Name of the Procedure:

Wrist-Hand-Finger Orthosis (WHFO) Custom Fabrication

Summary

A Wrist-Hand-Finger Orthosis (WHFO) is a custom-made medical device designed to support, align, or correct deformities in the wrist, hand, and fingers. It includes one or more nontorsion joints, and may feature turnbuckles, elastic bands, or springs to aid in movement and support. This orthosis may also include soft interface materials and straps for comfort and secure fitting.

Purpose

The WHFO is designed to address various medical conditions affecting the wrist, hand, and fingers, such as joint instability, deformities, or injuries. The primary goals are to improve functional use of the hand, prevent further deformity, reduce pain, and facilitate recovery from injury or surgery.

Indications

The WHFO is indicated for patients with:

• Joint instability in the wrist, hand, or fingers
• Deformities due to conditions like arthritis or cerebral palsy
• Injury recovery requiring immobilization or support
• Post-surgical support for proper healing

Preparation

• No special fasting or medication adjustments are typically required.
• Initial assessment and measurements of the wrist, hand, and fingers by a healthcare professional.
• Possible diagnostic imaging (X-rays or MRI) to assess the condition and guide the custom fabrication.

Procedure Description

1. Assessment: A healthcare provider evaluates the patient’s condition and anatomical structure.
2. Measurements: Detailed measurements and molds of the wrist, hand, and fingers to ensure a precise fit.
3. Fabrication: The orthosis is custom-made in a medical lab, incorporating features such as nontorsion joints, turnbuckles, and elastic bands as needed.
4. Fitting: The orthosis is fitted to the patient, with adjustments to ensure comfort and proper functionality.
5. Instructions: The patient is given instructions on how to use the orthosis, including donning, doffing, and daily wear time.

Duration

The fitting and adjustment process typically takes about 1-2 hours. The custom fabrication process may take a few days to a couple of weeks, depending on complexity.

Setting

This procedure is usually performed in an outpatient clinic or a specialized orthotics and prosthetics facility.

Personnel

• Orthotist or prosthetist
• Occupational therapist (optional, for functional training)
• Physician (for initial referral and ongoing care)

Risks and Complications

• Skin irritation or pressure sores
• Improper fit leading to discomfort or ineffective support
• Allergic reaction to materials used

Benefits

• Improved joint stability and alignment
• Pain relief and improved functional use of the hand
• Prevention of further deformity or injury
• Enhanced recovery from injury or surgery

Recovery

• Patients may need to gradually increase wear time to prevent skin irritation.
• Regular follow-up appointments to adjust the orthosis as needed.
• Immediate relief may be felt, but full benefits typically realized over weeks to months depending on the condition.

Alternatives

• Off-the-shelf wrist-hand-finger orthoses
• Physiotherapy and rehabilitation exercises
• Medication for pain and inflammation
• Surgical intervention in severe cases

Patient Experience

Patients might feel initial discomfort as they get used to wearing the orthosis. Pain management strategies, including over-the-counter pain relievers and proper skin care, can enhance comfort. The orthosis may initially feel bulky, but with proper guidance and adjustments, day-to-day functionality is expected to improve gradually.