2: Simple Practical Procedures Flashcards
What are the 3 principles of fracture management
- Reduce
- Hold
- Rehabilitate
What is reduction of a fracture
Fractures are re-aligned
What is immobilisation
A joint or bone is held in place using a splint, cast or brace
What is the purpose of immobilisation
To protect damaged structures and prevent further damage
What is the most common method of immobilisation
Splint or plaster cast
What type of cast should not be used in the first 2W following a fracture and why
Circumfrential cast
What type of case should be used in the first 2W
Back-slab cast
When is a total hip replacement indicated
OA of the hip
What structure are approaches for total hip replacement referenced to
Gluteus medius
What are the approaches for total hip replacement
- Anterior
- Anterolateral
- Lateral
- Posterior
What is the most common approach for total hip replacement
Posterior
What is the main advantage of posterior approach
Does not disrupt the hip abductors and therefore enables quick recovery
What is the main disadvantage of the posterior approach
Increased risk of damaging sciatic nerve
What are the main advantages of the anterior approach
Avoids abductor muscles permitting quick recovery
What is the main disadvantage of the anterior approach
There is a 10% risk of loss of sensation over distribution of the lateral femoral cutaneous nerve
Explain what happens in the anterolateral approach
The abductors are removed and excessive adduction to expose the acetabulum
What is the advtange of the anterolateral approach
It does not disrupt the superior reticular vessels and therefore reduces risk of avascular necrosis
What are disadvantages of anterolateral approach
Slow recovery
Risk of damage to superior gluteal nerve
What is the advantage of lateral approach
Lower dislocation rate
What is the main disadvantage of the lateral approach
Abductors are disrupted - resulting in longer recovery
Explain approach of total knee arthroplasty
There is a cap approached to femur and tibia with a plastic space between
What is arthroscopy
small incision is made in the joint and endoscope used to visualise within the joint
What procedure can arthroscopy be used for
meniscectomy
How can a tear in the outer 1/3 of the meniscus be repaired
sutured - due to being highly vascular
