Sunday, November 27, 2022


Maggie Thomas


Maggie Thomas here, I am an Orthotic Resident at COC Windsor.

I am looking for some ideas for orthotic management for upper extremity

I have a new client that suffered a crush injury many years ago and although
he has not been diagnosed with RSD, he presents with RSD-like symptoms
(Hypersensitivity to touch, temperature, pain with movement, fatigue etc.)

His crush injury was to his forearm, which is covered with a skin graft.

His hypersensitivity starts roughly mid tricep area and continues distal to
the finger tips .there really are no areas that he can tolerate any

ROM is poor with Pain (see below)


Flex =90 deg

Ext =5 deg

Int Rot =45 deg

Ext Rot =15 deg

Abduction =25 deg


Flex=100 deg

Ext =140 deg

Wrist /Hand/Fingers – 0 deg of movement .minimal PIP & DID movement of

All movements are with Pain . All motions above were Active . No Passive or
Resistive testing performed.

He also fatigues very quickly trying to hold his arm against his body. His
good arm (shoulder & neck) are suffering from over working.

He is looking for something to protect him from the environment and offer
some support and possible pain reduction.

He also sleeps on his back at night with a pillow under his arm.he can only
get approx 3 hrs of sleep a night . Pain wakes him.

He will be attending a Pain management clinic in July 2011.

He currently has 2 off-the-shelf orthoses (WHO & Elbow brace of sorts).
They are not really helping.

We have discussed sleeves, slings and a custom brace to offer support from

We are uncertain that he will be able to tolerate donning of a sleeve.
Anyone have any experiences with this?

Does anyone have any ideas or orthoses they have tried on similar clients ?
All suggestions welcome.

Thank you

Maggie Thomas


Get unlimited access!

Join EDGE ADVANTAGE and unlock The O&P EDGE's vast library of archived content.


Welcome Back!

Login to your account below

Retrieve your password

Please enter your username or email address to reset your password.

The O&P EDGE Magazine
Are you sure want to unlock this post?
Unlock left : 0
Are you sure want to cancel subscription?