Wrist, Thumb, and Finger Orthoses

There can be several reasons why you might need a wrist or thumb orthosis:

• You experience pain, or your wrist muscles are weakened after surgery or an injury
• You have arthritis or another form of joint disease
• You have hypermobile joints and need support for them
• You perform activities or tasks that put excessive strain on your wrist or thumb joints.

There are three types of wrist and thumb orthoses: wrist orthoses, which only support the wrist, thumb orthoses, which only support the thumb, and combined thumb and wrist orthoses, which support both areas.

The level of support provided by an orthosis varies. If the orthosis is soft, you can still move the joint to some extent. If the orthosis is more rigid, it immobilizes the joint, preventing movement. It can be difficult to determine whether an orthosis will support a joint or merely wrap around it to keep it in place.
If you are unsure about the type of orthosis you need, seek advice from a healthcare professional.

Wrist orthoses

If the issue primarily involves the wrist, you should choose an orthosis that supports only the wrist. Wrist orthoses come with or without braces. Wrist orthoses without braces can relieve the wrist and still allow some mobility. However, they provide less support than orthoses with braces.

Stiff wrist orthoses, with embedded metal or plastic braces, are designed to immobilize the wrist in a specific position. These are primarily used when a more restrictive support is required, such as immediate post-injury or for pain relief in arthritis.

A wrist orthosis with braces limits joint mobility, so you should only choose one if it is necessary to prevent joint movement.

Thumb orthoses

If the issue involves only the base joint of the thumb, select an orthosis designed to support that particular joint. Most orthoses affecting only the thumbs base joint do not have braces, but some come with braces or a reinforcing layer of fabric. Just like wrist orthoses, soft thumb orthoses provide relief, while those with braces offer a more rigid support when needed.

Combined thumb and wrist orthoses

If you have problems with both the wrist and the base joint of the thumb, you can choose an orthosis that supports the entire area. You can also choose between soft and rigid orthoses in this category.

In AssistData, you can find various types of finger orthoses for different purposes:

• Those that support weak fingers.
• Those that stretch contracted fingers.

Some finger orthoses are designed as splints or figure-eight-shaped finger rings, providing support for one finger at a time.

These are used to support weak fingers (e.g., due to arthritis), prevent hypermobile joints from going to extreme positions, or counteract contractures (the contraction of one or more joints).

Other finger orthoses are designed as gloves with braces on the upper side of the fingers or as passive splints that stretch the fingers from underneath. These orthoses help counteract contractures, especially in cases of spasticity.

The most common closure methods are Velcro, laces, buckles, or a combination of laces and Velcro. For some, Velcro or laces may be preferred because they allow for adjustment, determining how snug the orthosis fits and the level of support provided. If you have reduced finger function, Velcro may be easier to use than laces. The advantage of choosing an orthosis with a buckle closure is that it provides consistent fastening each time.

Wrist, thumb, and finger orthoses are prone to getting dirty; therefore, it is important to consider whether the orthosis can be adequately cleaned based on your daily routines. It is crucial to follow the manufacturers washing instructions, as some materials used in orthoses may not be machine washable.

As a general rule, please ensure that you have the right orthosis for your needs and use it correctly. If in doubt, seek professional guidance.

For persistent discomfort, it is recommended to consult a doctor, a therapist, or an orthotist to determine whether an orthosis is the best way to assist you or if you require a different form of treatment.

Many factory-made orthoses available over-the-counter come in multiple sizes. Choosing an orthosis that is too large or too small can affect comfort or, in worst case, cause harm, such as skin irritation.
It is important regularly to check if the orthosis still fits or whether it needs adjustments or replacement.
Depending on the reason for using an orthosis, your symptoms may change over time. If it is related to an injury, it is essential to stop using the orthosis once the injury stabilizes, so you can begin using your hand/fingers naturally.
It is also important to receive instructions on how much and in which situations to use the orthosis. Orthoses should rarely be worn around the clock, and in some cases, it is recommended to take breaks from wearing them.

When acquiring an orthosis, check for the CE mark. Orthoses intended to compensate for a disability must be CE marked as medical devices. The CE mark looks the same for different directive areas, so it should be specified in the user manual that the orthosis is CE marked as a medical device. The orthoses must meet various requirements related to strength and materials, and the manufacturer must be able to demonstrate that they serve the purpose they are marketed for. These requirements are outlined in standards such as:

• DS/EN ISO 21856: 2022. Assistive products - General requirements and test methods
• DS/EN ISO 22523:2007 External limb prostheses and external orthoses - Requirements and test methods