An articulated hip orthosis is composed of at least two separate pieces connected by a hinge that can typically be adjust to accommodate the needed abduction/adduction settings as well as flexion/extension settings. Additionally, articulated hip orthosis may be unilateral, meaning there is a component for only the left or right femur (better known as the thighbone) which can typically be removed and attached to the other femur, depending on what may be appropriate, or it may be bilateral, in which case it will have a hinge and brace for both femurs. An articulated hip orthosis may be appropriate for a someone at risk for problems related to hip instability or patients who have already undergone hip replacement surgery.
Hip, Knee, Ankle and Foot Orthosis (HKAFO)
A more complex orthosis, the hip, knee, ankle and foot orthosis (HKAFO) will provide more stability than other types of orthoses because it consists of four components: the hip, the knee or thigh, an ankle or calf, and finally a foot component. The ankle component typically stretches all the way to the bottom of the knee though to focus of the support for that component is the ankle. Because it has multiple components, the HKAFO is also a version of the articulated orthosis as all four components are connected via hinges between the hip and knee or thigh component as well as between the knee or thigh component and the ankle component. Typically, the joint connecting the ankle component and the foot component are not hinged. This device could be used for a number of conditions with examples being paralysis, muscular dystrophy, and of course complications relating to the hip. The HKAFO will be more effective in minimizing the possibility of the hip moving out of its proper position while also assisting with hip rehabilitation.
Hip Support Pad
For weaker patients whose bodies may not be able to carry the weight of some of the larger orthoses, a hip support pad may be more appropriate. Similar to other orthosis, a hip support pad may consist of support for one or both femurs. However, a hip support pad will primarily consist of fabric though it will still contain a method of controlling abduction and adduction via a number of removable aluminum bars which can typically be shaped as needed to accommodate the shape of the wearer. Because a hip support pad will not be as effective as some of the larger, more complex orthosis in terms of support, the wear should minimize movement though it is still appropriate for use after surgery has already occurred.
Hip and Knee Abductor
A hip and knee abductor generally does not allow its wearer to move about and is therefore intended for a patient confined either permanently or temporarily to a wheelchair or bed. Though, some models do allow for reciprocating gait. A hip and knee abductor consists of cuffs to be positioned on thighs and a bar connecting the two cuffs. The bar can be adjusted to the appropriate angle and is intended to control the scissoring of tight thigh abductors as well as provide adequate support for the knees. A hip and knee abductor is appropriate for a patient who has been through hip surgery or knee surgery or a person with physical disabilities needing help to keep their knees properly aligned and abducted.
Reciprocating Gait Orthosis
A reciprocating gait orthosis is perhaps the most complicated of hip orthoses or hip braces. It can be appropriate for a multitude of conditions because it provides excellent walking function. The device promotes hip stretching, in addition to stabilizing the hip, knee and ankle joints, by the way the orthosis connects the leg so that when one leg is flexed, it causes an extension of the other leg. A reciprocating gait orthosis is appropriate for paraplegia, muscular dystrophy, and complications relating to the hip.
Another less complex hip orthosis is a simple pelvic brace which primarily addresses the issue of hip rotation control. Like other orthoses, a simple pelvic brace can be adjusted to certain positions as necessary to limit flexion/extension of the hip as well as abduction and adduction. The simple pelvic brace can be used to reduce the likelihood of hip dislocation and limit the range of motion or it can also be appropriate for a patient who has already undergone surgery to the hip. The device can also be to provide limited motion after an injury has occurred.
A positioning kit is designed for after hip surgery as it holds the patient’s knees, ankles and feet together in that way prevents hip rotation. It can also prevent abduction and adduction and thereby allows the patient to be in an inclined position while still maintaining maximum comfort level after the surgery. The positioning kit may also be worn during hip surgery. The device can improve recovery time following hip surgery.
Bivalve Hip Orthosis
Bivalve Hip Orthosis is an articulated orthosis which provides reinforcements for the hip and thigh and in additional providing support for pre and post hip surgery, it can also be appropriate for recovering surgeries relating to the spine as well as immobilizing the lumbosacral joint. The portion of the brace which covers the hip can be extended to cover the middle and lower sections of the back for maximum support.
Pediatric Hip Braces
Pediatric versions of hip braces are also available including the HKAFO which can be used as early as 18-months. As hip dysplasia can be a problem for children as well as adults, there are versions designed specifically for children most notably the hip abduction brace versions of which are the reciprocating gait orthosis and the Pavlik harness. The Pavlik harness is specifically designed for babies and aligns their hips in the joint while keeping them secure. The Pavlik harness promotes normal growth and development of the hip joint. Hip abduction braces, like their larger counterparts for adults, vary in their look and, to a degree, in what they accomplish. There is also a device call the von Rosen splint which is designed specifically for newborns with unstable hips by attempting to prevent the development of permanently displaced hips. There are seven sizes of the von Rosen splint so the size can be adjusted to accommodate the growth of the child. The hip orthoses intended for children are typically worn at all times for at least the first 6-12 weeks after which an evaluation will occur to determine if the splint can be worn less frequently or if it can be removed permanently.
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