Arm slings & its types

In this i have mentioned the uses and different types of arm slings. Indications for different types of arm slings.
This is beneficial for those who are linked with prosthetics and orthotics field.

1. ARM SLINGS & ITS TYPES BY AAMIR SIDDIQUI BPO THIRD YEAR

2. CONTENTS Introduction Materials Indications Contraindications Functions Placement Biomechanical Efficacy Classification Conclusion

3. INTRODUCTION This orthotic allows supports the arm in a neutral position providing immobilization and stabilization to the shoulder. The sling can be held immobilized by a chest or stomach Velcro strap. These straps can be adjustable to accommodate for various patient size. This brace can be used with the thumb loop for additional stability or without. This brace should be snugly tightened to disallow for movement of the arm.

4. MATERIALS Cloth Webbing Elastic Metal ring / fastners Velcro Prefabricated slings are often used.

5. INDICATIONS Acromion-clavicular joint injuries. Scapular, humeral fracture Post-operative shoulder repair Arthroplasty Brachial plexus lesion Upper-motor neuron lesion.

6. CONTRAINDICATIONS Slings have fallen out of favor with a neurodevelopmental treatment approach to UMN lesions because they are thought to encourage flexion synergy, increase flexor tone, and promote contractures. The Rolyan hemi arm sling or the hook hemiharness may not approximate the GH joint in large patients.

7. FUNCTIONS Immobilize to promote tissue healing Prevent overstretching of GH musculature / ligaments. Decreased shoulder pain related to arm distraction and shoulder-hand syndrome. Keep hand and forearm elevated to reduce oedema .

8. PLACEMENT Most slings support the forearm with the elbow flexed, shoulder internally rotated, and arm adducted. The rolyan hemi arm sling supports the humerus and allows the elbow and forearm to be free by using a humeral cuff with figure-of-eight suspension. The Hook Hemiharness has two humeral cuffs connected by a posterior yoke and abducts each arm slightly while allowing the elbow and forearm to be free.

9. BIOMECHANICAL EFFICACY Slings may be static or dynamic. Dynamic slings use elastic straps and are designed to allow some motion of the forearm while supporting the arm. The wrist should be supported by the sling to prevent wrist drop if there is distal weakness. Hand should be higher than the elbow to decrease the edema. Care must be taken to mobilize the shoulder as soon as possible to prevent adhesive capsulitis.

10. CLASSIFICATION Slings may be classified as follows: Single strap sling Multiple strap sling Vertical arm sling Abduction arm sling Overhead sling

11. SINGLE STRAP SLING Most popular. Pre-fabricated, simple, economical and easy to don. Adjustable Distal cuff should span the wrist to prevent ulnar deviation. A diagonal strap passes from the distal cuff crosses the anterior aspect of contralateral shoulder to posterior chest and terminates at the proximal cuff.

12. MULTIPLE STRAP SLING The forearm cuffs and the diagonal strap of the single strap sling may be augmented by one or more straps, often including a vertical strap over the ipsilateral shoulder to create a multiple strap sling. Have additional strapping to a waist belt to aid stabilization. Pre-fabricated.

13. VERTICAL ARM SLING Permits the elbow to extend. Support consists of a shoulder saddle and forearm cuff joined together by dacron strap. Pre-fabricated.

14. ABDUCTION SLING Pre-fabricated Consists of bilateral arm cuffs joined by an adjustable posterior straps. Cuffs fit around the arms, terminating just above the elbow crease. FUNCTION Support shoulder in slightly abduction position.

15. OVERHEAD SLING / SUSPENSION SLING Pre-fabricated. May be attached to bed, wheel chair or any other chair, floor stand. It should be atleast 30 cm above the patient’s head to allow a sling length of 16-90 cm The higher the rod, wide and flattened will tie the arc of angle. Range of shoulder and elbow extension is directly proportional to length of webbing.

16. FIGURE-OF-EIGHT SLING Restrict motion to promote tissue healing. Improve posture. Reduce scapular myofascial pain. INDICATIONS Clavicular fractures. Forward shoulder posture. Pectoral contracture.

17. CONCLUSION Arm slings protect shoulder from painful motion after injury to shoulder capsule and its musculature. Arm slings are: Corrective Assistive Protective Supportive