Technical note-a thoracobrachial synthetic resin orthosis
S.-A. Ahlgren *
T. Olsson *
H. Wingstrand *
Certain operations on the upper limb or shoulder must be followed by some form of external immobilization of both the limb and the shoulder. Thoracobrachial plaster casts are heavy and awkward, and ready-made commercial abduction frames are sometimes difficult to adjust and rarely produce satisfactory immobilization which may induce the surgeon to refrain from undertaking an otherwise clearly indicated operation.
Plaster of Paris can, however, be replaced by a new synthetic material, *HexceliteR. Its advantages over plaster are that it is lighter, it is radiolucent, and its net-like fabric allows a certain circulation of the air. In addition, it is not affected by water and thereby facilitates the patient's personal hygiene. In 4 cases a frame for immobilization of the arm and shoulder was made of Hexcelite and served its purpose well.
Three women, aged 51, 53 and 70 years, with pseudarthrosis of the humerus were operated upon with bone transplantation and fixation with a plate and screws. One of the women had osteogenesis imperfecta with stunted growth and severe deformities (Fig. 1 ). A 17 year old man with complete dislocation of the acromioclavicular joint was operated upon with suturing of the ligaments and temporary fixation with Kirschner wires. Before the operation a frame of Hexcelite was made (Fig. 2 ) and tried out by the patient for a few days, during which it was adjusted.
Two of the orthoses weighed 1.2 and 1.4 kg, respectively, a corresponding thoracobrachial cast of plaster would weigh 3.5 and 4.5 kg. Following operation the orthosis was applied and fixed with straps and elastic bandage and when necessary also with a few turns of Hexcelite. To increase the stability of the arm in 2 cases a cap was made and held in position by straps. All the patients could wear the orthosis until healing was complete, which was up to 4 months.
Judging from the good results obtained in 4 cases, HexceliteR, can be used with advantage instead of plaster in the manufacture of thoracobrachial casts.
*Available from Camp Scandinavia AB.