Shoulder and forearm restraint. Shoulder Holders

The main task of any fixator is to immobilize the area of his responsibility. So, as for the upper limb, the shoulder and forearm retainer, shoulder girdle, wrist joint, hand and fingers can be applied here. Fixators are made of different materials, have different stiffness - the degree of restriction of mobility, a different degree of compression.

Depending on the material and the degree of rigidity and compression, they perform various functions. From complete immobilization (immobilization) to partial restriction of movements in the joints. But they all have one thing in common: the creation of conditions for a therapeutic effect.

Types of fixatives by the nature of the overlap

Bandages imposed on the body, without the involvement of internal structures, are called orthoses. First of all, all ortheses are divided into removable and non-removable.

Non-removable are those that are superimposed on the entire treatment period, in the process of which their periodic withdrawal is not implied. This group is represented, for example, with a bandage dressing Dezo with uncomplicated fracture in children or gypsum langets and circular plaster bandages.

Gypsum bandage can be replaced with a special plastic, which hardens like gypsum after application. However, it has a high stiffness, and therefore requires fewer layers, which makes the dressing much easier than gypsum. Another advantage of plastic - it can be wet, which greatly facilitates hygiene at the time of treatment.

Removable orthoses are dressed during the day with loads or with short-term treatment. Thus, the shoulder retainer, like any other area, can be represented by a simple bandage dressing, and an elastic orthosis on the shoulder joint, and a complex design that completely immobilizes the upper limb and the shoulder girdle of the corresponding side.

Types of orthosis according to the degree of rigidity

Soft, made of elastic materials, fixators are worn on a limb segment like a sleeve. They have a closed structure and are equipped with long straps or velcro fasteners. The purpose of these orthoses is to maintain the upper limb in a physiologically comfortable position (kosynochny soft shoulder bandage) or in the compression-warming action (elastic shoulder fixer) on the shoulder joint.

Semi-rigid orthoses are made of elastic materials, usually not possessing a heat-saving effect. They have a complex structure and are often provided with additional fixatives. They are used to immobilize the limb.

Materials from which orthoses are made, used as rigid fixatives, are used the same as for semirigid ones. A distinctive feature is the presence of metal or plastic inserts. Also, they include complex designs of metal with elastic gaskets, fixing the upper limb until complete immobilization.

Indications for use

Indications for the appointment of a particular fixative are determined by the nature of the disease (injury). Elastic orthoses are used for minor bruises of joints, sprains and injuries of the ligament apparatus, inflammatory diseases. They can be used in sports warm-ups to warm up the joint. With a supporting purpose for intensive work (work) on the limb in general or on the joint in particular.

Semi-rigid fixatives are indicated in the treatment of joint bruises, especially in combination with the formation of a large amount of joint fluid or hemorrhage in the joint (hemarthrosis). They are prescribed for stretching and ligament ruptures, muscle stretches. They are used in rehabilitation after repositioning of the dislocation, operations on the joint. Can replace gypsum in uncomplicated fractures.

Hard shoulder fasteners are recommended for complex fractures of the humerus in the upper third. In cases of severe joint injuries (with a rupture of ligaments requiring an operative correction), after plasty of the joint for recurrent dislocation of the head of the humerus. These orthoses are used for damage or inflammation of the brachial plexus and / or the brachial nerve.

Rings of Delbe

The clavicle, which belongs to the shoulder girdle, requires a certain approach in the treatment of her injuries. In clinical medicine, with clavicle fractures that do not require metalloosteosynthesis (operations with fixation of a metal plate), a bandage or plaster bandage of Deso is used. At the disposal of modern traumatology there is a shoulder retainer replacing it - the Delbe rings.

It is an orthosis with an average degree of fixation, it represents a system of unextensionable straps connected on the back by means of blocks. He easily copes with fractures of the clavicle without displacement or with a slight displacement of the fragments. At the same time, it is much easier to apply and does not cause inconveniences inherent in traditional bandages.

Another application of the Delbe ring was found in orthopedics. This is a wonderful tool for correcting the posture in the thoracic spine. The installation type of disorder, scoliotic or kyphotic posture, is easily eliminated by using this orthosis.

Orthoses for the elbow joint

The retainers applied to the forearm and the elbow joint are practically the same as the restraints placed on the shoulder or shoulder girdle. As well as the shoulder fixer, the elbow on the elbow performs a compression and compression-heating function, acts as a limiter for the mobility of the joint.

Similarly to the brachial, elbow orthoses are distinguished by restraints of soft, medium and rigid fixation. The difference is that the latter can have a hinge limiter in the design. Its purpose is to limit the amplitude of motion in the joint to flexion and extension with complete absence of rotation (rotation) in the elbow fold.

Clamp selection

Orthoses are a means of medical (orthopedic) correction of conditions and therapy of diseases. Therefore, should be used solely for the doctor's prescription! The doctor determines the effect necessary for treatment and rehabilitation, the fixity of the fixator and the duration of its application.

According to the size, the fixators of the shoulder and elbow joint are selected starting from the circumference of the chest for the first case and the circumference of the elbow joint (either the shoulder in the lower third and the forearm in the upper) for the second. Usually they have the Latin markings S, M, L and XL.

How to properly wear, remove and how to care for

Orthoses for joints in most cases are worn and removed without any difficulties. Available in their design, long straps, locks or "Velcro" allow the patient to do it themselves. The exception is the shoulder retainer with the effect of complete immobilization. The presence of additional elements requires external assistance. Also, a child or a person will have to help with limiting his physical abilities.

The materials from which orthoses are made can be sanitized. If the elbow and shoulder retainer is provided with removable metal or plastic elements, they must be removed before washing. Manual treatment requires warm water and a chlorine-free detergent. The product is dried naturally, away from heating appliances or heating.