Indications: Minimally displaced clavicle fractures, proximal humerus fractures, immobilization after shoulder dislocations, strains, and postoperative immobilization after upper extremity surgery.

Application: Position the elbow in the pocket of the sling. Place the strap over opposite shoulder, feed through the D-ring, and secure to itself. Hand should be elevated slightly above the elbow when secured. Many different variations of the arm sling are available in the market.

Advantages: Easy to use. Provides proper immobilization and support of the shoulder and elbow joints.

Disadvantages: Can cause discomfort and skin irritation.

Indications: Closed humeral shaft fractures in acceptable alignment. Acceptable alignment of humeral shaft fracture is considered to be:

Application: The brace consists of 2 shells applied either anterior -posterior or medial-lateral, and secured with Velcro straps. Use a collar and cuff to support the forearm. Provide additional padding around the collar to reduce discomfort

and avoid skin irritation. Avoid the use of a standard sling, which could cause fracture angulation.

Advantages: The fracture alignment is maintained through soft-tissue compression and gravity assistance. The brace permits early motion of the adjacent joints, giving providers the opportunity to encourage patients to begin early range-of-motion (ROM) exercises of the finger, wrist, elbow, and shoulder as tolerated.

Disadvantages: Contraindicated in patients with massive soft-tissue injury. Requires close supervision and follow-up with radiographs to ensure maintenance of reduction. Frequent brace adjustments are needed as swelling subsides.

Indications: Elbow instability, dislocation, collateral ligament repair or biceps/triceps repair. Also applicable in postsurgery or postinjury patients who have regained inadequate motion.

Application: Adjust the brace to fit the patient’s arm. Apply the brace, fasten the straps, and adjust the ROM dial as needed.

Advantages: Allows for early, protected ROM, permitting extension and flexion while reducing varus and valgus stress. Hinges can be adjusted weekly to allow for improvement in elbow ROM.

Disadvantages: Must be applied properly to be effective.

Indications: Used to gain ROM in patients with joint stiffness. It is typically used as an additional modality in patients who have regained inadequate motion with standard therapy or have plateaued in therapy.

Application: Similar to hinged elbow brace.

Advantages: Allows for improvements in elbow ROM.

Disadvantages: May cause discomfort.

Note: When ordering the splint, specify the joint and function, that is, static-progressive supination/pronation forearm splint.

Indication: Lateral epicondylitis.

Application: Wrap around the forearm, approximately 2.5 cm distal to the lateral epicondyle. Some straps have additional gel pads or pillows which should be placed against the radial muscles of the extensor forearm compartment.

Advantages: The strap is thought to decrease the pressure on extensor carpi radialis brevis tendon by dispersing the muscle contraction forces. It is inexpensive, adjustable, and easy to fit.

Disadvantages: Improper use can lead to nerve irritation.

Indications: Carpal tunnel syndrome, wrist sprain or tendinitis, buckle fracture, post-wrist or hand surgery.

Application: This is a removable wrist orthosis that can be applied and secured with Velcro straps. It typically contains a metal or thermoplastic insert in its volar (or dorsal) compartment providing rigid support.

Advantages: Provides wrist stability/immobilization, while allowing digital motion and forearm rotation. Easy to use and cost-effective.

Disadvantages: More rigid and less comfortable than custom-made thermoplastic splints.

Indications: MCL or LCL tear, MCL or LCL repair, post-op use after knee surgery to prevent valgus and varus stress.

Application: Adjust the brace to fit the patient’s leg. When applying the brace, be sure to align the hinges around the medial and lateral aspect of the knee. Fasten the straps and adjust the ROM dial as needed.

Advantages: Hinges can be adjusted to allow for advancement in ROM. Protects against varus and valgus stress.

Disadvantages: Must be applied properly to be effective.

Indications: ACL or PCL instability, ACL or PCL reconstruction, prophylactic use (controversial).

Application: The brace must be ordered through a local distributor. Measurements are obtained using anatomic reference points and the brace is custom-made to fit the patient. The brace reduces knee translation and rotation.

Advantages: Because it is custom-made, it can accommodate a broad spectrum of knee sizes. It can be customized with a variety of options and accessories. It has been reported to subjectively improve stability and function and can be used as an adjunct to graft protection after ACL reconstruction.¹,²

Disadvantages: Expensive. It can require multiple trips to the orthotist for proper fitting. It can increase energy expenditure and decrease agility.³,⁴ Relative lack of conclusive research on prophylactic benefits. Brace effectiveness diminishes at physiologic stress levels.⁵,⁶

Indications: Patellofemoral syndrome, patellar subluxation or dislocation, patellar tendinitis, post-op management (lateral release).

Application: Usually made from an elastic material such as neoprene and may include straps and buttresses to stabilize the patella. To apply, pull the brace onto affected leg and align patella in center of cutout. Secure the counterbalancing straps, if present, in moderate tension.

Advantages: Low cost, ease to use, widely available. Designed to improve patellar tracking with medially directed

force.⁷ Changes in regional temperature, neurosensory feedback, and circulation may also contribute to its effects.⁸ Has been shown to improve anterior knee pain in several studies.⁹,¹⁰

Disadvantages: Subjective benefits exceed objective findings. Some studies found the brace to be ineffective.¹¹,¹² Can cause skin irritation.

Indications: Stabilization after acute knee injury, quadriceps or patellar tendon rupture, patellar fracture or dislocation, post-op immobilization.

Application: Consists of rigid struts, foam liner, and Velcro straps. To apply, open all the Velcro straps and liner, place behind the leg with the strut centered, wrap the foam liner around the leg and secure the Velcro straps.

Advantages: Inexpensive, widely available, easy to apply.

Disadvantages: Tends to slide down when ambulating, thus requiring frequent adjustments. Extended use may lead to knee stiffness and muscle atrophy.

Indications: Unicompartmental knee osteoarthritis, knee malalignment.

Application: Can be off-the-shelf or custom-made. Most braces use a three-point leverage design applying external varus or valgus force to the knee which distracts the involved compartment and reduces the load.¹³,¹⁴,¹⁵

Advantages: Shown to reduce pain, improve function, and reduce the use of pain meds in patients with unicompartmental OA.¹⁴,¹⁶

Disadvantages: Expensive. Brace efficacy depends on proper application. Low compliance rate due to brace discomfort, poor fit, and skin irritation.¹⁷

Indications: Commonly used to maintain joint motion after knee manipulation and release of arthrofibrosis. May be used

after knee replacements, ACL reconstructions, microfracture, autologous chondrocyte transplantation, and chondroplasties.

Application: Motorized device applied externally to enable the joint to move passively through a predetermined ROM. ROM, speed, and hold times can be altered as needed.

Advantages: Helpful in maintaining ROM and reducing edema. Movement of synovial fluid allows for better diffusion of nutrients into damaged cartilage.¹⁸,¹⁹

Disadvantages: Does not improve long-term knee function. Can be cumbersome and difficult for patients to use properly at home. Can cause increased discomfort. Some studies show no added benefit in functional recovery after TKR.²⁰

Indications: Also known as a knee walker, coaster, or cruiser. Any ankle or foot injury/surgery/condition that requires the patient to be nonweight bearing (NWB) on the lower extremity.

Application: A two-, three-, or four-wheeled device that has a knee pad to support the shin of the affected extremity. The opposite foot makes contact with the ground to provide propulsion.

Advantages: Excellent alternative to crutches. Allows patients to be NWB safely. Comfortable and easy to maneuver. Allows patients to be active and mobile during the rehabilitation period. Can be rented temporarily.

Disadvantages: Heavier and more difficult to load in a vehicle than crutches. Cannot negotiate stairs.

Indications: Acute ankle sprain.

Application: This is a semi-rigid, functional ankle brace. It consists of thermoplastic countered medial and lateral shells lined with air-filled foam pads held together by encircling Velcro straps and adjustable heel pad. The air-filled pads provide support and graduated compression during ambulation to promote edema reduction. When applying the brace, adjust the heel attachment connecting the medial and lateral shell to ensure a snug fit. Apply the bottom encircling strap first, and then proceed to the top strap. The brace should be worn with socks and can fit inside most lace sneakers.