CTO Upper Extremity Orthotics 1 — Questions and Answers
Question 1: What is the primary purpose of a wrist cock-up orthosis?
- To provide dynamic assistance to finger flexion
- To stabilize the wrist in extension while allowing finger movement (Correct answer)
- To immobilize the entire hand and wrist in a resting position
- To facilitate elbow flexion during activities of daily living
Correct answer: To stabilize the wrist in extension while allowing finger movement
A wrist cock-up orthosis holds the wrist in a functional extended position while leaving the fingers free for use.
Question 2: In a standard resting hand orthosis, what is the recommended wrist position?
- 0 degrees (neutral)
- 10–20 degrees of extension (Correct answer)
- 30–40 degrees of extension
- 10–15 degrees of flexion
Correct answer: 10–20 degrees of extension
A resting hand orthosis places the wrist in 10–20 degrees of extension to maintain a functional resting posture and prevent contracture.
Question 3: Boutonnière deformity is characterized by which combination of joint positions?
- PIP joint hyperextension and DIP joint flexion
- PIP joint flexion and DIP joint hyperextension (Correct answer)
- MCP joint flexion and PIP joint extension
- Wrist flexion and MCP joint hyperextension
Correct answer: PIP joint flexion and DIP joint hyperextension
Boutonnière deformity involves PIP flexion and DIP hyperextension due to a central slip rupture allowing the lateral bands to migrate volarly.
Question 4: Which nerve injury would most likely require a low-profile dynamic MCP extension orthosis?
- Median nerve injury at the wrist
- Ulnar nerve injury at the elbow
- Radial nerve injury at the spiral groove (Correct answer)
- Brachial plexus upper trunk injury
Correct answer: Radial nerve injury at the spiral groove
Radial nerve injury at the spiral groove causes wrist drop and loss of MCP extension, requiring a dynamic orthosis to restore that function.
Question 5: A thumb spica orthosis is a primary conservative treatment for which condition?
- Carpal tunnel syndrome
- De Quervain's tenosynovitis (Correct answer)
- Dupuytren's contracture
- Trigger finger
Correct answer: De Quervain's tenosynovitis
A thumb spica orthosis immobilizes the first CMC and MCP joints to rest the inflamed tendons in De Quervain's tenosynovitis.
Question 6: The Kleinert protocol for flexor tendon repair uses which type of orthosis?
- Static wrist extension orthosis
- Dorsal blocking orthosis with rubber band traction (Correct answer)
- Static progressive flexion cast
- Functional electrical stimulation orthosis
Correct answer: Dorsal blocking orthosis with rubber band traction
The Kleinert protocol uses a dorsal blocking orthosis with rubber band traction that passively flexes the fingers while allowing active extension within the safe zone.
Question 7: Which measurement is most important when sizing a prefabricated wrist orthosis?
- Hand span at the widest point
- Wrist circumference (Correct answer)
- Distance from wrist crease to fingertip
- Palm length from wrist crease to MCP crease
Correct answer: Wrist circumference
Wrist circumference is the primary sizing parameter used by most prefabricated orthosis manufacturers to ensure proper fit and support.
CTO Upper Extremity Orthotics 1
What is the primary purpose of a wrist cock-up orthosis?