Fractures and Amputation

Question 1

An ankle disarticulation with attachment of heel pad to distal end of tibia; may include removal of malleoli and distal tibial/fibular flares– this describes what type of amputation?

Answer 1

Symes

Question 2

A physical therapist performs a dorsal glide to the distal radioulnar joint on a patient 12 weeks status post fracture. This technique is best used to increase:

Answer 2

supination

Question 3

The following are true regarding phantom limb pain, except:

Answer 3

If it is still present at 6 months post surgery, the prognosis is favorable

Question 4

A patient with severe fracture pattern, skin contusion and complicated with (+) compartment syndrome was referred for in patient physical therapy. What type/grade of closed fracture as to Oestern and Tscherne classification is being described?

Answer 4

Grade 3

Question 5

These complications develop only on the stumps on active prosthetic users as result of socket pressure, skin friction, and perspiration

Answer 5

Epidermoid cysts

Question 6

A 35-60% of transfemoral stump compared to normal is considered a ___________ stump

Answer 6

medium transfemoral stump

Question 7

A physical therapist treats a patient following a lower extremity amputation. The patient is currently one week post-op and has a postoperative rigid dressing. Which of the following is not a benefit of the rigid dressing?

Answer 7

allows for daily wound inspection and dressing changes

Question 8

Part of the management guidelines for fractures during the period of immobilization is decreasing the effects of immobilization. Which of the following interventions is not appropriate for the said plan of care?

Answer 8

Initiate joint play stretching using grades III and IV with force applied proximal to healing fracture site

Question 9

A physical therapist is evaluating a 70-year-old female patient who reports the onset of midthoracic pain after working in a garden for several hours. The presence of which of the following history items should increase the therapist’s suspicion of a thoracic compression fracture in the patient?

Answer 9

Smoking and prolonged steroid use

Question 10

A 29 year old female status post Colles’ fracture is referred to physical therapy. The patient has moderate edema in her fingers and the dorsum of her hand and complains of pain during active range of motion. The most appropriate method to quantify the patient’s edema is:

Answer 10

volumetric measurements

Question 11

Principles of Fracture Treatment

Answer 11

Reduction, Maintenance of Reduction, Preservation & Restoration of Function

Question 12

A 65-year-old diabetic male with forefoot gangrene is evaluated for possible amputation. When discussing the amputation levels with the patient, which of the following should be noted to require the greatest increase in energy expenditure for ambulation?

Answer 12

Transfemoral amputation

Question 13

All of the following describes an Type 3 open fracture as to Gustillo Anderson Classification; except?

Answer 13

No periosteal stripping

Question 14

A patient sustains a burst fracture of a thoracic vertebra secondary to a hyperflexion injury. The physician’s note indicates the fracture is stable. Which of the following would not be considered appropriate immediate physical therapy management?

Answer 14

active spinal range of motion exercises

Question 15

A physical therapist provides preoperative instructions to a patient scheduled for lower extremity amputation. Which of the following is the most common cause of lower extremity amputation?

Answer 15

peripheral vascular disease

Question 16

Fx of distal radius associated w/ dislocation of the ulnar head

Answer 16

Moore’s fx

Question 17

A patient fell while rock climbing 2 days ago. The fall resulted in a fracture of the right ankle, requiring an open reduction and internal fixation. The patient also sustained a nerve injury that resulted in significant weakness in the muscles in the right C6–C7 myotome. The patient is restricted to non-weight-bearing status on the right lower extremity. Which of the following assistive devices is MOST appropriate for the patient?

Answer 17

wheelchair

Question 18

fx involves volar displacement & angulation of distal fragment

Answer 18

Smith’s fx

Question 19

An amputation through the talonavicular and calcaneocuboid joints

Answer 19

Chopart

Question 20

To measure the transhumeral stump, it should be measured from the tip of the acromion process to the medial femoral condyle

Answer 20

false

Question 21

A physical therapist instructs a patient rehabilitating from a fractured right ankle to ascend a set of stairs equipped with handrails. The patient indicates that his job requires him to use the stairs frequently and expresses concern that he will be unable to adequately navigate through traffic. The most appropriate location to stand when guarding the patient is:

Answer 21

behind the patient toward the uninvolved side

Question 22

Which of the following muscles are not to be stressed in training above and below knee amputees?

Answer 22

shoulder elevators and elbow flexors

Question 23

An amputation through tarsometatarsal joint

Answer 23

Lisfranc

Question 24

All of the following suggests the disadvantages of an Immediate Post Operative Prosthesis compared with other post surgical dressings, except?

Answer 24

Easy access to incision

Question 25

extraarticular fx w/ dorsal displacement of distal fragment & radial shift of wrist / hand

Answer 25

Colle’s fx

Question 26

A physical therapist is preparing to evaluate a patient who had a closed reduction with cast fixation for an ankle fracture 1 day ago and currently has non-weight-bearing status. The patient reports foot pain in the injured extremity. Based on the patient’s report, which of the following procedures should the physical therapist perform?

Answer 26

Capillary refill in toes

Question 27

This complication develops gradually and is visible at the distal end of the mature amputation stump. It is characterized as thickened skin, “pully” discoloration, mushroom – like appearance, and dull sensation.

Answer 27

Verrucose Hyperplasia

Question 28

A physical therapist instructs a patient with a unilateral amputation to ascend and descend stairs. Which amputation level would you expect to have the most difficulty performing the described task?

Answer 28

transfemoral

Question 29

A patient rehabilitating from a trimalleolar fracture is cleared for 20 pounds of weight bearing. During a scheduled therapy session, the patient admits he has not used crutches during the past week. The most appropriate physical therapist action is:

Answer 29

inform the patient of the potential consequence of placing too much weight on the involved leg

Question 30

The sensation that the distal part of the amputated extremity has moved proximally up the arm

Answer 30

Telescoping