General Information
The SADER II is the first supinator/pronator that allows both motions to occur dynamically in a single bracing device. This allows the treating professional to choose the most appropriate motion to encourage contracture reduction. This brace has built in options for dynamic supination or pronation, static positioning and elbow positioning to accommodate multiple injuries. Limited free range-of-motion is also available at the elbow.
This device is light weight and comfortable to wear. Patients can expect to gain 1 1/2 degrees per day while wearing the device without discomfort. All tensions are adjustable and easily controlled by the patient.
Tensions are adjusted to the patients perceived sensation of stretch without pain. (SADER Dynamic Standard) These tensions can be adjusted by the patient by loosening the tension strap or changing the position on the forearm tension pins. Many patients will change the tension several times a day to adjust for comfort. This device can be worn with or without tension for varying times of the day or by alternating the stretch between supination and pronation.
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Wrist Fractures
Wrist fractures often result in length discrepancies and or associated soft tissue injuries to the surrounding area. The SADER II is an excellent choice for stretching the associated soft tissues and mobilizing functional range. Functional elbow motion should be encouraged before attempting to gain supination and pronation motion.
There has been numerous classification schemes developed for extension fractures of the distal radius. These wrist fractures tend to be complex and cumbersome. In general, the greater the degree of displacement and comminution of the skeletal system , the more severe the injury. Extension of a fracture into the radiocarpal or the DRUJ is also a marker for a more severe injury. More complex fractures tend to be more unstable. . None of the fracture classification systems can adequately predict the outcome following injury. The large majority of these injuries result in no loss of ROM, deficits in strength or function. However, those injuries that result in these sequelae can be difficult to manage. The SADER upper extremity product line has been developed by upper extremity specialists to provide the clinician and patients an opportunity to regain their functional ROM. These braces have been successfully utilized throughout the hand surgery and therapy community in the US.
Colles fracture is the most common extension fracture pattern. The term was described by Abraham Colles in 1814. Recent literature identifies the force required to produce these fractures between the range of 105 kg and 440 kg. A amount of force resulting in both skeletal and soft tissue injuries. 90 percent of these injuries result from a fall on an outstretched hand. Consolidation of the fracture frequently occurs within 3 to 8 weeks. 20 percent of patients with a colles fracture have residual symptoms. 10 percent of patients have residual functional impairment. The SADER I and SADER II provide the patient and clinicians the ability to work on bi-directional loss of ROM through the well defined principle of low force over extended periods of time Gelberman principles. The SADER product line also provides a positional locking mechanism to statically position the joint in end range of motions (static progressive). The controlled ROM that the SADER products provide, allow the clinicians to begin earlier, controlled ROM minimizing loss of ROM and function.
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TFCC Injuries and Reconstruction
The radius articulates directly with the scaphoid, lunate as well as the ulna. The scaphoid “locks out” and prevents extension end range of motion. Fractures of the scaphoid and associated ligaments can severely limit ROM. The distal radius and ulna also has a complex ligament system that provides bio mechanical stability and is known as the triangular fibrocartilage, or TFCC. This ligament system is interposed between the distal ulna and the triquetrum in the proximal row of carpal bones. Injuries to the TFCC often result in pain, hyper mobility of the ulna and loss of strength. Reconstruction surgery and subsequent post operative immobilization results in a “stiff wrist” often with supination and pronation ROM limitations. The SADER II is designed to quickly manage the supination and pronation limitations in conjunction with other ROM modalities for the wrist.
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Distal Radius/Ulna Dysfunctions
The radius and ulna themselves articulate at a segment known as the DRUJ, or distal radius ulna joint. At this segment, the vast majority of forearm rotation occurs in which the radius rotates about the ulna. These forearm movements are known as supination and pronation. The DRUJ is enclosed within a capsule and share multiple ligamentous attachments both on the volar and dorsal side of the wrist. Injuries to the TFCC can of result in capsular stiffness, articular changes and ligamentous injuries. The brachioradialis muscle attaches on the distal aspect of the radius and can also contribute to the displacement of fracture fragments. The SADER II acts as an immobolizer to the wrist complex while promoting full range of supination and pronation. Fractures associated with the distal radius, ulna and scaphoid account for the vast majority of upper extremity fractures. In the US: Fractures of the distal radius account for one sixth of all fractures seen and treated in the ER.
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Radial Head Injuries
