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Wilmer Carrying Orthosis

Repositioning of the shoulder, thanks to a smart balancing construction

More function - Less pain

The Wilmer Carrying Orthosis is the original ‘Wilmer’, a shoulder orthosis (also known as shoulder brace or shoulder splint), developed at Delft University of Technology. Recently, we came up with a major update for this product. The Wilmer2 Carrying Orthosis has emerged as a successor to the Wilmer Carrying Orthosis. However, the original carrying orthosis has many loyal fans worldwide. In addition, the classic carrying orthosis is a more convenient choice in case it needs to be combined with, for example, a custom made wrist orthosis. Therefore, the good old familiar Wilmer Carrying Orthosis (abbreviated WCO) remains available.

Dislocated shoulder (subluxation)

The Wilmer Carrying Orthosis is intended for people suffering from a partially dislocated or completely dislocated shoulder (luxation). This often painful situation prevents proper functional use of the affected arm. The arm hangs from its capsule and ligaments and in time dislocates further and further.

With the WCO, the upper arm pushes itself upwards, reducing tension on the joint capsule and tendons. The pain is relieved and the shoulder head brought back into its joint position again, regaining some of the arm functions.

Specifications
Symptoms
Support

Specifications of the WCO

Effective neutralisation of shoulder subluxation.
Regain some of the arm functions.
Reduced chance on oedema formation in hand, fingers and forearm.
Reduced pain and discomfort in arm and shoulder.
No neck loading.
Only minor limitation of arm mobility.
Can be worn fully underneath clothing.
High wearing comfort partly because of open and lightweight construction.
Custom made to perfectly fit your arm
Light weight orthosis: less than 170 gram
Weight of shoulder strap: 75 gram.

Further specifications and performances of the Wilmer Carrying Orthosis

Three basic models (see bottom of page)
- Standaard unit
- Hands-free unit
- Wrist free unit
All units are available in left and right models
All models are individually tailored and adjusted to fit your arm by your local orthotist.
Normal and large sizes
- Normal
  - forearm length between 23 and 29 cm
  - forearm circumference between 23 and 29 cm
- Large
  - forearm length between 23 and 29 cm
  - forearm circumference between 28 and 34 cm
On request, an orthosis can be delivered with a different size.
The carrying orthosis is preferably worn underneath clothing, but can be worn on top of clothing. The orthosis slips somewhat easier in that case.

Shoulder (sub)luxation: causes and backgrounds

The causes of shoulder (sub)luxation is usually the paralysis of the muscles around the shoulder (especially Supraspinatus muscle) by brain damage such as a (stroke (CVA)) or a Brachial Plexus lesion.

What is a Brachial Plexus lesion?

The latter is a damage to the ganglion behind the collarbone (clavicle) that controls almost all the muscles in the arm. If this ganglion is damaged, there are often severe deficits of the muscles in the arm, including around the shoulder. If the collarbone breaks, this breakage may sometimes damage the Brachial Plexus.

Broken clavicle

The clavicle is most commonly broken due to fall-impacts on the shoulder, for example in bicycle, moped or motorcycle accidents. In addition to the affected muscles around the shoulder, there are often deficits of elbow, wrist and hand muscles.

Also with hypermobility

Shoulder subluxations also occur with people with hypermobility complaints (eg due to joint hypermobility syndrome (JHS) or Ehlers-Danlos syndrome).

Post-operatively

The Carrying Orthosis is also used post-operatively to reduce loading of the shoulder joint, for instance after surgery on the humerus head or to prevent oedema formation after breast surgery resulting in a damaged lymph system.

Section of the glenohumeral (shoulder) joint. Clearly visible is the low contact surface of the upper arm (humerus (1)) with the shoulder blade (scapula (2)). The shape of the joint surfaces only contributes minimally to the stability of the joint. Capsule and liagments (3), but especially an active contribution of the muscles (especially supraspinatus_muscle) are necessary to ensure the integrity of the joint. (From : Kahle W, et al4, Sesam Atlas van de Anatomie, Fifth edition 1986; ISBN 90 246 6916 2, edited).

Line of action of the m. suprasinatus (blue) seen form the back side. This muscle generates, in contrast to the more vertical working m. biceps, m. triceps and most of the m. deltiod a slightly upward pointed compression of the joint. (From : Kahle W, et al4, Sesam Atlas van de Anatomie, Fifth edition 1986; ISBN 90 246 6916 2, edited).

Ordering codes WCO for the professional

Maintenance of the Wilmer Carrying Orthosis

The shoulder strap can be washed as well as the wrist and elbow straps. Remove the straps of the orthosis. Make sure the Velcro is closed so that no fabric sticks to it. Use a washing bag to wash the straps at a temperature of up to 30° C (86°F). The rest of the orthosis can be cleaned with a damp cloth.

Replacement of spare parts

It may occur that parts of the orthosis need to be replaced. Of course you can order these from us. Please contact us and we will send a replacement part.

WCO manual

Or download here the Wilmer Carrying Orthosis manual.

How does the Wilmer Carrying Orthosis work?

Treating a shoulder (sub)luxation by wearing a sling may reduce loading on the ligaments and capsule, it doesn’t neutralise the (sub)luxation itself. On top of that a sling needs to be worn over clothing, highly limits arm mobility and,last but not least, it loads the neck.

Working principle WILMER Carrying Orthosis

The WCO does have effect

The use of the WILMER Carrying Orthosis does lead to effective neutralisation of the (sub)luxation. The Carrying Orthosis suspends the arm close to the elbow (see photo), leading to a slight misbalance of the weight of the forearm in reference to the weight of the upper arm.

The gravity does the rest

When the forearm is directed downwards by gravity, the upper arm is, at the same time, pushed upwards, leading to the head of the upper arm finding its support in the shoulder joint again. This smart use of mechanics makes the WCO a unique product. It is still the only orthosis that is really capable of neutralizing (sub)luxation. If you want to know more about the operation of the WCO then download here an article explaining in detail how this orthosis works, but also why a sling doesn’t.

No neck load

The Carrying Orthosis is equipped with a shoulder cap that leaves the neck and often painful shoulder head unloaded. The design of the Carrying Orthosis allows it to be worn fully underneath clothing. There is only a mild limitation of arm mobility. The predominantly horizontal position of the forearm reduces the chance on oedema formation.

Treatment is necessary

In general a shoulder (sub)luxation is a permanent condition. If a (sub)luxation remains untreated, the shoulder will gradually increase its drop out of position. This is usually a highly painful situation. On top of that the arm can hardly be used functionally. An orthosis is necessary to prevent further increase of the (sub)luxation, to reduce pain and to regain some of the arm functions.

Could the Wilmer Carrying Orthosis benefit you?

If you’re interested in additional information on the carrying orthosis, or if you want to find out if the carrying orthosis could benefit you, please feel free to contact us. You can phone us at +31 53 430 28 36 or email us: info@ambroise.nl

One of our clinical experts Nils or Joep are more than happy to discuss the best solution for your problems with you. And we’re more than happy to see how we can realise a well fitted Carrying Orthosis for you, provided that this will be a suitable option in your case. Click here to read more about this route.
Your local orthotist or specialist should also be able to provide additional information on the applicability of the WILMER Carrying Orthosis in your case.

The orthoses of Ambroise are continuous in development

The orthoses of Ambroise are continuous in <strong>development</strong>

Wilmer Carrying orthosis

Improved shoulder cap The renewed shoulder cap contains an even greater reinforcement, which means there is even less chance of tearing out the fabric.
Quick slim closure The locking clip has been replaced by a slim Velcro system that makes it easy to close the strap with one hand.
Fine color The WDO is made in Ambroise anthracite (gray) and is therefore recognizable as a product from our own orthosis line.

The WILMER carrying orthosis standard unit, supports the paralyzed arm, wrist and hand

WILMER hands-free unit which optimally supports the paralyzed arm and wrist ensuring optimal hand and finger mobility

WILMER wrist-free unit which optimally supports the paralyzed arm ensuring optimal wrist, hand and finger mobility

Further specifications and models of the Wilmer Carrying Orthosis

Standard Unit – With hand support
- The standard unit is used when full hand support is required.
- The hand support brings the hand to a stable rest position.
- The curved edge ensures that the hand does not slip from the support.
- The perforated plastic (PE) hand support has rounded edges, giving a comfortable hand support, which is well ventilated, but also easy to clean.

Hands-free unit – With handspoon
- The model with a hand spoon is used by people whose control over the fingers of the hand is still (partly) present, but have insufficient control over the wrist.
- Through a small perforated hand spoon placed in the palm of the hand, the wrist is supported, but the fingers and thumb remain free so that (limited) functionality is possible.
- This creates an optimal combination of control and functionality.

Wrist-free unit
- The wrist-free unit leaves both wrist and hand free.
- Ideal for people with good control over hand and wrist.
- This gives you maximum freedom and functionality at your hand.
- Comfortable suspension of frame on the forearm.
- Adjustable wrist straps.

Specials
- Occasionally, a complete individual hand orthosis is produced that is connected to the WCO’s frame.
- This happens, for example, if there is severe spasticity around the hand and fingers.
- The original Carrying Orthosis model is a more convenient choice in that case than the Wilmer2 Carrying Orthosis