PhysicalTherapy.com Phone: 866-782-6258


Orthotics for Fractures of the Spine

Amit V Bhanti, CPO

May 8, 2012

Share:

Question

Are there differences in the types of braces you chose based on age or fracture type?  What is the most common orthosis you use? 

Answer

Braces can be made with many different materials, many different trim line variants, and many different other parameters.  For any fracture in the spine, I believe it really needs to be a TLSO.  A TLSO can be made in many different ways.  It can be made shorter, low profile, high profile, or it can be made with extension.  A custom-made TLSO is considered the best orthotic intervention for most of the spinal fractures.  The TLSO can be different by brand, by trim line and by materials.  For example, if I have a patient who is a child or an older woman, I might choose a different material.  I might choose a thinner plastic for that patient rather than going with a thicker plastic that I might choose for a 250-pound, 55-year-old male.  For an older woman, I might use a flex foam material with reinforcements with plastic to make it lighter for her and still provide appropriate forces.  The rigidity of the plastic is not what creates the stability or hyperextension.  Usually it is the cylinder created around the patient’s body through a total contact TLSO that reduces the axial loading.  An example I use is to take a piece of paper and shake it.  You see it is very flexible.  However, as soon as you roll it, the same thin piece of paper becomes hard to push on. This is the principle of a TLSO.  When you create a cylinder around a patient's body, the axial loading can be reduced much more effectively.  It does not matter if it is thick or thin as long as it is appropriately fabricated.

 


amit v bhanti

Amit V Bhanti, CPO

Amit Bhanti is an American Board Certified Prosthetist and Orthotist licensed in the State of Illinois and the Clinical Director and co-owner of Comprehensive Prosthetics and Orthotics (CPO). He also provides patient care at CPO's other satellite locations. Amit has a very successful track record in patient management and as a business owner. During his 3-year tenure as Clinical Director of Orthotics at Hanger Prosthetics and Orthotics in Peoria, he demonstrated exceptional abilities to lead the group, and helped establish a successful residency program in orthotics and prosthetics.


Related Courses

Fabrication of a Training AFO
Presented by Jennifaye V. Brown, PhD, PT, NCS
Recorded Webinar

Presenter

Jennifaye V. Brown, PhD, PT, NCS
Course: #3119Level: Advanced2 Hours
  'Thank you for sharing your knowledge!'   Read Reviews
Research indicated that in inpatient rehab "The largest percentage of time in physical therapy sessions was spent on gait activities" (Jette, et al., Physical Therapy, 2005; 85(3): 238-248, p. 241). Ankle foot orthotics (AFOs) are not issued in inpatient rehab due to the costs and interim interventions such as stabilizing the foot with an ace bandage are not adequate. Facilities do not have access to pre-fabricated AFOs or electrical stimulation units now being used as walking aides to replace AFOs. Focused rigidity casting is widely used in the orthopedic population and can be applied to the neurologic population. This course will provide insight on the use of focused rigidity casting to fabricate training an AFO. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Physical Therapy Examination for an Ankle Foot Orthosis
Presented by Jennifaye V. Brown, PhD, PT, NCS
Recorded Webinar

Presenter

Jennifaye V. Brown, PhD, PT, NCS
Course: #2946Level: Intermediate2 Hours
  'I enjoy orthotic information and gaining knowledge in this area'   Read Reviews
Very little research exists documenting the practice and evidence of the physical therapist’s role in recommending an ankle foot orthosis (AFO). The comprehensive examination should be patient-centered and collaborative in nature with the orthotist, but is often absent in rehabilitation practice. This course will review components of a physical therapy AFO examination as presented in the literature and provide evidence of what should be included, deleted or modified based patient impairments, social determinants of health and the presenter's experiences in AFO fabrication. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Trauma Informed Care Principles for Rehabilitation Professionals
Presented by Jennifer Stone, PT, DPT, OCS, PHC
Recorded Webinar

Presenter

Jennifer Stone, PT, DPT, OCS, PHC
Course: #3975Level: Intermediate2 Hours
  'Clearly organized and useful instruction'   Read Reviews
Acute and chronic trauma is very prevalent in the United States, and have been tied strongly to adverse health behaviors and outcomes. This course provides the rehabilitation professional with an overview of the physiology of trauma, as well as practical tools to work with patients who are experiencing trauma. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Utilization of Ankle Foot Orthoses in Patients with Neurological Dysfunction
Presented by Jill Seale, PT, PhD, NCS
Recorded Webinar

Presenter

Jill Seale, PT, PhD, NCS
Course: #3489Level: Intermediate2 Hours
  'I appreciated all the AFO examples and the cases'   Read Reviews
This course will provide participants with essential tools for determining appropriate orthotic management with an ankle-foot orthosis (AFO) based on detailed gait analysis. Evidence-based orthotic interventions will be presented and participants will have opportunities to see orthotic examples and practice application of information through video/paper cases. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Static Splinting Series
Presented by Kirsten Davin, OTD, OTR/L, ATP, SMS
Recorded Webinar

Presenter

Kirsten Davin, OTD, OTR/L, ATP, SMS
Course: #4063Level: Intermediate4 Hours
  'This course is very informative, descriptive and practically oriented for me in my clinical practice'   Read Reviews
The static splinting 4-course series consists of an overview of the history of splint fabrication, the advances in the splinting and orthotics arena, and an anatomical review of key structures and landmarks. A detailed demonstration of wrist orthotics is presented as well as radial gutter/thumb spica splints, dorsal and volar wrist cock-ups, functional position with an intrinsic plus modification option, hand-based thumb spica, finger gutter and MP joint blocking splints. The application and use of a spring finger extension splint, oval 8 splints as well as static progressive finger flexion and extension splints are included.Finally, the fabrication of a footplate for external fixator application, the application of lower extremity splints and orthotics as well as splinting considerations for specific diagnoses including burn injury occurs in part 4.

Please note: This course series is comprised of the following individual recordings: #4018, #4020, #4022, and #4024

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.