I. Classification of Orthoses by Function

Based on the main mechanism of action and clinical application scenarios, orthoses can be classified into the following six categories:

1. Fixed and Stabilizing Orthoses

Core Function: Limit abnormal limb movement, maintain joint stability, and promote fracture healing or inflammation resolution.

Applicable Scenarios: Fracture fixation, after joint dislocation reduction, acute stage of arthritis, postoperative immobilization, etc.

2. Corrective Orthoses

Core Function: Through continuous mechanical corrective force, improve limb or spinal deformities (such as scoliosis, clubfoot, etc.).

Applicable Scenarios: Adolescent idiopathic scoliosis, congenital clubfoot, varus or valgus knee (O-shaped or X-shaped legs), etc.

3. Compensatory and Ambulatory Orthoses

Core Function: Replace or assist limb function, helping patients restore motor ability (such as walking function after spinal cord injury or hemiplegia).

Applicable Scenarios: Weak lower limb muscle strength, paraplegia, post-stroke sequelae, etc.

4. Protective and Preventive Orthoses

Core Function: Reduce the pressure on joints or soft tissues, prevent injury or delay disease progression.

Applicable Scenarios: Prevention of sports injuries, protection of osteoarthritis, postoperative rehabilitation protection, etc.

5. Dynamic and Functional Orthoses

Core Function: While restricting abnormal movement, allow normal physiological activities, promoting active rehabilitation training.

Applicable Scenarios: Early rehabilitation after joint surgery, functional reconstruction after nerve injury.

II. Correct Usage Methods of Orthoses

The effect of orthoses depends on proper use, which requires clinical guidance and individual adjustment. The specific steps are as follows:

1. Preparation Before Fitting

Professional Assessment: A rehabilitation physician or orthotist determines the type based on the condition (such as fracture location, degree of deformity, muscle strength grade).

Personalized Adjustment: Custom orthoses need to be ensured to fit through 3D scanning or plaster molding (such as scoliosis braces need to closely follow the spinal curve), and ready-made orthoses need to be tried on to adjust the tightness (it should be possible to insert 1-2 fingers).

2. Wearing Norms

Wearing Sequence: First wear thin cotton underwear (to reduce skin friction), then wear from the proximal end to the distal end (such as hip-knee-ankle braces, first fix the hip joint, then adjust the knee joint).

Tightness Control: The tightness of the fixation straps should be moderate. If too tight, it may cause pressure sores (especially at bony prominences such as the ankle and scapula), and if too loose, the corrective effect will be lost.

3. Usage Duration and Cycle

Phased Adjustment

Fracture Fixation Braces: Wear 24 hours a day in the early stage (except for skin cleaning), and reduce the duration after 4-6 weeks based on the growth of callus.

Scoliosis Braces: Teenage patients need to wear 16-23 hours a day, and adjust the wearing time according to the correction effect.

Postoperative Rehabilitation Braces: Adjust the range of motion according to the rehabilitation plan in stages (such as knee braces after surgery gradually increase from 0° extension to 90° flexion).

Avoid Over-reliance: Under the guidance of a doctor, combine active training (such as muscle strength exercises), to prevent muscle atrophy (such as during the wearing of ankle braces, simultaneous calf muscle strength training should be conducted). 

4. Daily Care and Monitoring

a. Skin Protection: Check the skin at the contact points daily for any redness, swelling or indentations.

b. Orthosis Maintenance: Regularly inspect the fasteners (screws, buckles) for looseness.

c. Timely Adjustment: If there is increased pain, limb swelling or the orthosis becomes loose, contact a professional for adjustment. Do not modify the structure yourself.

5. Coordinating with Rehabilitation Training

Orthoses are auxiliary tools and need to be combined with targeted rehabilitation training (such as joint range of motion exercises, balance training) to achieve the best results. For example, after the removal of an ankle fracture brace, ankle flexibility can be restored through heel raises and toe curls.

Proper use of orthoses can significantly enhance treatment and rehabilitation outcomes. The core principles are "professional guidance, individualized fitting, and dynamic adjustment".