Comparison of fixation technologies

Transcription

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2 2 Comparison of fixation technologies

3 Table of contents Unique properties of Chrisofix products Finger and mallet finger splints Metacarpal and thumb ortheses Chrisofix Forte can replace POP and similar fixations Scaphoid orthesis Wrist & thumb orthesis for emergency Metacarpal IV-V ortheses De Quervain orthesis Carpal tunnel syndrome: clinical studies and products Thumb saddle joint osteoarthritis: clinical studies and products Dorsal and volar ortheses Palmar ortheses Elbow ortheses Foot corrector for babies Infusion splints Resting ortheses for lower limb Ankle & Achilles Knee Lower limb Reusable resting shells for hospital use Chest orthesis for fractured ribs Splints for first aid and sport injuries Accessories Exchangeable terry-cloth liners

4 Unique properties of Chrisofix products Chrisofix technology and products have been developed by Dr. K. Bolla, founder of Chrisofix Ltd. (Schaffhausen, Switzerland). The manufacturing of the Chrisofix products was started at Orkrisz Ltd. (Budapest) in Since then, Chrisofix Ltd. has been continuously extending its product range by developing new, patent-protected technologies and products. The main component of the Chrisofix products is a thin, corrugated aluminum core embedded in cotton-laminated foam on the inside and velour-coated polyethylene foam on the outside of the orthotic device. Since 2008 the Chrisofix technology has been extended with the systemic use of the patented Forte straps. The Forte straps made it first possible to develop quickly applicable, POP-like circular stable ortheses without water or heat, i.e. replace plaster or thermoplastic fixation with orthesis. This step extended the advantages resulted by the combination of semi-circular, well adjustable fixation (e.g., plaster of Paris, or thermoplastic materials) and those of the quickly applicable but only segmental stable ortheses. Due to our technology all Chrisofix ortheses ensure semicircular or circular stable quick fixation. they are adjustable and readjustable without water or heat, in seconds. all products are form-keeping and adjustable to the limb at the same time. most of traditional splints/ortheses and custom-made thermoplastic products can be replaced with Chrisofix ortheses. earlier unrealizable therapeutic ideas have become part of daily therapy - chest orthesis for rib fracture - quick interchangeability of an immobilizing night splint to a less restricting one for the daytime some Chrisofix Forte products can be used instead of plaster of Paris on upper limb before or after surgery allowing: - earlier start of controlled physiotherapy - more convenient daily hygiene. 4

5 Finger splints (ortheses) For immobilisation of the finger First aid Fixation of fingers II-V in case of injury, inflammation (e.g. panaritium), degenerative diseases and/or following surgery on the distal and/or middle phalanges and/or on the interphalangeal joints NEW length of splint FIRST AID & SPORT STANDARD BASIC XXXS (children small) 4.3 cm XXS (children large ) 5.5 cm S (small) 6.5 cm L (large) 7.2 cm XL (extra large) 9.7 cm Set of 2 pieces (S+L) The splint is covered with polyethylene outside, and padded with cotton inside. The splint is covered with a film layer outside, and padded with cotton inside. The splint is covered with blue velour outside, and padded with cotton inside. Mallet finger splints (ortheses) For immobilisation of the fingertip First aid Immobilisation for felons or injuries of the fingertip or nail bed Conservative treatment for extensor tendon ruptures or fractures of the distal phalanx Immobilisation following surgery on the DIP joint or on the distal phalanx Rehabilitation after stroke NEW length of splint STANDARD - SIMPLE STANDARD - OVERLAPPING BASIC S (small) 4 cm M (medium) 5 cm L (large) 6 cm The splint is covered with a film layer outside, and padded with cotton inside. The splint is covered with a film layer outside, and padded with cotton inside. The splint is covered with blue velour outside, and padded with cotton inside. 5

6 Metacarpal ortheses For immobilisation of the joints of the fingers II-IV, including the metacarpophalangeal ones First aid, initial treatment Isolated fixation of the basic joint of the fingers II-IV (short version) or combined fixation of all the joints of these fingers including the metacarpophalangeal one in case of injuries, inflammations (e.g. felons), degenerative diseases and following surgery FIRST AID & SPORT INJURIES (short) children <7.5 cm adult 7.5< cm FORTE (long) XXS (children large ) <7 cm S (small) 7-8 cm L (large) 8< cm Thumb ortheses (MCP) For immobilisation of the metacarpophalangeal I. joint First aid Fixation of the metacarpophalangeal joint of the thumb in case of injuries (e.g. strain or sprain), inflammation (e.g. tenosynovitis), degenerative diseases and following surgery FIRST AID & SPORT INJURIES IP joint of the thumb - line of wrist FORTE children <7.5 cm adults 7.5< cm IP joint of the thumb - line of wrist XXS (children large) <7 cm S (small) 7-8 cm M (medium) 8-9 cm L (large) 9< cm Extended thumb orthesis For immobilisation of MCP I. joint, extended to the saddle joint NEW First aid Fixation of the metacarpophalangeal joint of the thumb in case of injuries (e.g. strain or sprain), inflammation (e.g. tenosynovitis), degenerative diseases and following surgery Functional immobilisation of saddle joint FORTE S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm

7 Some POP-like fixations can be replaced with CHRISOFIX Forte ortheses Due to the aluminium containing straps, the Chrisofix Forte products ensure a POP-like stable circular fixation. All these products (some examples are below) can be applied and removed without water or heat in seconds. Consequently, many fixations with plaster of Paris, thermoplastic techniques and similar ones can be replaced with Chrisofix Forte products. Tendonitis, fracture-related temporary fixations, movement-stable osteosyntheses, immobilisation before and after hand surgery, all belong to the indication field of this product family. The use of the Chrisofix Forte products results in substantial advantages, e.g. time saving, sparing on the costs of raw materials, patient s convenience with respect to daily hygiene and earlier start of physiotherapy, etc. 7 Scaphoid orthesis For immobilisation of the carpal bones FORTE S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm Liner is available (page 30.) Wrist & thumb orthesis for emergency For immobilisation of the wrist and the thumb Immobilisation of the carpal region after injuries, especially in case of Scaphoid fracture before and after surgery Initial fixation after wrist injuries and/or following surgery or initial POP fixation in case of extended involvement of tendons. FORTE S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm

8 Short metacarpal IV-V orthesis For immobilisation of the basic (MCP) joints of fingers IV-V Immobilisation of the basic (MCP) joints of fingers IV-V after injuries and following surgery on flexor tendons or osteosynthesis FORTE PIP joint of finger V - line of the wrist S (small) <10.5 cm M (medium) cm L (large) 12< cm Long metacarpal IV-V orthesis For immobilisation of the wrist and the basic (MCP) joints of fingers IV-V Immobilisation of the wrist and the basic (MCP) joints of the fingers IV-V including the metacarpal bones after injuries and following surgery on flexor tendons or osteosynthesis FORTE with liner PIP joint of finger V - line of the wrist S (small) <10.5 cm M (medium) cm L (large) 12< cm The orthesis is delivered with exchangeable liner. Additional liner is available (page 30.) Orthesis for De Quervain Syndrome For De Quervain s tenosynovitis NEW Extended immobilisation of the thumb to the forearm for blocking all possible movements within the synovial sheaths, trough which the tendons of the thumb abductors (extensor pollicis brevis and abductor pollicis longus) pass. FORTE with liner length of thumb S (small) <5.5 cm M (medium) cm L (large) 6.5< cm The orthesis is delivered with exchangeable liner. Additional liner is available (page 30.) 8

9 DAY and NIGHT A CHANCE TO AVOID SURGERY THE QUICK AND SIMPLY EXCHANGEABLE CIRCULAR STABLE FIXATION HAS OPENED UP NEW HORIZONS IN THE THERAPEUTIC FIXATION TECHNIQUES The commercially available splints/ortheses restrict the movement only in one or two directions. Consequently, the efficacy of the fixation with them can be also only limited in syndromes where immobilization would be desirable. In such indications, a circular stable fixation provides a far better efficacy. The quick interchangeability of such night splint to a less movement-restricting one for day time activities is another important benefit of this new permanent splinting treatment. SPLINTING IN CARPAL TUNNEL SYNDROME (CTS) Functional CTS orthesis for daytime activities CTS orthesis for night and rest Remarks to the pathomechanism The immediate cause of carpal tunnel syndrome (CTS) is an increase of the local pressure in the carpal tunnel. Illnesses, genetic and environmental factors (e.g., hormonal diseases, obesity, pregnancy, heavy manual work or work with vibrating tools, etc.) or even their combinations may contribute to the development of the increased pressure. In addition, the movement of the wrist has been shown to be a steady state increasing factor in the regulation of the tunnel pressure (George S. Phalen: 1966). In spite the fact, that improvement in CTS has also been reported after using of wrist splints that only restrict the movement in one or two directions, we claim that significantly more efficient treatment can be provided by the Chrisofix CTS ortheses, which ensure a circular stable fixation like POP. Considering the differences between the requirements of the resting and working splints, two different Chrisofix CTS Wrist Ortheses have been developed for long-lasting (at least for 4-6 weeks) continuous therapy. Interruptions are proposed to limit only for the time of the daily hygiene. The Chrisofix CTS Wrist Orthesis which ensures a virtual immobilization of the wrist in neutral position is proposed for the night or at rest. The Functional CTS orthesis is more comfortable and allows minimal movement in the wrist; it has been developed for painless performing the daily activities. Hygienic aspects are also supporting the regular changing of the two ortheses. Explorative clinical study: During a 4-6 week long exploratory study 23 neurologically confirmed CTS cases were monitored, in which 5 men and 13 women participated (5 of them with bilateral symptoms). Their age ranged between 9

10 23 and 80, the existence of their disease ranged from a few months to several years. The patients should have worn the Chrisofix CTS orthesis for 24 hours if possible, but most of them used it only at night. Therefore, we developed a more comfortable version: the earlier mentioned Functional CTS Orthesis dedicated to daytime use. The limitation of daytime activities and the severity of symptoms were assessed with the help of the Boston questionnaire at the beginning and end of the observation period. The results are presented in a graphic and a table on the next page. A significant improvement was observed in all examined parameters (Wilcoxon-test; p<0.01). The number of patients (n=18), for whom the nigh time rest was undisturbed increased from 1 to 9; for those who characterized their symptoms with less than 10% of the maximum score increased from 2 to 11 (Chix2 test: p<0.01). Due to the small number of patients, the statistical interpretation of these observations is extremely limited. Even thought, the observations clearly support our initial assumption that: a circular orthesis with POP-like stability is more effective in CTS, than the commercially available ones with only segmental stability. Results of the evaluated Boston questionnaires Median (min-max) (0-40) (0-16) (1-21) (0-19) (0-21) (1-22) (0-25) (0-12) (0-4) (0-12) before splinting after splinting 1 = impairment of daily activities 2 = symptoms severity scores total 3 = wake-up related scores (frequency & severity) 4 = pain-related scores (frequency & severity) 5 = paresthesia-related scores (frequency & severity) The algorithm of the recommended treatment scheme Symptoms day & night Splints day & night for 4-6 weeks Improvement Symptom free Worsening Symptoms only night Night splint for 4-6 weeks Symptom free Worsening Improvement Long-time night splint or trial without splinting SURGERY 10

11 Wrist orthesis for Carpal Tunnel Syndrome For immobilisation of the wrist (CTS) Immobilisation of wrist for rest and night in carpal tunnel syndrome Fixation or immobilisation of the wrist after injuries (e.g. distortion), surgery and fixation with plaster of Paris Conservative treatment in tendonitis, inflammation and degenerative diseases of the wrist Rehabilitation phase after fractures and hand surgery FORTE with liner S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm The orthesis is delivered with exchangeable liner. Additional liner is available (page 30.) Functional wrist orthesis for Carpal Tunnel Syndrome Immobilisation of the wrist (CTS) for daily activities Immobilisation of wrist for daily activities in carpal tunnel syndrome Fixation or immobilisation of the wrist after injuries (e.g. distortion), surgery and fixation with plaster of Paris Conservative treatment in tendonitis, inflammation and degenerative diseases of the wrist Rehabilitation phase after hand surgery FORTE S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm Primarily recommended for daytime activities Postoperative (CTS) wrist orthesis For accelerated recovery after carpal surgery NEW After Carpal Tunnel surgery for wound protection FORTE S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm

12 Forte SADDLE JOINT ORTHESES FOR A BETTER LIFE QUALITY Habitual overnight immobilization for painless days without medication Effective immobilization of thumb is the precondition of optimal efficacy

13 THUMB SADDLE JOINT ORTHESES FORTE The osteoarthritis of the thumb is one of the most frequent degenerative joint disorders (3-4 times more frequent by females than males). The prevalence of patients with active symptoms is assumed to be about 10% of the population over 60 years. The leading symptom is pain at base of thumb which occurs by grasping or peak-catching (taking the objects between thumb and index finger, opening a bottle, turning key, etc.). Sudden sharp pain may result in dropping of the grabbed object. In most cases, the symptoms develop gradually. Constant discomfort and symptom-free periods may vary over years. The pain might persist at rest, too and the alteration may result eventually in deformities. The origin of primary osteoarthritis of saddle joint is multi-factorial, i.e., not clearly known. Yet, micro-traumas (overwork/ exhaustion) are generally assumed to participate in the background of thumb saddle joint osteoarthritis. Due to altered statics of the joint and its affected surface/s, the movement of the thumb triggers at least two self-generating process: 1. static alterations cartilages destruction aggravation of static alterations 2. cartilages destruction (in absence of steady state II.) inflammation aggravation of cartilages destruction The central role of movement in assumed mechanism of osteoarthritis (see above) clearly shows the importance of a quickly applicable immobilizing orthosis. The circular stable Chrisofix Forte orthoses fulfil these requirements. Sporadic clinical observations and conclusions of small explorative studies have indicated more detailed investigation/s on habitual overnight immobilization with Chrisofix Forte Wrist & Thumb Orthosis in thumb saddle joint osteoarthritis. Habitual overnight immobilization as single therapy significantly improves the clinical symptoms, functionality of hand and life quality of patients with CMC osteoarthritis (J. Hand Surg. (Eur) 42 Suppl. 1. P:191). 27 patients with thumb osteoarthritis (X-ray: II-III stages) were involved into the study. Spontaneous and provoked pain (VAS) in various situations and the patients' ability to perform functional tests at the start of the study, as well as 3 and 6 weeks later were assessed. In addition, 17 patients reported on life quality-related standardized question (quick DAS) at the start and end of the study, too. The overnight immobilization with Chrisofix Forte orthosis was the only allowed therapy. Methods Pain assessments reported by the patients: night pain, pain at rest, pain during the daily activities Pain assessments in presence of the physician: at pressure and at performing four different functional tests Performing functional tests: thumb adduction, by holding firm a pétanque ball, holding a bottle by the cap, and by twisting off the cap of a bottle 13

14 THUMB SADDLE JOINT ORTHESES FORTE Characteristic examples from the results: Changes (mean of 27 pts) in situation-dependent pain severity (VAS%) during the study Occurance of disturbing pain after awakening (n=27; p<0,0000) Start 1st control morning End of study afternoon none study start 1. control 2. control Patients able/not able to open the bottle (n=27); p<0,00 Number of patients (17) who assesed the severity of life quality disturbing factors based on 10 targeted questions Start of study Life quality End of study Not disturbing Disturbing Strongly disturbing Extremely disturbing <2 >2 >3 >4 study start 1. control 2. control Ongoing follow up investigations 1,5 year after finishing the study (17 pts by the time) Changes (mean of 17 pts) in situation-dependent pain severity (VAS%) during the study Number of patients (12) who assesed the severity of life quality-disturbing factors based on 10 targeted questions Start End of study Follow up Start End of study Follow up Disturbing >2 Extremely disturbing >4 Not disturbing <2 Strongly disturbing >3 All parameters improved significantly (p<0,05) during the observation period. The improvements correlated (p<0,05) with the duration of the treatment period. The effect of habitual overnight immobilization persisted in the follow up period, too. The results strongly suggest to use immobilizing orthoses instead of NSAIDs as primary therapy for thumb osteoarthritis PROPOSED STRATEGY FOR THE FIXATION THERAPY Habitual overnight use of the corresponding Chrisofix Forte Saddle Joint Orthesis Short-term temporary use of the functional orthosis versions if necessary during the day Leaving off NSAIDs 14

15 Saddle joint orthesis For immobilisation of the saddle joint - during the night (resting splint) Immobilisation of the metacarpophalangeal (MCP) and saddle (CMC) joints of the thumb. Especially for saddle (CMC) joint arthrosis, distortions, post-fracture stages of the thumb and following surgery related to this region, even as night splint FORTE S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm Wrist & saddle joint orthesis For immobilisation of the wrist (inc. saddle joint) and basic (MCP) joint of the thumb - during the night (resting splint) Immobilisation of the wrist and metacarpophalangeal (MCP) joint of the thumb. Especially for saddle (CMC) joint arthritis, tenosynovitis, distortions, post-fracture stages of the thumb and following surgery related to these joints and region FORTE with liner S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm The orthesis is delivered with exchangeable liner. Additional liner is available (page 30.) Extended thumb orthesis (Functional saddle joint orthesis) For immobilisation of the MCP I. joint, extended to the saddle joint NEW First aid Fixation of the metacarpophalangeal joint of the thumb in case of injuries (e.g. strain or sprain), inflammation (e.g. tenosynovitis), degenerative diseases and following surgery Functional immobilisation of saddle joint FORTE S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm Functional wrist & saddle joint orthesis For immobilisation of the basic (MCP) and saddle (CMC) joints of the thumb Immobilisation in saddle joint osteoarthritis For distortions, inflammatory states and states following surgery related to this region FORTE with liner S (small) <8 cm M (medium) 8-9 cm L (large) 9< cm The orthesis is delivered with exchangeable liner. Additional liner is available (page 30.) 15

16 Volar wrist ortheses SHELL (Polyethylene/Cotton) For fixation of the wrist First aid and first care: transitory fixation before or just after surgery (specially after surgery for carpal tunnel syndrome) Fixation or immobilisation (Forte version) of the wrist after injuries (e.g. distortion), surgery and fixation with plaster of Paris Conservative treatment in tendonitis, inflammation and degenerative diseases of the wrist, even as resting splints Rehabilitation phase after hand surgery Dorsal wrist ortheses SHELL (Polyethylene/Cotton) XXXS (children small) < 6 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 9< cm SHELL (Blue velour/cotton) SHELL (Blue velour/cotton) In green colour: 70_ BASIC XXXS (children small) < 6 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 9< cm In green colour: 72_ BASIC XXXS (children small) < 6 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 9< cm Liner is available (page 30.) 16

17 Palmar forearm ortheses For immobilisation of the wrist, hand and fingers First aid and first care (transitory fixation before or just after surgery) Combined fixation or immobilisation (Forte version) of the wrist, hand and fingers after injuries (e.g. distortion), surgery and fixation with plaster of Paris Conservative treatment in tendonitis, inflammation and degenerative diseases of the wrist, hand and fingers even as resting splint Rehabilitation phase after hand surgery Adjuvant therapy in Sudeck-dystrophy SHELL (Polyethylene/Cotton) length of hand XXXS (children small) <14.5 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 19< cm SHELL (Blue velour/cotton) length of hand XXXS (children small) <14.5 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 19< cm In green colour: 71_ BASIC length of hand XXXS (children small) <14.5 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 19< cm Liner is available (page 30.) FORTE length of hand XXXS (children small) <14.5 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 19< cm Liner is available (page 30.) 17

18 Palmar forearm ortheses with thumb support For immobilisation of the wrist, hand, fingers and thumb First aid and first care (transitory fixation before or just after surgery) Combined fixation or immobilisation (Forte version) of the wrist, hand, fingers and thumb after injuries (e.g. distortion), surgery and fixation with plaster of Paris Conservative treatment in tendonitis, inflammation and degenerative diseases of the wrist, hand, thumb and fingers even as resting splints Rehabilitation phase after hand surgery Adjuvant therapy in Sudeck-dystrophy SHELL (Polyethylene/Cotton) length of hand XS (extra small) <16.5 cm S (small) cm M (medium) cm L (large) 19< cm SHELL (Blue velour/cotton) length of hand XS (extra small) <16.5 cm S (small) cm M (medium) cm L (large) 19< cm In green colour: : 73_ : 74_ BASIC length of hand XS (extra small) <16.5 cm S (small) cm M (medium) cm L (large) 19< cm Liner is available (page 30.) FORTE length of hand XS (extra small) <16.5 cm S (small) cm M (medium) cm L (large) 19< cm Liner is available (page 30.) 18

19 Palmar ortheses for spastic paresis For immobilisation of the wrist, hand, fingers and thumb Immobilisation of the wrist, hand and fingers before and after phyrsiotherapy of patients with spastic paresis PALMAR ORTHESIS FORTE PLUS length of hand XXXS (children small) <14.5 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 19< cm The extra stability of this orthesis is assured trough the external stiffener bar. Liner is available (page 30.) PALMAR ORTHESIS WITH THUMB SUPPORT FORTE PLUS length of hand XS (extra small) <16.5 cm S (small) cm M (medium) cm L (large) 19< cm The extra stability of this orthesis is assured trough the external stiffener bar. Liner is available (page 30.) 19

20 Elbow orthesis - With adjustable angle of For fixation of the elbow : Fixation of the elbow following injuries and surgery SHELL elbow - finger base BASIC XXXS (children small) <20 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 34< cm _ In green colour 80_ Elbow and wrist orthesis - With adjustable angle of For fixation of the elbow and wrist : Fixation of the elbow and wrist (pronation and supination inhibited) following injuries and surgery SHELL elbow - finger base FORTE XXXS (children small) <20 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 34< cm _ In green colour Basic version - blue Basic version - green Liner is available (page 30.) - 77_ _ Foot corrector for babies For correction of congenital deformities of the foot For correction of congenital deformities of the foot (ped adductus, pes calcaneus, pes supinatus) For ensuring the correction of foot abnormalities after surgery or after the application of a circular plaster cast FORTE with terry-cloth liner length of the foot XXXS (children small) 7.5 cm XXS (children large) 9 cm XS (extra small) 10.5 cm The orthesis is delivered with removable spongy liner. Liner is available (page 31.) REMARKS The very light device does not burden the baby in any way and has an extremely low risk for inducing decubitus. It is easy for professionals to make corrective readjustments and also the parents can easily remove the device for hygienic purposes and reapply it. 20

21 Infusion splints INFUSION SHELL/SPLINTS FOR BABIES length of splint STANDARD SHELL REUSABLE XXXS (children small) 11 cm XXS (children large) 17.5 cm XS (extra small) 22 cm INFUSION SPLINT FOR ADULTS Fixation: with the textile straps delivered with the device. (Polyethylene/ Cotton) Fixation: with optional bandages. (Polyethylene/ Cotton) Fixation: with optional bandages. (Polyethylene/ Polyethylene) length of splint Adults 24.5 cm The splint is covered with polyethylene outside and padded with cotton inside. DIALYSIS SHELL ARTERIAL INFUSION SHELL length & width of splint XXS (children large) 45 cm; 18 cm S (small) 53 cm; 20 cm M (medium) 53 cm; 24 cm The splint is covered with polyethylene outside and padded with cotton inside. length of splint S (small) 33 cm The splint is covered with polyethylene outside and padded with cotton inside. CUBITAL / IV-LINE SHELL length of splint M (medium) 34.5 cm The splint is covered with polyethylene outside and padded with cotton inside. SPLINT FOR RADIAL ARTERY CANNULATION NEW S (small) < 8 cm M (medium) 8 < cm

22 Resting ortheses for ankle & Achilles For fixation of the foot and ankle Short-term fixation of the ankle region (incl. Achilles tendon) and foot following injuries and surgery length of the foot SHELL (Green velour/cotton) BASIC FORTE XXXS (children small) <18 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 27.5< cm In blue colour: 75_ _ Liner is available: - page 31. page 31. Resting ortheses for ankle - Open at the Achilles tendon For fixation of the foot and ankle Short-term fixation of the ankle region and foot following injuries and surgery length of the foot SHELL (Green velour/cotton) BASIC FORTE XXXS (children small) <18 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 27.5< cm In blue colour: 82_ _ Liner is available: - page 31. page

23 Resting orthesis for knee For fixation of the knee Short-term fixation of the region of the knee following injuries and surgery SHELL (Green velour/cotton) length of the splint BASIC XXXS (children small) 36 cm XXS (children large) 43 cm XS (extra small) 50 cm S (small) 56 cm M (medium) 67 cm L (large) 76 cm In blue colour: 76_ length of the splint XXXS (children small) 36 cm XXS (children large) 43 cm XS (extra small) 50 cm S (small) 56 cm M (medium) 67 cm L (large) 76 cm In blue colour: 76_ Liner is available (page 31.) Resting orthesis for lower limb For fixation of the lower limb Short-term fixation of the ankle region (incl. Achilles tendon) and foot following injuries and surgery 23 SHELL length of the foot S (small) < 24.5 cm M (medium) cm L (large) 27.5 < cm In blue colour: 78_

24 Reusable Chrisofix shells (ortheses) For repeated use by several patients! 90% Time Saving at Half the Cost! Time & Raw Material (costs) 100% 100% PLASTER >90% PLASTER >50% Adjustment & readjustment within one minute without water or heat Readjustment directly on the patient Transparent to X-ray The initial care of injured and/or surgically treated extremities often includes a temporary and subsequent repeated splinting or casting. For mainly economic reasons, plaster of Paris is still the most frequently used device for this purpose. The world-wide patented Swiss-Hungarian Chrisofix technology has made it possible to develop a splint line for repeat use in hospitals specialised in limb surgery. Instead of castings, any of these orthotic devices (ankle, knee, elbow and forearm splints) can be used and reused after exchanging the liners similar to the covering sheet on an investigation table. The shells can be washed and even disinfected. The reusable shells are delivered with 5 pcs of terry-cloth liners. Additional liner is available (page 31.) 24

25 Volar wrist shell XXXS (children small) < 6 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 9< cm Dorsal wrist shell XXXS (children small) < 6 cm XXS (children large ) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 9< cm Palmar forearm shell length of hand XXXS (children small) <14.5 cm XXS (children large) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 19< cm Palmar forearm shell with thumb support length of hand XS (extra small) <16.5 cm 73/4* S (small) cm 73/4* M (medium) cm 73/4* L (large) 19< cm 73/4* *73... right, 74...left Elbow shell elbow - finger base XXXS (children small) <20 cm XXS (children large) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 34< cm Foot shell length of foot XXXS (children small) <18 cm XXS (children large) cm XS (extra small) cm S (small) cm M (medium) cm L (large) 27.5< cm Knee shell length of the splint XS (extra small) 43 cm S (small) 57 cm M (medium) 67 cm L (large) 76 cm

26 CHEST ORTHESIS FOR FRACTURED RIBS IMMEDIATE PAIN REDUCTION (p<0.05) IMMEDIATE PAIN REDUCTION accelerated recovery of respiratory function reduced risk of pneumonia shorter hospitalisation breathable and waterproof properties 26

27 Chest orthesis/rib splint For partial fixation of the chest in case of fractured or bruised ribs S (small) cm L (large) cm SUPPLEMENTARY INFORMATION: The rib splint in the small size (S) is intended for fixing of 1-3 ribs. The chest orthesis is recommended to be used for 7-10 days. Reapplication of the same splint is not possible. The splint is waterproof and breathable. It allows showering, with care. CLINICAL STUDY REFERENCES 1. L. Zsiros, Z. Záborszky, et al.: Easy and effective method for the treatment of rib fracture by using Chrisofix -technique. 7th European Trauma Congress, Ljubljana, 2006, Int. Proceeding: A non-randomized, placebo-controlled single-blind multicenter study on 106 hospitalized patients: the Chrisofix treated group of patients was in all assessments older and had more fractured ribs. The results are presented in the graphics below. The pain becomes significantly (p<0,05) reduced immediately after splint application Changes (ml) in the vital capacity (fvc) after admission and splint application (p<0,01) Visual Analog Scale (VAS) h 24 h 48 h 72 h Control Chrisofix (n=18) (n=72) FVC Changes (ml) h 24 h 48 h 72 h Time after Admission Control Chrisofix (n=12) (n=29) 2. T. Mészáros, A. Sárváry et al.: Use of chest Orthesis can significantly shorten the hospitalization of rib fracture patients. 7th European Trauma Congress, Ljubljana, 2006, Int. Proceeding: This report includes clinical studies (a randomized and a subsequently evaluated clinical study) which were evaluated and subjected to a meta-analysis. The cause of hospitalisation of the patients was for 2-7 rib fractures. In the two studies 14 and 26 patients respectively were treated with the splint while 16 patients comprised the control groups in each of the two studies. The splinted patients were hospitalised for on average 2.2 days less than the control group

28 Splints for First aid & Sport Injuries Seven or eight splints in a box Applicable & adjustable in seconds without water or heat Breathable First aid box with chest orthesis REFERENCE NUMBERS children adults First aid box without chest orthesis REFERENCE NUMBERS children adults

29 The splints of the first aid box can be ordered even piece by piece with the following reference numbers Chest orthesis REFERENCE NUMBERS small (S) Finger splint package REFERENCE NUMBERS 1 pc small (S) + 1 pc large (L) Metacarpal splint - short REFERENCE NUMBERS children <7.5 cm adults 7.5 < cm Thumb splint IP-joint of the thumb - line of wrist REFERENCE NUMBERS children <7.5 cm adults 7.5 < cm Volar wrist splint REFERENCE NUMBERS children <7.5 cm adults 7.5< cm First aid wind-up splint REFERENCE NUMBERS wind-up splint 600x110 mm wind-up splint 900x110 mm wind-up leg splint 900x190 mm

30 ACCESSORIES EXCHANGEABLE LINERS (Liners in pack of 2 pcs) Scaphoid orthesis (S) Small (M) Medium (L) Large Long metacarpal IV-V orthesis (S) Small (M) Medium (L) Large De Quervain orthesis (S) Small (M) Medium (L) Large CTS wrist orthesis (S) Small (M) Medium (L) Large Wrist & saddle joint orthesis (S) Small (M) Medium (L) Large Functional wrist & saddle joint orthesis (S) Small (M) Medium (L) Large Volar orthesis (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Dorsal orthesis (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Palmar orthesis (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Palmar orthesis with thumb support (XS) Extra small (S) Small (M) Medium (L) Large Elbow orthesis (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Elbow & wrist orthesis (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large

31 Club foot corrector orthesis for babies (XXXS) Children small (XXS) Children large (XS) Extra small Resting orthesis for ankle & Achilles Resting orthesis for ankle & Achilles open at the Achilles tendon (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Resting orthesis for knee (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Exchangeable liners for reusable shells (Liners in pack of 5 pcs) Reusable volar wrist shell (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large (XXXS) Children small (XXS) Children large (S) Small (M) Medium (L) Large Reusable dorsal wrist shell (XXXS) Children small (XXS) Children large (S) Small (M) Medium (L) Large Reusable palmar forearm shell (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Reusable palmar shell with thumb support (XS) Extra small (S) Small (M) Medium (L) Large Reusable elbow & wrist shell (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Reusable resting shell for ankle & Achilles (XXXS) Children small (XXS) Children large (XS) Extra small (S) Small (M) Medium (L) Large Reusable resting shell for knee (XS) Extra small (S) Small (M) Medium (L) Large

32 Combines the advantages of ortheses and cast-like (e.g. POP) fixations In contrast to the conventional ortheses (segmental fixations), the Chrisofix product range ensures stable semicircular or circular fixation, can be adjusted and readjusted in seconds, can be adjusted directly on to the patient, has opened up new horizons in the usage and benefits of therapeutic splinting, can provide more targeted immobilisation. In contrast to the cast-like fixations, the Chrisofix products cut down the costs, can be adjusted without water or heat in seconds, saving time for the clinical personnel and the patients, can allow more convenient daily hygiene and an earlier start of physiotherapy, can replace most of the thermoplastic fixations, are light and comfortable similarly to the usual ortheses, can repeatedly be adjusted for the same patient, in case of Reusable Shells they can be readjusted and reused by several patients after disinfection and exchange of the liner. Manufacturer: CHRISOFIX AG. CH-8201 Schaffhausen, P.B Tel: ORKRISZ Patented Production (EN ISO 13485:2012): ORKRISZ Kft. H-1239 Budapest, Grassalkovich út Tel.: Fax: