Medical expert of the article
New publications
Orthosis on the hand
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
[Why use an orthesis on the brush?
Orthosis on the wrist reduces local inflammation and pain, ensures the correct position of the wrist and joints of the hand during sleep (prevention of vicious installations and contractures).
Indication: arthritis of the wrist, metacarpal and interphalangeal joints; non-fixed stages of ulnar deviation of fingers of stages I-III according to Zeyfrid; tendonitis and tendosynovitis in the wrist area; carpal tunnel syndrome; stenosing theodosynovitis of the flexor of the fingers ("snapping finger"); lateral epicondylitis.
Contraindication: persistent deformities of articular surfaces.
Preparation is not needed.
Methods and subsequent care
Ortheses on the brush can be either serially or individually manufactured. For individual manufacture various thermoplastic and polymerizing materials are used. As a model, the arm is used in the neutral position: extension in the wrist joint at an angle of 25-30 °, the thumb is diverted, metacarpophalangeal and interphalangeal joints in the flexion position at an angle of 15-20 °. Necessarily eliminate the non-fixed ulnar deviation of the fingers. In an acute period of arthritis, the orthosis on the hand is used constantly, except for the time of exercise therapy. Its goal is to preserve the full volume of the hand movements. In the subacute period, the tutor is used for several hours during the day and at night.
The preventive role of static orthoses on the hand with respect to the progression of ulnar deviation has been studied little. However, in a number of works it has been shown that, at early stages of the disease, nocturnal immobilization reduces the likelihood of ulnar deviation.
Factors affecting efficiency. The use of orthoses on the hand is most effective in the early stages of the disease.
Complications. Long-term continuous immobilization can lead to the development of muscle malnutrition.
Alternative methods. Orthosis on the wrist is often used against a background of local glucocorticoid therapy. If the conservative measures are ineffective, surgical treatment is indicated.
Orthosis on the wrist and the first finger
Inflammatory and destructive changes in I metacarpophalangeal and metacarpal joint, as well as periarticular structures, usually lead to a significant disruption of the function of the hand due to severe pain syndrome and instability of the thumb.
Goal. Reduction of pain, improvement of function and prevention of development of contractures by stabilization of metacarpophalangeal and metacarpal joint.
Indications: defeat of the joints of the 1st finger with rheumatoid arthritis; "Snapping" a finger; De Quervain's disease.
Preparation is not required.
Methods and follow-up care. For arthrosis and arthritis, use a rigid or semi-rigid orthosis on the wrist, which grasps the metacarpophalangeal and metacarpal joint, leaving the wrist-free thumb free.
With De Kerven's disease, a combined orthosis is applied to the hand, immobilizing the metacarpal joint of the big toe in the position of the moderate lead and the wrist band in the position of slight extension and radial deviation. The interphalangeal joint is left free. Mode using alternating with exercise.
Effect. Reducing pain and improving function.
Factors affecting efficiency. The use of fixation devices is effective in the early stages of the disease. There were no significant differences in the effectiveness of their modifications.
Complications are not described.
Alternative methods. In 80-90% of cases, topical application of glucocorticosteroids is effective. If the orthosis on the wrist is ineffective, surgical treatment is indicated.