Name of the Procedure:

Shoulder Elbow Wrist Hand Orthosis (SEWHO), Abduction Positioning (Airplane Design) with thoracic component and support bar. Commonly referred to as L3973.

Summary

The Shoulder Elbow Wrist Hand Orthosis (SEWHO) is a custom-made device designed to help position the arm and shoulder in the "airplane position," providing support and stabilization after injury or surgery. This orthosis includes a thoracic component and support bar, along with various adjustable elements like elastic bands and turnbuckles, and may feature soft interfaces and straps.

Purpose

The SEWHO is primarily used to address conditions requiring immobilization and support of the shoulder, elbow, wrist, and hand. It aims to:

• Promote proper healing post-surgery or injury.
• Prevent contractures or stiffness.
• Maintain alignment and reduce pain.

Indications

The use of this orthosis is indicated for:

• Post-operative recovery from shoulder, elbow, or wrist surgery.
• Severe shoulder injuries requiring immobilization.
• Conditions like brachial plexus injuries, shoulder dislocations, or fractures.
• Patients needing prolonged limb positioning or support.

Preparation

Patients generally need to:

• Follow specific instructions given by their healthcare provider.
• Stop taking certain medications that may interfere with healing, as directed.
• Undergo necessary diagnostic tests (e.g., X-rays, MRI) to determine the correct fit and type of orthosis.

Procedure Description

1. Assessment and Measurements: The orthotist assesses the patient's specific needs and takes measurements for custom fabrication.
2. Fabrication: The orthosis is custom-made to fit the patient’s anatomy.
3. Fitting: During a fitting session, the orthotist adjusts the device to ensure it fits comfortably and provides proper support.
4. Instruction: The patient and caregiver are given instructions on how to use, adjust, and care for the orthosis.

No anesthesia or sedation is required for this fitting procedure.

Duration

The fitting and adjustment session typically takes about 1-2 hours.

Setting

This procedure is usually performed in a specialized orthotics and prosthetics clinic.

Personnel

• Orthotist or Prosthetist: A specialist who designs, fits, and adjusts the orthosis.
• Physician: May oversee the process and provide medical prescriptions.

Risks and Complications

• Common: Discomfort, skin irritation.
• Rare: Pressure sores, improper fit leading to further injury. Proper instruction and regular follow-ups can help manage these risks.

Benefits

• Stabilizes and positions the arm for optimal healing.
• Reduces pain and risk of further injury.
• Enables gradual movement recovery over time.

Benefits are often realized within a few weeks to months depending on the underlying condition and usage adherence.

Recovery

• Care: Regularly check and adjust the orthosis; clean it as instructed.
• Time: Recovery time varies from weeks to months.
• Restrictions: Follow specific movement or activity restrictions as advised by the healthcare provider.
• Follow-Up: Regular follow-up appointments to adjust and assess the orthosis and healing progress.

Alternatives

• Bracing: Different types of braces depending on the injury or condition.
• Physical Therapy: To improve mobility and strength.
• Surgery: In severe cases where orthosis alone is not effective. Each alternative has its own set of pros and cons based on the patient's condition and lifestyle.

Patient Experience

• During: Mild discomfort during the fitting and adjustment process.
• After: Initial discomfort as the patient gets used to the orthosis; pain management may involve over-the-counter pain medications and comfort measures like padding adjustments. Regular use and following instructions can significantly enhance comfort and efficacy.

Overall, patients can expect a supportive and healing experience that helps in proper recovery and return to daily activities.