A Patient's Guide to Brachial Plexus Injury Orthoses

This Orthosis has been designed to:

• Provide functional and cosmetic elbow and hand positioning

Every new orthosis is individually made to your requirements. The upper limb orthosis is designed to allow positioning of the upper limb joints for support, comfort and function. Improvements in body symmetry and reduction in pain may also be achieved.

The elbow joint can be held in several positions with the use of a lockable joint and the orthosis maybe extended into the hand to maintain a neutral alignment of the wrist.

It may alter the way you balance and move. We expect that this will take you some time to become acclimatised to. While we make every effort to ensure that your orthosis is safe and effective for you to use, you will need to gradually build up the length of time your splint is worn to ensure that it will not cause skin damage.

A close fitting Orthosis sometimes causes mild redness on the skin. Whilst some redness is to be expected, any discomfort, pain or skin marks that do not readily resolve within 20 mins should be reported to your Orthotist.

This Orthosis has been designed to:

• Neutralise Gleno-humeral joint subluxation

This orthosis can be worn in conjunction with the elbow locking orthosis and is designed to reduce any subluxation at the shoulder joint. This may improve body symmetry and reduce the strain on the upper back/neck caused by the weight of the arm.

A mesh, gently elastic silicone tube is fitted to the arm which provides an effective suction force can be achieved to transmit humeral elevation force. Then a simple shoulder harness with leather shoulder yoke is then fitted to the same side shoulder and fastened round the chest. This shoulder harness provides suspension point. When the two items are fastened together the shoulder subluxation is effectively reduced.

This simple orthosis can provide reduction of subluxation in the most direct and effective manner; consequentially resulting in minimal force application. Subluxation reduction is also attained in any arm position therefore allowing for uninhibited upper limb function / positioning.

This orthosis will require assistance to put on in the correct manner.

Any sensation of abnormal movements within the orthosis should be immediately reported to your Orthotist, and checked, to ensure prevention of joint or material failure.

Simply requires the inside surfaces to be wiped daily using a moist cloth, with mild disinfectant and warm water.

Do

• Take a moment to inspect the orthosis before each use – check for sharp edges, loose components or foreign objects on/inside the orthosis which could injure you
• Inspect the skin visually before and after every use, using a mirror if necessary. If you have problems carrying this out due to poor eyesight or mobility ask someone to help you
• Use fabric interfaces e.g. a sock or Tubigrip as directed to help protect you from friction
• Clean your orthosis with warm soapy water and allow it to dry naturally
• Observe good skin care and hygiene measures.

Do not

• Pad your orthosis out yourself as this may actually increase pressure problems

• Heat, glue, bend or otherwise attempt alteration or repairs

• Use strong solvents to clean the orthosis
• Use a heat source to dry the orthosis e.g. radiator or hair dryer as this could damage the device
• Artificially try to harden your skin e.g. by applying alcohol to the skin.

• If any discomfort, pain or skin marks appear that do not readily resolve (in around 20 mins).
• If your weight changes and the device no longer fits

Once you have received the prescribed orthosis and we have reviewed your progress we will likely place you on “Supported Discharge”. In brief, this is when we will continue to refurbish your orthosis but you will not be provided with a new one. Information regarding provision of further orthotic devices will be available on your discharge letter.

Orthotist:

Orthotics Department
Royal National Orthopaedic Hospital
Stanmore
Middlesex
HA7 4LP

Tel: 0208 909 5418