What are the most commonly used types of limited contact TLSOs

Design: Consists of a three-point fixation system with anterior pads located over the sternum and pubic symphysis and a posterior pad located over the thoracolumbar region. This orthosis restricts flexion but permits free extension. It is reported to be uncomfortable due to force concentration over a small area as a result of its three-point design Indication: For pain relief associated with minor stable thoracic and upper lumbar fractures (e.g. fractures secondary to osteoporosis) CASH (Fig. 18-13)

Design: The CASH orthosis is shaped like a cross with bars and pads anteriorly that are opposed by a posterior thora-

columbar strap Indication: Similar to Jewett KNIGHT-TAYLOR (Fig. 18-14)

Design: Pelvic and thoracic bands are connected by a pair of posterior and lateral metal uprights. An interscapular band stabilizes the uprights and serves as an attachment for axillary straps. Over the shoulder straps attempt to limit lateral bending and flexion-extension. A cervical extension may be added. Poor rotational control is provided by this orthosis Indications: Minor stable fractures and stable soft tissue injuries

Figure 18-12. Jewett orthosis.
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