Orthotic Devices and Nail Bracing Flashcards

What is the primary mechanism of action of a nail brace (orthonyxia) for involuted nails?

Answer: It applies continuous outward tension to flatten nail curvature and reduce lateral groove pressure

Nail braces use the elastic memory of composite or wire materials to apply sustained outward force that gradually corrects nail involution over weeks to months.

The Fraser (3TO) brace system uses:

Answer: A thin composite resin strip adhered to the dorsal nail surface with hook-and-eye anchors

The Fraser/3TO brace is a composite adhesive system that bonds to the nail surface; it is non-invasive and particularly suited for delicate nails and elderly patients.

When selecting an orthotic insole for a patient with a dropped metatarsal head, the goal is to:

Answer: Redistribute plantar pressure away from the painful metatarsal head

A metatarsal pad or bar placed just proximal to the affected metatarsal head redistributes pressure away from the plantar prominence, reducing pain and callus formation.

Nail bracing is contraindicated in patients with:

Answer: Active nail fold infection, extreme nail fragility, or severely compromised circulation

Infection, very thin/fragile nails, and poor circulation are contraindications because bracing can worsen infection spread, damage the nail, or impair healing in ischemic tissue.

Which measurement is most important before fitting a toe orthosis or pad?

Answer: Accurate assessment of the toe's pressure points, deformity type, and footwear fit

Effective orthotic fitting requires identifying the specific pressure points, deformity (e.g., hammer toe, mallet toe), and ensuring the device fits within the patient's footwear.

Silicone toe separators are used to:

Answer: Prevent and reduce pressure/friction between adjacent toes, redistributing force and protecting soft tissue

Silicone separators cushion the interdigital spaces, preventing corns, blisters, and ulceration caused by toe-on-toe friction, especially in patients with overlapping or crowded toes.