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Hand orthosis
Last reviewed: 03.07.2025
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[ What is a hand orthosis used for?
A hand orthosis reduces local inflammation and pain, ensures the correct position of the wrist and hand joints during sleep (prevention of malpositions and contractures).
Indications: arthritis of the wrist, metacarpophalangeal and interphalangeal joints; non-fixed stages of ulnar deviation of the fingers of stages I-III according to Seyfried; tendinitis and tenosynovitis in the wrist area; carpal tunnel syndrome; stenosing tenosynovitis of the flexor muscles of the fingers ("snapping finger"); lateral epicondylitis.
Contraindication: persistent deformations of the articular surfaces.
No preparation required.
Methodology and aftercare
Wrist orthoses can be either mass-produced or custom-made. For custom-made orthoses, various thermoplastic and polymerizable materials are used. The model is a hand in a neutral position: extension at the wrist at an angle of 25-30°, the thumb is abducted, the metacarpophalangeal and interphalangeal joints are flexed at an angle of 15-20°. Unfixed ulnar deviation of the fingers is necessarily eliminated. In the acute period of arthritis, the wrist orthosis is used constantly, except for the time of therapeutic exercise. Its purpose is to maintain the full range of hand movements. In the subacute period, the tutor is used for several hours during the day and at night.
The preventive role of static hand orthoses in relation to the progression of ulnar deviation has been little studied. However, a number of studies have shown that at early stages of the disease, night immobilization reduces the likelihood of ulnar deviation.
Factors Affecting Efficiency: The use of hand orthoses is most effective in the early stages of the disease.
Complications: Long-term continuous immobilization can lead to the development of muscle wasting.
Alternative methods. A hand orthosis is often used in combination with local glucocorticoid therapy. If conservative measures are ineffective, surgical treatment is indicated.
Orthosis for the hand and first finger
Inflammatory and destructive changes in the first metacarpophalangeal and metacarpophalangeal joints, as well as periarticular structures, usually lead to significant impairment of hand function due to severe pain syndrome and instability of the thumb.
Objective: To reduce pain, improve function and prevent the development of contractures by stabilizing the first metacarpophalangeal and carpometacarpal joints.
Indications: damage to the joints of the first finger in rheumatoid arthritis; "snapping" finger; De Quervain's disease.
No preparation required.
Methodology and subsequent care. In case of arthrosis and arthritis, a rigid or semi-rigid orthosis is used on the hand, covering the first metacarpophalangeal and metacarpophalangeal joints, leaving the radiocarpal thumb free.
In De Quervain's disease, a combined orthosis is used on the hand, immobilizing the metacarpophalangeal joint of the thumb in a position of moderate abduction and the wrist in a position of slight extension and radial deviation. The interphalangeal joint is left free. The mode of use alternates with the performance of exercises.
Effect: Reduced pain and improved function.
Factors affecting efficiency. The use of fixing devices is effective in the early stages of the disease. No reliable differences in the efficiency of their modifications have been identified.
Complications are not described.
Alternative methods. In 80-90% of cases, local application of glucocorticosteroids is effective. If the hand orthosis is ineffective, surgical treatment is indicated.