Choosing the Right Orthopedic Immobilization

Aircast ankle splint

There is no really clearly defined classification to differentiate splints from orthoses and support sleeves. The difference between these three types of orthopedic immobilization depends on the degree of immobilization of the limb or joint in question.

• Splints are firm and rigid. They enable total immobilization of the limb or joint.
• Orthoses provide moderate stabilization. They allow a certain degree of mobility in order to be able to work the limb or joint.
• Orthopedic bandages and sleeves provide light support and elastic restraint rather than true stabilization.

Thuasne clavicle orthosis

When choosing a type of immobilization, there are several important factors to consider, including:

• The severity of the injury
• The type of injury or pathology involved (fracture, ligament tear, osteoarthritis, congenital deformity, etc.)
• The use of orthopedic immobilization (for sports or at home)
• The size of the limb or joint to be immobilized

There are several precautions to take when using orthopedic immobilization. Here are the main ones:

• It’s best to seek advice from a healthcare professional (i.e. general practitioner, physiotherapist) when choosing an orthopedic immobilization, if the choice is left to the patient.
• Even if the pain is moderate, it is necessary to respect the prescribed duration of the orthopedic immobilization.
• It is advisable to wait for the approval of a healthcare professional before resuming any sustained sports activity involving the immobilized joint or limb.

Pavis knee orthosis with patellar stabilization

A knee orthosis, more commonly known as a knee brace, has several features. It can be:

• Open: these offer better comfort and aeration of the skin
•  Articulated and ROM (Range of Motion): these help guide the movement of the joint. Some orthoses have a ROM system that allows you to adjust the range of motion of the knee.
•  With patellar support: these protect the patella from potential shocks.
•  With patellar stabilization: patellar stabilization limits the movement of the patella during knee flexion and extension.
•  With ligament stabilization: knee orthoses with ligament stabilization offer the advantage of limiting certain knee movements that require particular ligaments, such as the cruciate ligaments, the lateral ligament, etc.

We can distinguish three main types of finger splints: stabilization splints, flexion splints and extension splints. For each type, there are several specific splints.

• Stabilization splints: these prevent the movement of part or all of one or more fingers. They can be placed on a single finger, or they can start at the wrist and stabilize several fingers. It is also possible to immobilize the phalanx of a single finger with this type of splint. We distinguish between:
  • Mallet splints: these are mainly used to limit the flexion of the last phalanx of a finger (the one closest to the nail).
  • Cot splints: these can limit the flexion of the whole finger.
  • Baseball splints: these allow the immobilization of the proximal or distal interphalangeal joints.
  • Frog splints: these are mainly used to stabilize and align the interphalangeal joints following a ligament injury.
  • Four-spindle splints
  • One or two prong splints
• Extension splints: these dynamic splints allow the recovery of joint amplitude, often following the stiffening or tearing of tendons.
• Flexion splints: these dynamic splints are used to rework the flexion of one or more fingers. The finger is generally kept bent by the splint.

Optec USA thoraco-lumbo-sacral support corset

The following is a series of special features specific to certain splints and orthoses:

• Orthoses or splints with dynamic response: this is the case with many AFOs (ankle-foot orthoses).
• Articulated orthoses or splints and ROM
• Orthoses or splints specifically for children or for adults
• Braces for abduction of certain limbs: some shoulder braces have abduction cushions.
• Multi-joint orthoses: these are often used in cases of deformities. They include:
  • AFO (ankle-foot orthosis)
  • KAFO(knee-ankle-foot orthosis)
  • HKAFO (hip-knee-ankle-foot orthosis)
• Orthoses for one or more groups of vertebrae:
  • SIO (sacroiliac orthosis)
  • LSO (lumbo-sacral orthosis)
  • TLSO (thoraco-lumbo-sacral orthosis)
  • CTLSO (cervico-thoraco-lumbo-sacral orthosis)