A Patient Guide to “Serial Bracing”: Elbow hinge brace for fixed flexion deformity of the elbow

Serial Bracing is used to help improve functional range of motion (ROM) for flexion (bending) of the elbow. Serial bracing is usually carried out over a 6 week period and can be done using a brace or regular weekly changed plaster casts. The advantage of a brace over a cast is it can be removed and then refitted for washing or playing sport, but ideally is worn for as long as possible in a 24 hour period.

1. Unfasten all buckles and straps of the brace.
2. Locate the hinge pivot centre (the circle part) over the lateral humeral epicondyle (outer elbow centre) see step 1.
3. Device length should be adjusted to provide optimal elbow stabilisation - this will be carried out during the first fitting by pushing down the length adjusting grey buttons to unlock and slide telecoping paddle until desired length is achieved. See step 2.
4. Ensure all length adjustment buttons are in locked position
5. To adjust the cuff strap length – begin with the buckle closest to the elbow and secure the blue buckles by fastening and tightening the straps. See step 3. The device struts may be bent to achieve a better fit.
6. While supporting the treating arm, fasten buckle one below the hinge, listening for the “click” sound of it locking in place and tighten the strap adjusting the cuff strap length. See step 4.
7. Pull the white button (set to 120) and black botton (set to 0) on the hinge pivot centre. Unlock blue lock to release the locked positon and stretch the arm into a comfortable poition before only securing the blue lock button. See step 5
8. You may initially feel a tight stretch in your arm which is completely normal. However, if you experience tiggling in your fingers this could indicate that the stretch is too intense. In that case,simpy unlock the device and reduce the stretch to a more compforatable position.