Orthotic Selection - Nbcot Registered Occupational Therapists Otr

1. Which orthosis is typically used to immobilize the wrist to reduce pain and inflammation in acute wrist tendinitis?

   Wrist cock-up (volar wrist immobilization) orthosis. This orthosis stabilizes the wrist in neutral or slight extension to minimize tendon stress and promote healing during the acute phase of tendinitis.

2. Which orthosis is indicated for cubital tunnel syndrome to reduce ulnar nerve tension during sleep?

   Elbow extension night splint (limits flexion). This orthosis prevents elbow flexion beyond 30 degrees to minimize ulnar nerve compression at the cubital tunnel during nighttime positioning.

3. Which orthosis positions the thumb in palmar abduction to support key pinch with median nerve palsy?

   Opponens (short opponens) orthosis. This orthosis stabilizes the thumb in opposition to compensate for median nerve weakness, enabling lateral pinch without excessive strain on affected structures.

4. Which orthosis is indicated after extensor tendon repair zones V–VIII to protect repair with wrist extension?

   Volar wrist and MCP extension orthosis. This orthosis positions the wrist and MCP joints in extension to minimize tension on repaired extensor tendons in proximal zones during immobilization.

5. Which orthosis is most appropriate to prevent ankle plantarflexion contracture and assist bed positioning?

   Ankle-foot orthosis (AFO) or night resting splint. This orthosis holds the ankle in neutral to counteract plantarflexor tone, preventing contractures and supporting positioning in bed.

6. Which orthosis is used at night to maintain low-load stretch for mild to moderate carpal tunnel syndrome?

   Neutral wrist night splint. This orthosis positions the wrist neutrally to decrease median nerve compression in the carpal tunnel, providing relief during periods of rest.

7. Which orthosis is used to maintain thumb web space and support CMC in early thumb CMC osteoarthritis?

   Thumb spica (hand-based CMC support) orthosis. This orthosis immobilizes the CMC joint to alleviate pain and inflammation in early osteoarthritis while preserving thumb web space for functional use.

8. Which orthosis type is primarily used to apply a constant gentle force for contracture remodeling over time?

   Dynamic orthosis (low-load prolonged stretch). This orthosis type delivers sustained low-force tension to elongate contracted tissues, promoting collagen realignment over extended periods.

9. Which orthosis is indicated after flexor tendon repair to protect the repair while allowing controlled motion?

   Dorsal blocking orthosis. This orthosis limits active extension to protect the repaired flexor tendon during early healing while permitting controlled flexion exercises.

10. Which orthosis is used to protect an unstable thumb UCL injury at the MCP joint (skier's thumb)?

    Thumb spica orthosis immobilizing MCP joint. This orthosis stabilizes the MCP joint to protect the ulnar collateral ligament from valgus stress, allowing controlled healing of the injury.

11. Which orthosis is indicated to block PIP flexion and allow DIP flexion for boutonniere deformity management?

    PIP extension splint (static or dynamic) with DIP free. This orthosis immobilizes the PIP in extension to promote central slip healing while permitting DIP flexion to prevent lateral band tightening.

12. Which orthosis is most appropriate for trigger finger to limit tendon excursion at the affected digit?

    MCP blocking (extension) orthosis. This orthosis restricts MCP extension to decrease flexor tendon gliding under the A1 pulley, alleviating triggering and promoting resolution.

13. Which orthosis is indicated for early-stage Dupuytren disease to maintain extension and slow contracture?

    Night extension orthosis for involved fingers. This orthosis applies low-load extension during rest to counteract fascial thickening and maintain finger extension in early Dupuytren progression.

14. Which orthosis is used to prevent PIP hyperextension and promote PIP flexion in swan neck deformity?

    PIP flexion orthosis (silver ring or figure-of-8). This orthosis blocks PIP hyperextension to correct swan neck alignment, encouraging balanced flexor-extensor forces during functional activities.

15. Identify the best orthosis type to reduce edema and protect healing tissue in the acute inflammatory stage.

    Static immobilization orthosis. This orthosis type restricts motion to minimize stress on inflamed tissues, facilitating edema reduction and tissue protection in acute stages.

16. Which orthosis is used for elbow flexion contracture to provide prolonged low-load stretch?

    Static progressive elbow extension orthosis. This orthosis applies adjustable tension to gradually increase elbow extension, remodeling soft tissues in stable flexion contractures.

17. Which orthosis is indicated for lateral epicondylitis to reduce extensor muscle force at the elbow?

    Counterforce forearm strap (tennis elbow strap). This orthosis applies pressure distal to the lateral epicondyle to offload the extensor tendon origin, reducing pain during gripping activities.

18. Which orthosis is indicated to block DIP flexion for acute mallet finger (terminal extensor tendon injury)?

    DIP extension splint (Stack or custom) worn continuously. This orthosis maintains DIP hyperextension to allow terminal tendon reattachment and healing without disruption from flexion forces.

19. Which orthosis is indicated to prevent MCP hyperextension and assist IP extension in ulnar nerve claw hand?

    Anti-claw (lumbrical bar) orthosis. This orthosis maintains MCP flexion to counteract the claw deformity from ulnar nerve palsy, preventing hyperextension while allowing IP extension for functional grasp.

20. Which orthosis is indicated for radial nerve palsy to assist wrist and MCP extension during functional grasp?

    Dynamic wrist and finger extension assist orthosis. This orthosis uses springs or elastics to facilitate active finger extension, compensating for radial nerve deficits while allowing grasp and release.

21. Which orthosis is indicated for acute scaphoid fracture immobilization including the thumb?

    Long opponens (thumb spica) orthosis. This orthosis immobilizes the wrist and thumb to stabilize the scaphoid bone, promoting union during the acute healing phase of the fracture.

22. Identify the best orthosis type to increase ROM when tissue is stable and can tolerate adjustable stretch.

    Static progressive orthosis. This orthosis type allows incremental adjustments to apply progressive stretch, improving joint mobility in stable tissues ready for remodeling.

23. Which orthosis is typically used to maintain first web space and prevent thumb adduction contracture?

    Thumb web spacer orthosis. This orthosis gently stretches the thumb web to counteract adduction forces, preserving range of motion and preventing contracture development.

24. Which orthosis is most appropriate to prevent hip adduction contracture and aid positioning in SCI?

    Hip abduction wedge or abduction orthosis. This orthosis maintains hip abduction to counteract adductor spasticity in spinal cord injury, preventing contractures and aiding positioning.

25. Which orthosis is used for De Quervain tenosynovitis to immobilize wrist and thumb MCP/CMC?

    Forearm-based thumb spica orthosis. This orthosis restricts thumb and wrist motion to reduce inflammation in the first dorsal compartment tendons associated with De Quervain syndrome.

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