Ortheses

Ortheses, or orthotic devices, are external supports worn to diagnose, align, prevent, or correct deformities and functional limitations of the musculoskeletal system. They modify the structural and functional properties of the neuromusculoskeletal system. Orthotics is the field; practitioners are orthotists. Orthoses differ from prostheses, which replace missing limbs.

Common types include spinal orthoses (such as cervical collars and thoracolumbosacral orthoses) and limb orthoses (ankle-foot orthoses, knee-ankle-foot orthoses, knee braces, wrist-hand orthoses, elbow supports). In the spine, braces aim to stabilize or restrict motion; in the limbs, orthoses may immobilize, support, or assist movement.

Indications include immobilization after injury or surgery, stabilization of deformities (e.g., scoliosis), relief of pain, improvement of function in neurological or musculoskeletal disorders, and prevention of contractures. Design and fitting can involve custom-made devices from thermoplastics, composites, or metal, or off-the-shelf products. The process typically includes clinical assessment, measurements or casting or 3D scanning, fabrication, fitting, and training in wear schedules, skin care, and exercises.

Effectiveness varies by condition and patient, but orthoses can reduce pain, improve function, and slow deformity progression when properly fitted and used. Risks include skin irritation, pressure ulcers, discomfort, and gait changes; regular follow-up helps address fit and comfort. Care recommendations emphasize keeping devices clean and dry, inspecting the skin, and replacing worn or damaged devices.

History and profession: modern orthotics developed in the 19th and 20th centuries, with growing specialization. Related professionals include orthotists, prosthetists, and pedorthists who design, fabricate, and fit orthotic devices.