O Orficast. Introduction to Orf icast TM. Ella Donnison. Splinting by Promedics.

Transcription

1 Introduction to Orf icast TM Ella Donnison Clinical Specialist (Hand Therapy) Promedics Hand Therapist Pulvertaft Hand Unit Accredited Hand Therapist British Association of Hand Therapists O Orficast Splinting by Promedics twitter.com/promedics facebook.com/promedicsorthopaedic youtube.com/promedicsorthopaedic

2 Introduction to Orficast Reasons for Splinting Definition of a splint: The term splint is used to describe an external device applied to the body that is designed to immobilise or restrain injured tissues, align or correct deformity or improve function Benefits of a Splint - Clinical Reasoning VS POP Positive + Negative - Removable Cost Wound management Skill of therapist There are 3 main types of classifications of splints: Immobilisation Mobilisation Restriction Remouldable / adjustable Lighter than POP Functional splinting Client Centred Pain relief Time Resources available Compliance Immobilisation Mobilisation Restriction Pain relief Protect and position oedematous hand Remodel long-standing, dense, mature scar tissue Elongate soft tissue contractures, adhesions, musculoskeletal tightness Limit motion after tendon injury / repair Limit motion after nerve injury / repair Protect healing structures incl. surgery/grafts Increase passive joint ROM Limit motion after bone-ligament injury / repair Maintain/protect fracture Protect/improve joint alignment Block/transfer power of movement to enhance exercise Reduce tone/contracture of a spastic muscle Realign and/or maintain joint and ligament profile Substitute for weak/absent muscle power Maintain reduction of intra-articular fracture whilst maintain joint mobility Provide resistance for exercise Provide / improve joint stability / alignment Assist in function Maximise function Position of safe immobilisation - POSI/Edinburgh twitter.com/promedics facebook.com/promedicsorthopaedic youtube.com/promedicsorthopaedic

3 O Orficast Splinting by Promedics Splinting Terminology Static splint: Have a firm base and immobilise the joint they cross. Can also have no direct influence on joint mobility and provide protection, stability and support to a body segment. Serial static splint: These are moulded to hold the tissues at their maximum length. As the position improves they can be remoulded to serially increase the stretch. Dynamic splint: Have a static base to which dynamic components can be attached. The patient actively achieves the motion in one direction, whereas the return is accomplished passively by the splint. Static progressive splint: Construction is similar to a dynamic splint, but the mobilising force is non-elastic i.e. string, wire. High time doses of low-load stress adequate to position the shortened tissue at or near the end of its current available length.

4 Introduction to Orficast ORFICAST Thermoplastic Tape ORFICAST Thermoplastic Tape is a low temperature thermoplastic material, with a textile-like feel, used for the fabrication of small immobilisation splints. ORFICAST Thermoplastic Tape is applied directly to the patient after it is activated. Characteristics Thermoplastic knitted textile on a 3-meter roll Comes in different widths, thicknesses and colours Excellent elasticity in two directions Easy to cut Self-adhesive capacity, especially when dry heated Breathable fabric material How it works Material on a roll makes cutting a strip of material for splint fabrication easy and saves time. Easy to make a pattern. A large variety in widths and thicknesses enables you to treat a wide range of clinical applications and to accommodate different splint designs. Orficast More allows, among others, for making a volar or dorsal slab. Allows precise modelling conform to the patient's anatomy, for example the web space. Easily cut small pieces to use as a reinforcement of the splint. Dry heat is helpful for bonding corners and straps. Overlapping seams are not perceptible on the inside. Excellent patient comfort and compliance: lightweight, allows ventilation and prevents maceration of the skin. Colours Available Black Blue twitter.com/promedics facebook.com/promedicsorthopaedic youtube.com/promedicsorthopaedic

5 O Orficast Splinting by Promedics Orficast Range Immobilisation Size Thickness Colour Roll length Orficast Original 3cm 6cm 1.3mm Blue Black 3-meter roll Orficast More 6cm 12cm 15cm 2.6mm Blue Black 3-meter roll Double thickness of original Orficast, enables treatment of wider range of clinical applications i.e. wrist immobilisations Recommended Applications: Perfect for traumatic and orthopaedic conditions which require quick and easy immobilisation splints. Recommended as a first aid product in casting rooms and operating theatres. Serial static splints to regain range of motion. Recommended for paediatrics and clients with fragile skin and/or arthritic conditions. Orficast is ideal for all types of immobilisation finger splints and hand based wrist and thumb splints. Orficast More is ideal for the fabrication of splints that go beyond the wrist: thumb wrist opponens splint, De Quervain splint, radial/ulnar gutter splint and volar wrist cock-up splint. Clinical Applications Include: Finger Thumb Hand Wrist and Thumb Mallet Instability Metacarpal Fracture Dequervains Tuft fracture UCL / RCL Clawing (median and/or ulnar nerve) Radial sided wrist pain Swan neck deformity MCP joint arthrodesis Extensor Tendon injury / repair PIP joint contracture CMC OA Boutonniere Deformity Volar Plate Injury

6 Introduction to Orficast Activation / Heating ORFICAST Thermoplastic Tape is softened by heating at a minimum temperature of 65 C (149 F). Possible activation sources are: water bath, dry heater, heating plate, microwave oven and heat gun. The activation time depends on the heat source and the product size, and varies from 30 seconds to 5 minutes. When using wet heat ensure that excess water is drained off and the material is dried well on a towel. Make sure that the temperature of the activated ORFICAST Thermoplastic Tape will not burn the patient. Orficast Original and Orficast More shrink slightly when heated. twitter.com/promedics facebook.com/promedicsorthopaedic youtube.com/promedicsorthopaedic

7 O Orficast Splinting by Promedics Activation temperature 65ºC Minimum activation time 1 minute Maximum activation time 30 minutes Drying time Max. 10 seconds Moulding time 1 minute Hardening time Min. 5 minutes Tips and Tricks for Working with Orficast ORFICAST Thermoplastic Tape sticks to itself and to all porous surfaces very easily. In case of accidental bonding, keep it activated and gently pull the layers apart. ORFICAST Thermoplastic Tape has a memory. The material can be reactivated and unwrapped if not totally pressed together. This allows you to make small corrections to the splint if necessary. ORFICAST Thermoplastic Tape is not suitable for internal use. It may not be used on open wounds or in the mouth.

8 Introduction to Orficast Storage It is advised to store to ORFICAST Thermoplastic Tape in a dark, cool, dry place at a temperature of min. 10 C (50 F) and max. 30 C (86 F) and in the original packaging. Once removed from the packaging, the left-over material should be stored back in the packaging to avoid biodegradation. Low temperature thermoplastics can only be kept for a limited period of time and must be protected as much as possible from light, heat and humidity. The material ages in relation to storage circumstances. Hygiene and Maintenance It is not recommended to soak the splint in warm soapy water as it will be impossible to remove all of the soap, and this will irritate the skin. To clean the ORFICAST Thermoplastic Tape, use lukewarm running water i.e. under a tap or shower and non-aggressive soap. The waterjets will remove the soap, due to the open-cell structure of Orficast. The splint will remain wet for a while. To dry carefully tap the splint dry with a towel or use a hairdryer on a cool setting. Do not put the entire splint into water as this might cause loss of the shape. How to remove Orficast Once you get the Orficast wrapped around the patient s finger or hand in a circumferential manner, the easiest method for removal is to cut a straight seam using small surgical scissors or plaster cast scissors. If you prefer to leave a finger orthosis as a circumferential design, simply slide it off the finger this will work if there is only a minimal contracture and the knuckles are not enlarged. In case of a thumb immobilisation splint you can press and pull proximally with your finger on the thenar eminence to help remove the orthosis. Applying adhesive backed straps The Orficast stays damp for a while, nevertheless you will need to apply straps right away. Using a heat gun, directly on the spot where you want to attach the adhesive backed fastening, to heat up the Orficast until it turns a bit darker in colour and gets sticky. Heat up the glue a bit to activate it and adhere together firmly. Use another small piece of Orficast and heat it up with the heat gun. Apply this as edging around the hook to reinforce the bonding. Edge finishing Use sharp scissors and cut smooth long strokes to make nice edges of the material. You can also heat up and roll the edge or use our soft edging velvet strip for a softer border. twitter.com/promedics facebook.com/promedicsorthopaedic youtube.com/promedicsorthopaedic

9 Notes

10 Notes

11 Patterns

12 Patterns twitter.com/promedics facebook.com/promedicsorthopaedic youtube.com/promedicsorthopaedic Promedics Orthopaedics Ltd. Port Glasgow Industrial Estate Gareloch Road, Port Glasgow Scotland PA14 5XH Telephone: +44 (0) Sales Fax: +44 (0) General Fax: +44 (0)