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The Bilt-Rite Mutual Open End Arm Sling-XLarge- 4 pack (10-59000-XL-4) is a lightweight sling that still provides quality support. Application and removal are simple as the ends are open for easy use. The weight is displaced to the upper shoulder and back with the use of the adjustable strap. Hold it in place with the hook & loop or ladderlock closure. There is an available thumb loop holder as well. For best fit, measure arm size. XSMALL 10-11" SMALL 11”-13” MEDIUM 13”-14” LARGE 14.5”-15.5” XLARGE 15.5” and up.