(Thoracolumbar Spinal Orthosis) Body Jacket
Your Physician has recommended that you wear a custom-fabricated TLSO to immobilize your thoracolumbar spine. The length of time you will need to wear the TLSO will depend upon your condition and is determined by your physician. DO NOT get out of bed without your TLSO unless you have permission from your physician.
Design and Fabrication
The TLSO is customized to fit your dimensions. The lightweight and hygienic materials are the highest quality available. The soft liner is closed-cell polyethylene foam. The outer shell may be either rigid foam or rigid thermoplastic and will be customized to your needs. The liner and hard outer shell are heated in a large oven to 390°. They are draped and vacuum formed over your model, cooled, trimmed, and cut. The edges are finished and polished.
Application (Putting it on)
The TLSO has two pieces, a back, and a front. The front overlaps the back along the sides. Lying on your back, log roll and slide the back section under your side. Roll back and adjust for comfort. Your back should lie comfortably and feel the support of the TLSO. If you have had surgery, your incision may be tender but will improve with time.
Place on the front section, overlapping the back, so the inside seam along each side is smooth. Gently fasten the Velcro to a firm but comfortable tightness.
Clean your brace with mild soap and water and towel dry. If your physician allows, you may shower wearing the brace. The Velcro straps will be the only parts that absorb water.
Wearing a cotton t-shirt under the TLSO reduces irritation. Clean your TLSO to prevent bacteria build-up and reduce skin irritation.
Your Physician has recommended that you wear a SOMI brace to provide support, correct deformities, and prevent specific joint and body movement. The SOMI brace holds your neck in a straight line with your spine, providing rigid support to the unstable and weakened muscles and bones of your neck. The brace prevents movements and protects your neck injury as it heals. Your Orthotist will provide proper instructions during the fitting of your brace. The SOMI brace should be worn and adjusted only as your physician instructs.
Parts of the Brace
The chin piece supports your lower jaw by forming a cup for your chin to rest. It is attached to the headpiece by straps and a front metal extension to the chest piece. It must be worn when walking and whenever active movement of the head and neck would occur. The chin piece may be removed only when instructed by your physician.
The headband straps across the forehead and is fitted to a plastic device at the back of your head. You must wear the headband whenever you have removed the chin piece. Activities may include eating, bathing, and shaving.
The occipital piece supports the base of your head and helps hold your head in an upright position.
The chest piece rests upon your chest and connects to the chin and occipital pieces. The chest piece and occipital piece should be removed only when instructed by your physician.
Switching the Headband and Chin Piece:
A daily routine of skin care is important, to prevent skin problems.
For most people, a sponge bath is the best method of daily cleansing. Areas in direct contact with the brace, such as your chin and lower jaw, may need more frequent cleaning.
Inspecting your skin is important, especially those areas that receive pressure, rubbing, or friction from the brace. Irritations may develop over bony areas such as the chin and jawline, shoulder bones, and back of the head. Reddened or bruised areas are the first clues to developing skin irritations.
Signs of skin irritation:
Check your chin and jawline closely for signs of irritation. This area receives constant pressure and is most likely to develop skin problems. Alternating the chin piece and headband will help prevent skin irritations in this area.
Wearing a light cotton T-shirt under the SOMI brace serves as a cushion and absorbs perspiration. You may prefer to wear T-shirts that are slightly larger than your usual size. Changing T-shirts daily is best accomplished with the assistance of another person and always while lying on your back.
To put on a T-shirt, place the T-shirt over your head and pull it down to your neck. Remove the chin piece and pull the T-shirt down enough to allow the placement of one arm into a sleeve and then the other. Pull the T-shirt under the brace, making sure to pull out all wrinkles. Reverse this process to remove the T-shirt, and always do this while lying on your back.
Call the hospital and ask for the orthopedic resident on call if any of the following symptoms develop:
SOFTPRO™ GRIP WHFO
Orthotic therapy for moderate to severe wrist, hand, finger joint stiffness or contractures, wrist contractures (flexion or hyperextension), radial or ulnar deviation of the hand, flexion/hyperextension contractures of the MP/IP joints of the fingers and adduction of the thumb.
The orthotic device can be used to restore lost range of motion or to maintain range while providing support and protection and corrected positioning of the affected joints. The SHFO is hand bendable to provide the desired therapy and positioning of the wrist, hand, and fingers. Two incrementally larger MP/IP extension rolls are used to gradually extend the MCP and PIP joints of the fingers. Ulnar or radial drifts of the hand can be treated by device modification. Thumb abduction is increased as incrementally larger MP/IP extension rolls are added. By increasing wear time to three to six hours of use, the total end range time or device wear provides long effects stretch and permanent increases in joint range of motion of time. Orthotic treatment should be continued until function is restored.
Increase wrist, hand, and finger (including thumb) range of motion improve the hygiene of the hand, and where possible, improve functional ability of the fingers/hand to assist with activities of daily living.
Check for skin redness, pressure, and potential discomfort every two to three hours. Evaluate red areas using the Blanch Test. Remove the orthotic device immediately if significant redness, pressure, or pain and discomfort are evident. Discontinue use until skin integrity or comfort issues are resolved. Device or wearing schedule modifications may be made to eliminate skin integrity and comfort problems.
A significant wearing schedule disruption often requires a re-adaption period. A gradual re-introduction and increased wearing endurance may be necessary. Note wearing schedule changes in the patient’s care plan.
Follow manufacturer’s instructions for care of the orthotic device. Always inspect the device between applications to ensure the soft goods are properly in place, the device settings have not been altered, and the device has not been soiled or would provide any other risk to the patient prior to application.