The main task of any fixer is to immobilize the area of his responsibility. So, with regard to the upper limb, a fixator of the shoulder and forearm, shoulder girdle, wrist joint, hand and fingers can be used here. Clamps are made of various materials, have different stiffness - the degree of limitation of mobility, different degrees of compression.
Depending on the material and the degree of stiffness and compression, they perform different functions. From complete immobilization (immobilization) to partial restriction of movement in the joints. But they all have one thing in common - the creation of conditions for a therapeutic effect.
Varieties of retainers according to the nature of the overlay
Bandages applied to the body, without involving internal structures, are called orthoses. First of all, all orthoses are divided into removable and non-removable.
Fixed are those that are superimposed on the entire duration of treatment, during which there is notheir periodic removal is implied. This group is represented, for example, by the Dezo bandage for an uncomplicated fracture in children, or plaster splints and circular plaster bandages.
The plaster bandage can be replaced with a special plastic that hardens like plaster after application. However, it has greater rigidity, and therefore fewer layers are required, which makes such a bandage much lighter than gypsum. Another advantage of plastic is that it can be wetted, which greatly facilitates hygiene during treatment.
Removable orthoses are worn during the day during exercise or for short-term treatment. So, the shoulder fixator, like any other area, can be represented by a simple scarf bandage, and an elastic orthosis on the shoulder joint, and a complex structure that completely immobilizes the upper limb and the shoulder girdle of the corresponding side.
Types of orthoses according to the degree of rigidity
Soft, made of elastic materials, the retainers are put on the limb segment like a sleeve. They have a closed structure and are equipped with long straps or Velcro fasteners. The purpose of these orthoses is to maintain the upper limb in a physiologically comfortable position (scarf soft shoulder brace) or in a compression-warming effect (elastic shoulder fixator) on the shoulder joint.
Semi-rigid orthoses are made of elastic materials, which usually do not have a heat-saving effect. They have a complex structure and are often equipped with additionalclamps. They are used to immobilize a limb.
Materials from which orthoses are made, used as rigid fixators, use the same as for semi-rigid ones. A distinctive feature is the presence of metal or plastic inserts. They also include complex metal structures with elastic pads that fix the upper limb until complete immobilization.
Indications for use
Indications for the appointment of a fixative are determined by the nature of the disease (injury). Elastic orthoses are used for non-severe bruises of the joints, sprains and injuries of the ligamentous apparatus, inflammatory diseases. They can be used during sports warm-ups to warm up the joint. With a supporting purpose during intensive loads (work) on the limb in general or on the joint in particular.
Semi-rigid fixators are indicated in the treatment of bruised joints, especially in combination with the formation of a large amount of joint fluid or bleeding into the joint (hemarthrosis). They are prescribed for sprains and ruptures of ligaments, muscle sprains. They are used in rehabilitation after reduction of dislocation, operations on the joint. May replace cast for uncomplicated fractures.
Rigid shoulder braces are recommended for complex fractures of the humerus in the upper third. In cases of severe joint injuries (with torn ligaments requiring surgical correction), after joint plasty due to recurrent dislocationheads of the humerus. These orthoses are used for damage or inflammation of the brachial plexus and/or brachial nerve.
Delbe rings
The clavicle, which belongs to the shoulder girdle, requires a certain approach in the treatment of its injuries. In clinical medicine, for fractures of the clavicle that do not require metal osteosynthesis (surgery with fixation with a metal plate), a Deso bandage or plaster bandage is used. At the disposal of modern traumatology there is a shoulder fixator replacing it - Delbe rings.
This is an orthosis with an average degree of fixation, it is a system of inextensible straps connected on the back with the help of blocks. He easily copes with fractures of the clavicle without displacement or with a slight displacement of fragments. At the same time, it is much easier to apply and does not cause the inconvenience of traditional dressings.
Another use of the Delbe ring was found in orthopedics. This is a wonderful tool for correcting posture in the thoracic spine. The installation type of violation, scoliotic or kyphotic posture, is quite easily eliminated when using this orthosis.
Elbow braces
Retainers applied to the forearm and elbow joint, according to their purpose, practically do not differ from retainers applied to the shoulder or shoulder girdle. As well as the shoulder fixator, the elbow orthosis performs a compression and compression-warming function, acts as a joint mobility limiter.
Similar to shoulder, elbow orthosesThey are divided into soft, medium and hard fixation limiters. The difference is that the latter may have a hinged limiter in their design. Its purpose is to limit the range of motion in the joint for flexion and extension with a complete absence of rotation (turn) in the elbow bend.
Selection of retainer
Orthoses are a means of medical (orthopedic) correction of conditions and treatment of diseases. Therefore, they should be used only as prescribed by a doctor! The doctor determines the effect required for treatment and rehabilitation, the stiffness of the fixative and the duration of its use.
The size of the shoulder and elbow joint fixators are selected based on the circumference of the chest for the first case and the circumference of the elbow joint (or shoulder in the lower third and forearm in the upper) for the second. Usually they are labeled S, M, L and XL.
How to put on, take off and how to care
Joint orthoses are in most cases put on and taken off without any difficulty. The lingering straps, locks or Velcro available in their design allow the patient to do this on their own. The exception is the shoulder fixator with the effect of complete immobilization. The presence of additional elements requires outside help. You will also have to help a child or a person with limited physical capabilities.
Materials from which orthoses are made can be sanitized. If the elbow and shoulder brace is equipped with removable metal or plasticelements, they must be removed before washing. Manual processing requires warm water and a chlorine-free detergent. The product is dried naturally, away from heaters or heating.
