Name of the Procedure:

• Common Name: Custom-Fabricated Dynamic Flexor Hinge Wrist-Hand-Finger Orthosis
• Medical Term: L3900 Wrist Hand Finger Orthosis, Dynamic Flexor Hinge, Reciprocal Wrist Extension/Flexion, Finger Flexion/Extension, Wrist or Finger Driven, Custom Fabricated

Summary

A custom-fabricated dynamic flexor hinge orthosis is a specialized device designed to support and enhance the functional movement of the wrist, hand, and fingers. It allows for reciprocal wrist extension and flexion along with finger movements, aiding in rehabilitation and improved mobility for patients with upper limb impairments.

Purpose

• Medical Conditions: This orthosis is primarily used for patients with conditions such as stroke, spinal cord injury, cerebral palsy, or other neuromuscular disorders that result in weakened or dysfunctional wrist and finger movements.
• Goals: The primary aims are to enhance functional hand use, improve mobility, support joint alignment, and prevent deformities.

Indications

• Symptoms: Limited wrist and finger movements, muscle weakness, spasticity, and impaired hand function.
• Patient Criteria: Suitable for patients needing mechanical assistance to achieve reciprocal wrist and finger movements. Candidates usually undergo an assessment by a specialist to determine their eligibility.

Preparation

• Pre-Procedure Instructions: Patients may need to undergo a thorough physical and neurological examination.
• Diagnostic Tests: Range of motion assessments, muscle strength testing, and possibly imaging studies to understand the extent of the impairment.

Procedure Description

1. Assessment: Detailed assessment of the patient's hand and wrist function by an orthotist.
2. Casting: Moulds of the patient's wrist, hand, and fingers are taken to ensure a custom fit.
3. Fabrication: The orthosis is custom-fabricated using high-quality, lightweight materials.
4. Fitting: The patient is fitted with the orthosis and adjustments are made for comfort and functionality.
5. Training: The patient is trained on how to use the orthosis effectively.

• Tools and Equipment: Custom molding materials, dynamic flexor hinge components, and specialized fabrication tools.
• Anesthesia: Generally, no anesthesia or sedation is needed.

Duration

• The entire process, from initial assessment to final fitting, can span several weeks.

Setting

• Typically performed in an orthotics and prosthetics clinic or a specialized rehabilitation center.

Personnel

• Orthotists, occupational therapists, and rehabilitation specialists.

Risks and Complications

• Common: Discomfort or minor skin irritation during initial use.
• Rare: Severe skin breakdown, improper joint alignment if not fitted correctly. Any issues are usually manageable with adjustments.

Benefits

• Expected Benefits: Improved functional use of the hand, increased independence in daily activities, and prevention of deformities.
• Realization: Benefits are typically observed within weeks to months with regular use.

Recovery

• Post-Procedure Care: Regular follow-up appointments for adjustments and monitoring.
• Expected Recovery Time: No significant recovery time needed; gradual improvement in functionality expected.
• Restrictions: Patients may be advised on initial limited wear times to acclimate to the orthosis.

Alternatives

• Other Options: Static orthoses, physical therapy, surgical interventions.
• Pros and Cons: Static orthoses do not offer active movement assistance; physical therapy may not provide the same structural support; surgical options carry higher risks.

Patient Experience

• During Procedure: Little to no discomfort during the fitting process.
• After Procedure: Initial period of adjustment, potential for mild discomfort that typically resolves. Pain management focused on ensuring comfort via proper fitting and gradual increased wear time. Comfort measures include padded lining and customizable fit adjustments.