Drop Wrist In Radial N Palsy
Seen in fractures junction of mid and lower 1/3rd humerus
Radial N palsy makes loss of wrist and MCP joints dorsiflexion
Nerve function recovers with passage of time (if not cut)
Prevention of deformity is important

13. Dynamic wrist splint = Wrist & MCP Joints Orthosis in Radial N Palsy

14. Prevention of Deformity in Brachial plexus Palsy
Brachial Plexus Palsy usually leads to loss of shoulder Abduction and External Rotation
If not treated it leads to Adduction & Internal Rotation deformity (taking a tip position)
Abduction Orthosis is used to prevent this deformity

15. Prevention of Deformity in Brachial Plexus Palsy
Brachial Plexus injury is usually a stretching injury
Shoulder should be splinted in functional position awaiting nerve recovery
Also Active and Passive exercises and electrical nerve stimulation should be done

17. Correction of Deformity : Foot Orthosis= Shoe Raise& Heel Cup
Shoe Raise is a simple orthosis which corrects limb length asymmetry
Heel cups inserted into shoes may prevent development of varus or valgus heel deformity

18. Correction Of Deformity : Spinal orthosis
Are used in deformities in excess of 25 degrees of cob’s angle
Are used in Growing individuals
To be effective they have to be used for 23 hours daily
They have to be used till bone growth cease

19. Spinal Orthosis Many types : Can be Rigid or Semi-Rigid
Most comprehensive form is Milwaukee Brace= Cervico- Dorso - Lumbosacral Orthosis
Boston brace or Jewett brace is a type of rigid Dorso-lumbosacral orthosis

20. Spinal Orthosis = DLS May be concealed under the clothes
Can control deformities or injuries at lumbar spine as well as dorsal spine up to level D6
Can control scoliotic or kyphotic deformities

21. Spinal Orthosis = CDLS
Milwaukee brace

23. Correction of Deformity : Clubfoot

24. Maintenance of Correction of Deformity: Clubfoot Orthosis
Plaster of Paris is a type of Temporary Orthosis following surgical correction of clubfoot
Later it is replaced by backslap foot-ankle orthosis or Dennis brown night boots

25. Maintenance of Correction of Deformity: Dennis-Brown night boots
They are used to maintain correction AT NIGHT following surgical correction and removal of Plaster of Paris
Once the child is walking his body weight will maintain correction

27. Instability control : Knee Orthosis
Knee Orthosis is a knee brace which controls of knee instability following Ligaments injuries like collateral ligaments or cruciate ligaments
They stop lateral instability and control knee movements between certain degrees

28. Weight relief function of Orthosis: e.g. Perth's disease

29. Weight Relief function of Orthosis : Thomas Splint
It is an orthosis which transmits the weight from the ground to Ischial Tuberosity (so weight is relived from affecting the hip
In Perth's disease a similar orthosis has to be used for up to 2 years

30. Weight relief function of Orthosis
Weight relief Foot-Ankle orthosis may be used following comminuted fractures of lower tibia ( Pylon Fractures)
Weight is transmitted from the ground to patellar tendon and upper flare of tibia

31. Pain Relief function of Orthosis
Lumbar corset, Lumbar brace or soft, semi-rigid or rigid Lumbar or Lumbo sacral orthosis is commonly used for acute pain or following injury

32. Pain relief Function of orthosis= Cervical collar or Cervical Orthosis

33. Functions Of orthosis: Facilitates Mobilisation
Paralysed or weak limbs Will be able to support weight bearing if fitted with suitable orthosis
This is very important in cases of Polio or other paralytic disorders

34. Functions of orthosis: Facilitates mobilisation
Paraplegic patients may be able to mobilise if fitted with adequate Orthosis and received the necessary training

35. Functions of Prosthesis
Restores function (Weight Bearing)
Restores Shape ( Cosmetic )

36. Stump Is the part of the limb remaining following amputation
Weight bearing is normally NOT at the end of the stump

37. Stump In Above Knee amputation weight bearing is at Ischial Tuberosity
In Below Knee amputation weight bearing is at Patellar Tendon and upper flare of tibia

38. The Socket The socket is the immediate part the stump has to be placed
It is usually made of plastic material and padded at pressure points
A venting opening is made at the end to ease getting stump in

39. Lower Limb Prosthesis May be Below knee or Above knee
It consists of the socket and the additional part
Picture shows above knee artificial limb ( Above Knee Prosthesis)
Weight bearing is at the Ischial Tuberosity

40. Ideal Orthosis / Prosthesis
Functional
Fits well
Light in weight
Easy to use
Cosmetically acceptable
Easily maintained/repaired
Ideally locally manufactured