Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Orthotic Devices—General Principles ++ Uses three-or four-point force system to prevent, assist, or control motion at one or more joints Devices are named for the joints that are encompassed: CTLSO—cervicothoracolumbosacral orthosis HKAFO—hip-knee-ankle-foot orthosis EWHO—elbow-wrist-hand orthosis Devices are typically custom-made, but "off the shelf" options are available All orthotic devices have the potential to cause skin breakdown if not worn or fitted properly; periodic skin checks and education of child and caregiver on proper donning and doffing are required +++ Axial Skeleton Orthotic Examples ++ Table Graphic Jump Location|Download (.pdf)|Print Helmet/Skull Shaping Unique attributes Custom-molded May need adjustments over time Common uses Skull reshaping in plagiocephaly Precautions Best results if started <1 yr old Device worn 23 hr/day Cervical Orthosis Unique attributes Can be of flexible tubular PVC or plastic and foam May be customized Common uses Used either to stabilize cervical spine or to limit movement Head positioning and movement support in torticollis Precautions Not tolerated well by children <4 mo Must be able to move away from flexible collar for torticollis application Spinal Orthoses Unique attributes Design depends on level of control needed Can control motion/position in all three planes Common uses Scoliosis/posture Postsurgical Protection post-injury Precautions Typically worn 23 hr/day Milwaukee brace (CTLSO) Boston brace (TLSO) +++ Lower Limb Orthotic Examples ++ Table Graphic Jump Location|Download (.pdf)|Print Hip Orthosis (HpO)—SWASH Unique attributes Prevents hip adduction and internal rotation Common uses Reduces scissoring gait Reduces hip adduction in sitting Precautions Must be worn outside of clothes Standing-walking-and-sitting hip orthoses (SWASH) Hip Orthoses (HpO) for Hip Dysplasia Unique attributes Maintains legs in flexed, abducted position May be made out of straps only or employ plastic and leather components Common uses Conservative management for hip disorders or dysplasia Prevents hip dislocation Precautions Hygiene Scottish-Rite brace (typically used for Legg-Calvé-Perthes disease) Hip-Knee-Ankle-Foot Orthosis (HKAFO) Unique attributes Controls hip, knee, ankle Allows reciprocal or swing-through gait Common uses Standing and gait support after spinal cord injury and with myelodysplasias Precautions Device weight may challenge mobility Parapodium/standing frame HKAFOs Reciprocating Gait Orthosis (RGO) Unique attributes Type of bilateral HKAFO—controls hip, knee, ankle Prevents double hip flexion ("jackknife") Common uses Reciprocal or swing-through gait after spinal cord injury and with myelodysplasias Precautions Device weight may limit mobility Knee Immobilizer Unique attributes Holds knee in extension or limits ROM Common uses Postsurgical Night splinting Precautions Adequate knee ROM needed Knee-Ankle-Foot Orthosis (KAFO) Unique attributes Various knee joints to allow manual or independent locking/unlocking Ankle positioned in some dorsiflexion can aid hip stability Common uses Stability during standing or gait (knee, ankle, foot) Blocks knee flexion or recurvatum Can be used at night for splinting/stretching Correction of deformity Precautions Weight of device may limit mobility Universal Foot Orthosis (UFO) Unique attributes Adjustable dorsiflexion tension Common uses Provides nighttime dorsiflexion stretch Prevents plantar flexion contractures Precautions Must maintain strap ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.