Today we want to show how to create a dorsal wrist cock-up orthosis with Orfilight Black NS, completed with an Orfitube outrigger attachment.
The Dorsal Wrist Cock-Up Orthosis immobilizes the wrist joint to allow healing and rest or protection of injured structures. It can be used to help support the wrist in an extended position to allow for functional grasp and release, alleviate pressure on the median nerve while supporting the wrist in neutral or slight flexion, or substitute for weakened or absent wrist extensor muscles. The advantage of the dorsal design is that the sensory surface of the palm is not blocked by thermoplastic material. The dorsal design also provides an excellent base for outrigger attachments as demonstrated in the video:
The outrigger is fabricated using Orfit Industries’ patient pleasing, low profile Dynasyst mobilization system. This mobilization system of Orfitubes and Orfitube adjustors provides an easy to align and easy to adjust outrigger attachment. In this featured video, the Orfitube outrigger passively supports the Metacarpo-phalangeal (MCP) joint in extension while allowing full flexion of the digit.
This type of orthosis is typically prescribed post-operatively for extensor tendon repair or following MCP joint arthroplasties. A recently published systematic review of rehabilitation protocols following extensor tendon repairs (Zones V-VIII) highlights the advantages of dynamic splinting protocols over static splinting protocols for superior patient outcomes. (Sameem et al. A Systematic Review of Rehabilitation Protocols after Surgical Repair of the Extensor Tendons in Zones V- VIII of the Hand. Journal of Hand Therapy. 2011;24:365–73) Additional support for dynamic orthoses following tendon repair is also offered in a recent Level V paper. (Evans. Managing the Injured Tendon: Current Concepts. Journal of Hand Therapy. 2012; 25:173–90).
The Orfitube outriggers can also be used to provide low load prolonged stretch to stiff joints on either the volar and dorsal surfaces of any orthosis to facilitate lengthening of tight capsular structures.
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