A Comprehensive Review of Wrist-Hand Orthoses: Biomechanics and Additive Manufacturing

Year 2025, Volume: 11 Issue: 2, 135 - 145, 31.08.2025

Ahmet Gökhan Acar , Harun Gökçe , Serap Alsancak , İsmail Şahin

Abstract

Upper extremity orthoses play a critical role in supporting individuals with limited limb functionality due to musculoskeletal injuries or neurological disorders. Wrist-hand orthoses (WHOs), particularly those designed with wrist-driven mechanisms, enhance hand function by leveraging the tenodesis effect—a natural movement pattern where wrist extension causes passive finger flexion. Wrist-driven orthoses (WDOs) enable users with residual wrist motion to perform functional grips, improving their independence in daily tasks. However, patients lacking active wrist movement require additional assistance such as elastic bands, shoulder motions, or external power sources to activate the mechanism. Despite their functional benefits, WDOs often present challenges in usability, including complex donning and doffing procedures, poor fit, mechanical reliability issues, and cosmetically unappealing designs, which may limit patient compliance and long-term use. The fit of the orthosis and the alignment of the finger mechanism significantly affect comfort and effectiveness. This study presents a comprehensive literature review focusing on wrist-hand orthoses that incorporate wrist mobility. It highlights current design approaches, functional outcomes, and existing limitations while emphasizing the need for efficient, user-friendly, and reliable solutions to enhance patient satisfaction and improve usage rates in clinical and everyday settings. This review explores the significance of wrist-hand orthoses, focusing on their biomechanical aspects and the advancements in additive manufacturing techniques. Key findings, research gaps, and potential future developments are highlighted to provide a comprehensive understanding of the topic.

Keywords

wrist driven wrist-hand orthosis , biomechanics , additive manufacturing

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