Responses to Elbow Stretching Orthosis

Responses to Elbow Stretching Orthosis

Chris Phillips

9/8/2005

Thank you all for the great responses to my inquiry. Cudo's to the List
serve for bringing together so many knowledgeable folks!

These are most of the responses with some duplicates removed:

I have found the Neuroflex elbow orthoses to work well in ranging
flexion contractures. They can be used long term(12-16 hours), versus
the half hour treatments from others. The design is simple for
caregivers. They don't appear as impressive as the others at first, but
work better in the long run.

NeuroFlex Orthotics are static orthotics with dynamic properties. By
setting the elbow hinges with 5 to 15 degrees of additional extension
beyong the comfortable end range of stretch, the brace will stretch the
contracture with continued use. They are billed w/ L codes as single
patient use only braces, not a capped rental like a dynamic orthotic.
They are designed to reverse a contracture and provide Low Load
Prolonged Stretch (LLPS) therapy. The braces are not spring loaded like
a dynamic brace, but manufactured with flexible components that will
flex into the contracture to provide the LLPS. NeuroFlex braces are
also unique in that they are patented to provide unique tension
characteristics that will not feed into tone if the patient has
spasticity.

We use custom made plastic elbow orthoses with metal free motion elbow
joints and heavy duty static progressive turnbuckles for the end range
extension.

I often get this request for nursing home patients who
don't have good insurance and I have used the elbow
extension splints from RCAI. They are not dynamic
spring loaded ones like dynasplint or ultraflex but
work similarly to serial casting. They hold the elbow
in as much extension as possible with just a little
stretch, and as they loosen up, the brace is
tightened. Look in the RCAI catalogs.

You can make one using a turnbuckle. I believe this is available from a

manufacturer as well but don't have the info today.

Ortho Europe Has a set of Worm Gear Variable Static Joints. They are
very nice but very expensive.

I make a single upright elbow Orthosis you are inquiring about; I use
one OTS Step Lock Joint Laterally. The trim lines of the orthosis are
such that it requires no straps and seems to be relatively simple for
the wearer to donn independently.

Anatomical Concepts Inc. has the EMO (Elbow Management Orthosis) that
incorporates a dorsal adjustable hinge that can be set to whatever the
patient's end range is after passive stretching. This is not a constant
stretching orthosis, but offers great stability for the elbow and is
quite cost-effective for you and your patient. For more information
call (800) 837-3888.

Anatomical Concepts Inc. has the EMO (Elbow Management Orthosis) that
incorporates a dorsal adjustable hinge that can be set to whatever the
patient's end range is after passive stretching. This is not a constant
stretching orthosis, but offers great stability for the elbow and is
quite cost-effective for you and your patient. For more information
call (800) 837-3888.

The Ambroise wrist orthosis may be doing just what you need, and I think
there is an extending version of the Wilmer elbow orthosis as well. More
can be found on the Steeper website:
<URL Redacted>

Check out ortho innovations,works well for me

I typically use the Ultraflex EO because I like dynamic, but if this is
out of the question, then I recommend using the Monodos static
progressive. Just be sure on any design you choose to use anterior
instead of posterior shells and also a padded strap right over the elbow
for a nice three point pressure system.

Richard Miller, CO of Prosthetic Labs of Rochester in Minnesota has an
orthosis specifically for your application. They developed the Ox at the
Mayo Clinic. It is a nice off-the-shelf design that offers progressive
adjustable reduction. I am not sure who is distributing their product,
but I do know you can buy direct @ (507) 281-5250.

I have had great success with a turnbuckle system for elbow flexion
contractures. It is simple and easy to fabricate. The parts can be
obtained at the local hardware store. If you don't want to fabricate it
yourself, Becker Oregon makes them out of thermoplastic or laminate.



Christopher Phillips, CO

NCOPE Resident Prosthetist

New England Brace Co.
One Hampton Rd Ste 204
Exeter, NH 03833

(603) 772-2388
(603) 775-7120 fax

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