Splints and orthosis
During the course of treatment many special needs kids need splints or braces to help them become independent in walking and other activities of daily living.
In the medical community, splints and braces are called “orthotics”. Orthotics are aids strapped on to a person’s body to assist weak muscles, to position or immobilize a certain part of the body or to correct and prevent deformities. Orthotics for the hands are usually called splints while those attached to the legs are called braces or calipers.
A child who cannot move in normal ways is in great danger of developing muscle contractures. A contracture is the permanent shortening of a muscle, tendon or joint structure which prevents the normal range of motion. Contractures lead to deformities which over time become “fixed”. Fibrous tissue is laid down in the muscle and if a long time passes after that happens, the muscle can only be lengthened by surgery. But, if caught early, contractures can sometimes be stretched out using plaster casting and stretching exercises. To prevent contractures, splints and braces are applied to support the weak muscles.
Some children have muscles that are very strong on one side of a joint and very weak on the other side. For example the muscles that bend the knee may be strong while the muscles that straighten the knee joint may be weak. This muscle imbalance can also cause contractures so it is often necessary to apply braces to prevent deformity.
Braces and splints should only be used if they help the child move better and become more independent. Too much bracing may actually weaken muscles. Also, braces that are too heavy for weak muscles may make it even more difficult for the child to walk and will discourage him from even trying. So the best approach is to use as little and light bracing as possible to meet the goal of helping the child move more easily.
Hand splints are often applied to hold the wrist and hand bones in the proper alignment so that the hand can be used more comfortably. Often, hand splints are given to protect the bones and soft tissue from further damage following an injury. The hand is held in a safe and well supported position while the healing is progressing.
Each child must be carefully assessed to determine what type of bracing will help increase his ability to use his body properly. A brace that works very well for one child may not help another child. This assessment can be done by an Orthotist, or an Occupational Therapist or a Physical Therapist.
An ideal brace should:
- Be comfortable
- Be lightweight and strong
- Easy to put on and take off
- Easy to repair and adjust as the child grows and develops
- And the most important… it should serve its purpose which is to make it easier for the child to walk or function better!