Monday, March 27, 2023

Flacid arm orthosis

Shane Jansen (NDHB)

Dear list
Here is my patient summary:

Male 52.
Renal dialysis and T 2 Diabetes.
Sports injury L) arm pre 2011 leaving it flaccid at shoulder and elbow. Retained hand function at the time.
CVA approx 2011 affecting L) side. Unclear if this further affected arm.
More recent loss of hand function following fistula surgery.
Therapy has brought some return of function to thumb and 3rd, 4th and 5th.
No active elbow or shoulder movement at all on L). No muscle tone L) upper arm.
? subluxed L) shoulder.
Not painful.
L) cock up wrist brace worn.

R) hand dominant. Attempts to use L) hand/arm as much as possible.
Propping, resting on table to allow L) hand to hold utensil during meals.
Passively places L) arm in position with R) as needed.

Goal:
Increased functional use L) hand. Possibly some sort of assisted elbow flexion to facilitate that.

Please comment as follows:
His suitability as a candidate for the Wilmer Carrying Orthosis and any experience you have with this device.
Any other orthotic management you might suggest.

Many thanks in advance.

Shane Jansen Accredited MNZOPA
Clinical Orthotist
Orthotic Service
Whangarei Hospital
Northland District Health Board
* Ph +64 9 4304100 – #7451 | 7 Fax +64 9 470 0020| * [email protected]

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