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Orthotics > Lab 4: Hip and Special Orthoses > Flashcards

Lab 4: Hip and Special Orthoses Flashcards

1
Q

What orthosis is shown in the image?

A

Post-operative hip orthosis

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2
Q

Describe the optimal fit for a post-op hip orthosis

A

Pelvic band is laterally between the greater trochanter and iliac crests, over the sacrum. Inferior band extends into the gluteal region without interfering with sitting. Thigh cuff just proximal to knee

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3
Q

What motions are controlled with a post-op hip orthosis?

A

Flexion and adduction

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4
Q

Describe the force system to control hip flexion with a post-op hip orthosis

A

Primary: originates posterior at the inferior border of the pelvic girdle on the operative side and is directed anterior

Secondary: originates anterior at the superior portion of the pelvic girdle and is directed posterior

Secondary: originates anterior at the distal thigh cuff and is directed posterior

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5
Q

Describe the force system to control LEFT hip adduction with a post-op hip orthosis

A

Primary: originates on the left area of the pelvic girdle and is directed right

Secondary: originates lateral and superior in the area of the pelvic girdle on the right and is directed left

Secondary: originates on the medial portion thigh cuff on the left and is directed left

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6
Q

What is the purpose of a post-op hip orthosis?

A

Reduce chance of dislocation

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7
Q

What are cons of the post-op hip orthosis?

A

Difficult to don, unacceptable with respect to cosmesis

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8
Q

What orthosis is shown in the image?

A

Pavlik Harness

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9
Q

What is the purpose of a Pavlik harness?

A

Treatment of congenital hip dislocation or development of dysplasia of the hip in young infants

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10
Q

What is the wear schedule for a Pavlik harness?

A

As often as possible for several months until hip stabilizes

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11
Q

What ages is the Pavlik harness appropriate for?

A

Birth - 6 months

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12
Q

What developmental milestone is considered the indication to progress from the Pavlik harness to a different orthosis?

A

Weight bearing in quadruped and supported standing

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13
Q

What orthosis is shown in the image?

A

Ilfeld Splint

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14
Q

When is an Ilfeld splint indicated?

A

Treatment of congenital hip dislocation and developmental dysplasia, but it is more appropriate for a child just prior to and during the early stages of walking

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15
Q

What is the general positioning of the hip and knee with the Pavlik harness and Ilfeld splint?

A

Knee flexion, hip flexion, abduction, and ER

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16
Q

What orthosis is shown in the image?

A

Hip adduction control orthosis

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17
Q

What is the definition of a SWASH orthosis?

A

Standing walking and sitting hip orthosis

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18
Q

Describe the optimal fit for the SWASH orthosis

A

Pelvic band between greater trochanter and iliac crest. Abdominal strap below umbilicus, thigh cuffs 3-4” from groin.

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19
Q

What motions does a SWASH orthosis control?

A

Adduction

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20
Q

Describe the force system that controls adduction of the LEFT hip with a SWASH orthosis

A

Primary: combination of forces originating from the superior and inferior lateral portions of the left thigh band and is directed right

Secondary: originates from the right lateral portion of the pelvic band and is directed left

Secondary: originates from the distal medial portion of the left thigh band and is directed left

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21
Q

What is the purpose of a SWASH orthosis?

A

Restrict hip adduction, minimize imbalance at the hip joint, increase BOS

22
Q

What pt would a SWASH orthosis be indicated for?

A

CP, spina bifida, head injury

23
Q

What is a con of the SWASH orthosis?

A

Does not include distal components that may be necessary to improve function with optimal alignment

24
Q

What orthosis is shown in the image?

A

Twister

25
Q

When is a twister indicated?

A

Spastic CP to control excessive adduction and IR

26
Q

Describe how a twister functions

A

Cabling system biases the child towards ER and abduction during ambulation. Steel cables are anchored to the pelvic band and AFO

27
Q

What is a negative biomechanical consequence of wearing a twister?

A

Increased stress on the knee through the tibia

28
Q

What orthosis is shown in the picture?

A

Scottish Rite Orthosis

29
Q

When is a Scottish Rite Orthosis indicated?

A

Legg-Calve-Perthes

30
Q

What motions are controlled and allowed with a Scottish Rite Orthosis?

A

Hip held at 45 degrees of abduction, allows for full mobility of knee and ankle

31
Q

What orthosis is shown in the image?

A

Denis Browne Splint

32
Q

When would a Denis Browne Splint be prescribed?

A

Children with a flexible foot deformity such as clubfoot, valgus, varus, abnormal tibia torsion

33
Q

What is a negative biomechanical consequence of the Denis Browne Splint?

A

Increased stress on the knee and questionable management of the foot and ankle

34
Q

What device is shown in the image?

A

Parapodium

35
Q

Where should the foam knee block sit on a parapodium?

A

Just inferior to the knee joint

36
Q

What is the purpose of a parapodium, and what patients is it indicated for?

A

Spina bifida. Allows them to being weight bearing through LE with good alignment

37
Q

What orthosis is shown in image?

A

Metal HKAFO

38
Q

When would a HKAFO be indicated?

A

Poor hip, knee, and ankle control when standing is required

39
Q

What conditions would an HKAFO be prescribed for?

A

Spina bifida, CP, SCI

40
Q

What are the disadvantages to an HKAFO?

A

Heavy, restrictive, ambulation requires excessive amounts of energy so it limits function

41
Q

What orthosis is shown in the image?

A

Reciprocating gait orthosis

42
Q

What is the purpose of a reciprocating gait orthosis?

A

Provides opportunity for a reciprocal gait pattern in individuals with little to no active hip flexion

43
Q

Describe how a pt uses a reciprocating gait orthosis

A

Lateral weight shift through use of UE and upper trunk

44
Q

What patients would be appropriate for a reciprocating gait orthosis?

A

Older children with spina bifida who have mastered standing and ambulating with a parapodium. SCI

45
Q

What is the purpose of cranial shaping orthoses?

A

Gently correct the shape of a babies skull over time

46
Q

When is a cranial shaping orthosis indicated?

A

Moderate to severe cranial asymmetry due to intrauterine constraint or extrauterine compression due to sleeping positions, time in swings, car seats, torticollis

47
Q

What time frame is appropriate to use a cranial shaping orthosis?

A

Prior to hardening of fontanels, which fuse by 12 months. Research supports the orthosis being introduced before 6 months

48
Q

What deformity is present in the image?

A

Plagiocephaly

49
Q

What deformity is present in the image?

A

Brachycephaly

50
Q

What deformity is present in the image?

A

Brachycephaly with Plagiocephaly

51
Q

How do cranial helmets work?

A

Gentle, persistent pressure applied to inhibit growth in prominent areas and allowing growth in flattened regions

52
Q

What is the wear schedule for cranial shaping orthoses?

A

23 hours per day for several months or until optimal symmetry is achieved. Research indicated that it will take significantly less time if initiated prior to 6 months

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