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The Pronosupinator! A new wrist orthosis.

By Holger Dielenberg

In the clinical world of trauma rehabilitation, do you break the rules to help your patient? Usually not.

Certified hand therapists, Brodwen McBain and Jeff Sanderson found that listening to their patients lead them to push their solution design out of the therapist guidebook comfort zone. The result is a better orthosis providing mobility following elbow and wrist trauma at a cheaper price.

A desire to provide better care for their patients has led the innovative duo on a journey of skills development in industrial design, tool making, engineering, business and marketing. Their garage became a factory where they tested prototypes, and used pneumatic tools to bend and shape aluminium. To keep costs down and speed up the design iteration process, initial prototypes were made from balsa wood and cardboard to test things like hinges and telescoping and lengthening arms.

Patients who have severely damaged their wrist and elbow will usually endure a long period of time with their arms and wrists strapped in splints or braces to hold them immobile. Try sleeping with one digging into your ribs at night! Following trauma or immobilisation, limitations in forearm rotation (turning your palm up and down) can manifest as stiffness or pain at end-of-range. For most patients, standard hand therapy consisting of exercise, short stretches, massage , and return to everyday activities solves this issue. If that fails, in most cases a rotation mobilisation orthosis (a brace that stretches into rotation) is indicated. This is where Brodwen and Jeff come in.

The problem that Brodwen and Jeff found in their daily practice is that most rotation mobilisation orthoses have limited motion and will nearly always lock the elbow at 90 degrees. They are uncomfortable and expensive which means they are usually used as a last resort when critical healing has already happened in static conditions.

Brodwen and Jeff wanted to give patients more mobility freedom to their elbows and wrists during therapy to eliminate discomfort and increase recovery of joint rotational function. Their solution, the Pronosupinator! allows the right therapy from the start, speeds recovery, decreases the need for post physio work, and ensures an optimal result.

“The orthosis needed to be comfortable, and importantly allow function. Patients simply can’t function with an elbow locked at 90 degrees or in static rotation. While patients need a firm stretch at end-of-range rotation, function is impossible without rotation, so a rotation mechanism needed to dynamic to allow brief functional rotation and free up the elbow.”

They decided to patent their idea to allow for future improvements and cost control after searching for Australian orthotic manufacturers, found that most, if not all of them had gone offshore! They managed to get tasks done to a high quality at reasonable cost by some local manufacturers however, the frame and hinge mechanisms needed to be designed, machined to acceptable tolerances and drilled, tapped for nut threading. They had to do all this themselves.

“The Pronosupinator! had gone full circle from cardboard, balsa and plastic prototypes to aluminium and neoprene with fasteners. We’d moved from a bespoke therapist made design to a prefabricated self-manufactured design which unbelievably achieves a better fit than most alternatives. We’d moved away from some splinting rules to patient-demanded, rule breaking design which worked better than by-the-book. And we had a product and patent which we believed rivalled all others on all levels.”

Concurrently, the team were admitted into the Bench 2 Business training program by Space Tank Studio, supported by LaunchVic, for the purpose of making the Pronosupinator! Space Tank Studio designed the Bench 2 Business program to train and support start-ups in manufacturing technology and business skills. The program gave Brodwen and Jeff access to and training in technologies such as 3D printing, CNC milling, laser cutting, metalworking, timberworking and others, and will eventually cover patent and business skills.

“We have been fortunate enough to meet and learn from design professionals and other aspiring manufacturers, proving to be a valuable source of idea sharing and problem-solving. We were also afforded the opportunity to present our idea to The Hon. Philip Dalidakis, State Minister for Innovation and the Digital Economy, and LaunchVic through this program.”

The dynamic duo are well on their way to providing better care for patients with their new therapy solution and in doing so may have stumbled onto something that can have far reaching positive effects for therapists and patients everywhere around the world.

Brodwen and Jeff are a great example of the kinds of passionate and resourceful people who are coming through the Bench to Business training program. Check out their website Upperlimbco for more information and feel to contact us at Space Tank if you have an idea or product concept of your own that you’d like to develop and bring to market.

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