SOMI Brace: A Guide for Patients

Orthopaedic Nursing Division
Department of Nursing
The University of Iowa Hospitals and Clinics

SOMI Brace

Braces are fitted to a body region to provide support, correct deformities, and prevent specific joint and body movement.

The SOMI brace holds your neck in a straight line with your spine by providing a rigid support to the unstable and weakened muscles and bones of your neck. The SOMI brace prevents movement such as bending and twisting your neck and protects your neck from injury as it heals.

SOMI is an abbreviation for sterno-occipital-mandibular immobilizer. S = sterno (upper and midchest), O = occipital (base of skull), M = mandibular (chin and jaw), I = immobilizer (gives support and prevents movement of body parts).

During your hospital stay or clinic visit, the physicians and nurses will explain the parts and functions of the SOMI brace. Your physician will supervise the first fitting of your SOMI brace and direct adjustments or alterations if needed. Feel free to inform your physician of any discomfort caused by your brace. The SOMI brace should be worn and adjusted only as your physician instructs.

Parts of the SOMI Brace

Chin Piece

The chin piece supports your lower jaw by forming a cup for your chin to rest upon. The chin piece is attached by straps to the headpiece and by a front metal extension to the chest piece. The chin piece must be worn when walking and whenever active movement of the head and neck would occur. The chin piece may be removed only when instructed by your physician.

Headband

The headband straps across the forehead and is fitted to a plastic device at the back of your head. You must wear the headband whenever you have removed your chin piece. Activities such as eating, bathing, and shaving are appropriately undertaken with use of the headband.

Chest Piece

The chest piece rests upon your chest and connects to the chin piece and occipital piece. The chest piece and occipital piece should be removed only when instructed by your physician.

Occipital Piece

The occipital piece supports the base of your head and helps hold your head in upright position.

How to Switch Headband and Chin Piece

• Attach velcro band across forehead.
• Unsnap chin piece from occipital piece.
• Resnap headband to occipital piece.
• Remove chin piece only when headband is attached.
• To reattach chin piece, replace chin piece to occipital piece.
• Remove headband.

• Always return piece to the indicated mark on the front extension.
• Use a mirror to check position of your head when changing these pieces.
• Check your chin and lower jaw for redness and skin problems each time you switch pieces.
• Chin piece should be worn during periods of walking, riding in a car, and those activities which place any stress on the neck muscles.

A daily routine of skin care is very important, because it helps to prevent skin problems. Skin care involves inspecting and cleansing your skin.

For most people, a sponge bath is the best method of daily cleansing. Areas in direct contact with the brace, such as your chin and lower jaw, may need more frequent cleansing.

Inspecting your skin is important, especially those areas that receive pressure, rubbing, or friction from the brace. In particular, irritations may develop over bony areas such as the chin and jawline, shoulder bones, and back of the head. Reddened or bruised areas are the first clues to developing skin irritations.

Signs of skin irritation

• indentation or marks on your skin
• bruises
• blisters
• swollen or puffy areas
• abrasions
• scrapes or cuts
• reddened areas
• rashes

Remember: Preventing is easier than treating

Wearing and Changing T-shirts

Wearing a light cotton T-shirt under the SOMI brace serves as a cushion and absorbs perspiration. You may prefer to wear T-shirts that are slightly larger than your usual size. Changing T-shirts daily is best accomplished with the assistance of another person and always while lying on your back.

To put on a T-shirt, place the T-shirt over your head and pull it down to your neck. Remove the chin piece and pull the T-shirt down enough to allow the placement of one arm into a sleeve and then the other. Pull the T-shirt under the brace, making sure to pull out all wrinkles. Reverse this process to remove the T-shirt, and always do this while lying on your back.

General Information

• Your brace should not be altered or removed without your physician's consent.
• The headband or chin piece must be in place at all times. The chin piece should be worn most, because it best supports your neck and head.
• Follow a daily skin care and hygiene routine.
• Those areas likely to develop irritation may be padded to minimize pressure and friction. A T-shirt, soft clothes, adhesive Band-Aids, or thin foam may be used to act as a cushion between the brace and your skin.
• A front button shirt is recommended for over the brace. This will allow easier removal and application of the chin piece.
• If possible, have another person become familiar with the process of changing the chin piece and headband.
• Call the hospital and ask for the orthopaedic resident on call if any of the following symptoms develop:
  • increasing discomfort caused by the brace
  • a sore caused by pressure over an area
  • numbness or tingling in extremities
  • increased pain
  • inability to move arm or hand
  • extremity weakness

After you return home, if you have any question or concerns, please telephone the Orthopaedic Clinic (319) 356-2377, Monday - Friday from 8:00 a.m. to 5:00 p.m. On weekends, telephone the University Hospitals switchboard operator (319) 356-1616 and ask to speak with the orthopaedic resident on call or to the orthopaedic nursing supervisor.

Written by:
Judy Theisen, R.N.

See related Patient Textbooks about Orthopaedic Surgery.

See related Patient Topics Orthopaedic Surgery, Procedures and Therapies or Rehabilitation.

See related Provider Textbooks about Orthopaedic Surgery.

See related Provider Topics Orthopaedic Surgery or Procedures and Therapies.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

http://www.vh.org/adult/patient/orthopaedics/somibrace/index.html