Introduction to

Orthotics & Prosthetics

Dr.Muhammad sulman
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
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
Dynamic wrist splint = Wrist & MCP Joints
Orthosis in Radial N Palsy
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
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
Correction of Deformity :
Foot Orthoses = 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
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
 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
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
Spinal Orthosis = CTLSO
Milwaukee brace
Correction of Deformity : Clubfoot
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
Maintenance of Correction of Deformity

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
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
Weight Relief function of Orthosis
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
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
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
 Pain relief Function of orthosis
Cervical collar or Cervical Orthosis
 Functions Of orthosis
Facilitates Mobilization
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
 Functions of orthosis
Facilitates mobilization
Paraplegic patients
may be able to mobilize
if fitted with adequate
Orthosis and received
the necessary training
Functions of Prosthesis
Restores function (Weight Bearing)
Restores Shape ( Cosmetic )
Stump
Is the part of the limb
remaining following
amputation
Weight bearing is
normally NOT at the end
of the stump
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
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
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
Ideal Orthosis / Prosthesis
Functional
Fits well
Light in weight
Easy to use
Cosmetically acceptable
Easily maintained/repaired
Ideally locally manufactured
THNAKS…