Orthotics are assistive devices applied externally to problematic parts of the body. Depending on the material produced or the place of use, they can also take different names such as splints, braces, splints, corsets.
The history of orthoses dates back to ancient times; orthoses dating back to 2700 BC have been found in archaeological excavations. Depending on what the problem is, they are used to protect, restrict or support the relevant part. They are classified in three sections: orthoses for the hand and/or arm (hand/wrist splints, shoulder straps, etc.), orthoses for the foot and/or leg (insoles, knee pads, AFO/ KAFO, etc.), spinal orthoses (waist/neck braces, scoliosis braces).
In which diseases are orthoses used and for what purpose?
Orthoses can be used for different purposes in a wide range of diseases.
Some of them are as follows:
- In musculoskeletal system injuries; to restrict the movement of that area, to accelerate healing
- In congenital musculoskeletal disorders (congenital hip dislocation etc.); to ensure proper development of joints and bones
- In rheumatic diseases; to keep the joint in the appropriate position, reduce joint inflammation and prevent deformity
- In neurological diseases; to support weak muscles, to facilitate fulfillment of function (such as the use of AFO in low standing)
In which cases should personalized orthotics be made?
Orthoses are used in musculoskeletal injuries such as sprains, cracks, fractures, congenital joint disorders, some neurological diseases and scoliosis. For common diseases such as tennis elbow, herniated disc, carpal tunnel syndrome, commercially available, adjustable, ready-made orthoses can be used.
However, in more serious cases such as fractures and neurological diseases, custom-made orthoses should be made according to the needs of the person. In some developmental problems such as scoliosis, orthoses are reviewed periodically and renewed according to measurements.
Which materials are orthoses made of?
Orthosis production and the materials used are changing and developing with technology. It is written in historical sources that orthoses made of wood were used in the time of Hippocrates. While orthoses made of metal and leather were widely used in the past, today, lighter materials such as thermoplastic, which are shaped by heat and easier to use, are preferred. Carbon fiber composite orthoses are likely to be used more in the future, although their high cost and inaccessibility limit their current use. More comfortable, fabric-containing materials are used in orthoses such as waist corsets and knee braces that are used only for support.
How to Select and Prescribe Orthotics?
When choosing an orthosis, the purpose of use should be clearly defined. Accordingly, the material, shape, angle etc. of the orthosis is determined. For example, harder materials may be chosen to restrict the movement of a joint, while lighter materials may be preferred in AFOs used to facilitate walking.
The disease and intended use should be specified when prescribing the orthosis. Features such as the material from which the orthosis will be produced, whether it will be articulated or not, must be written in detail.
What should be considered when using orthosis?
The orthosis should be designed in accordance with the anatomical structure of the area to be used and should not be too big or too small. Especially after the first use, the skin should be checked for redness, irritation, and percussion, and the orthosis should be corrected if any. The orthosis may also need to be redone with growth, weight gain and loss. The orthosis should be kept clean and dry and ventilated frequently to prevent odor.
