Orthopaedic Technologist Certified Orthopaedic Appliances and Bracing Questions and Answers — Questions and Answers
Question 1: A patient is being fitted for a functional hinged knee brace following an ACL reconstruction. What is the primary purpose of the adjustable hinges on this type of brace?
- To provide rigid immobilization of the knee joint.
- To allow for a controlled and gradually increasing range of motion. (Correct answer)
- To apply continuous cold therapy to the surgical site.
- To increase varus and valgus stress for ligament testing.
Correct answer: To allow for a controlled and gradually increasing range of motion.
Functional hinged knee braces are designed to protect the healing ligament while allowing for controlled movement. The adjustable hinges can be set by the physician or technologist to limit flexion and extension to a specific, safe range, which is gradually increased as the patient progresses through rehabilitation.
Question 2: A 13-year-old patient with a progressive thoracic curve is prescribed a Milwaukee brace (CTLSO). Which of the following is the primary condition this brace is designed to treat?
- Lumbar lordosis
- Cervical kyphosis
- Scoliosis (Correct answer)
- Spondylolisthesis
Correct answer: Scoliosis
The Milwaukee brace, a cervico-thoraco-lumbo-sacral orthosis (CTLSO), is specifically designed to treat spinal curvatures like scoliosis and kyphosis in growing adolescents. It applies corrective forces to the spine to prevent the curve from progressing.
Question 3: When instructing a patient on the proper use of a Controlled Ankle Motion (CAM) walker boot, which of the following is a critical fitting instruction?
- The heel should be positioned as far forward as possible in the boot.
- Straps should be tightened to the point of causing mild discomfort to ensure stability.
- The uprights of the boot should be angled towards the back of the leg.
- The patient's heel should be seated securely at the very back of the boot. (Correct answer)
Correct answer: The patient's heel should be seated securely at the very back of the boot.
Proper fitting of a CAM walker is essential for its effectiveness. The patient's heel must be positioned all the way at the back of the boot to ensure the ankle is in the correct position for immobilization and that the rocker bottom sole functions correctly during ambulation.
Question 4: An Orthopaedic Technologist is fitting a 3-month-old infant with a Pavlik harness. This appliance is the primary treatment for which of the following conditions?
- Developmental Dysplasia of the Hip (DDH) (Correct answer)
- Congenital clubfoot (talipes equinovarus)
- Metatarsus adductus
- Tibial torsion
Correct answer: Developmental Dysplasia of the Hip (DDH)
The Pavlik harness is a soft brace specifically designed to treat Developmental Dysplasia of the Hip (DDH) in infants. It holds the hips in a position of flexion and abduction, which encourages the femoral head to seat properly within the acetabulum, promoting normal hip joint development.
Question 5: Following successful serial casting for congenital clubfoot, an infant is prescribed a brace consisting of shoes attached to a bar. What is the name of this orthosis, used to maintain correction and prevent relapse?
- A Jewett Brace
- A Swedish Knee Cage
- A Denis Browne Bar (Correct answer)
- A Boston Brace
Correct answer: A Denis Browne Bar
A Denis Browne Bar (or splint) is a foot abduction orthosis used to maintain the correction achieved through casting for conditions like clubfoot. It consists of a bar that connects to the patient's shoes, holding the feet in an externally rotated position to prevent the deformity from recurring.
Question 6: A patient with a stable thoracic compression fracture is fitted with a Jewett brace. This type of brace primarily functions by limiting which spinal motion?
- Rotation
- Lateral bending
- Extension
- Flexion (forward bending) (Correct answer)
Correct answer: Flexion (forward bending)
The Jewett brace is a hyperextension orthosis that works on a three-point pressure system. It has pads on the sternum and the pubis anteriorly, and a pad over the thoracolumbar spine posteriorly. This design specifically restricts spinal flexion (bending forward) to offload the anterior portion of the vertebral bodies, allowing compression fractures to heal.
Orthopaedic Technologist Certified Orthopaedic Appliances and Bracing Questions and Answers
A patient is being fitted for a functional hinged knee brace following an ACL reconstruction.
What is the primary purpose of the adjustable hinges on this type of brace?