Hip fx/Replacements (AOTA) Flashcards
significant risk factors for hip fractures
osteoporosis
reduced mobility
primary cause of hip fractures
trauma, particularly falls
types of hip fx
- femoral neck
- intertrochanteric
- subtrochanteric
femoral neck fracture common causes
slight trauma or rotational force, most commonly in women with osteoporosis
intertrochanteric fracture common causes
direct blow to area between greater trochanter and lesser trochanter, most commonly in women under age 60
subtrochanteric fracture common causes
direct blow to letter trochanter, most often result of MVA or fall
most commonly in people under age 60
goals of medical management of hip fx
relieve pain
maintain good bone position (reduction)
allow fx healing
restore optimal function of the client
weight bearing restrictions for hip ORIF
NWB TTWB Partial WB WBAT Full WB
TTWB
toe of affected extremity can touch the ground for balance only; 90% of body weight must be placed on unaffected extremity
Partial WB
affected extremity may only bear 50% of body weight
most common purpose of hip replacement (arthroplasty)
restore joint motion
address joint pain
not considered until other forms of tx are unaffected (cortisone injections)
common causes of hip replacement
osteoarthritis, rheumatoid arthritis, DJDs, trauma, congenital deformity
Posterolateral approach precautions
NO:
flexion greater than 90*
IR
adduction
Anterolateral approach precautions
NO:
ER
Extension
Abduction (?)
OT role in hip replacement tx
- complete occupational profile
- provide home safety recommendations
- educate on precautions and ways to safely transfer and complete ADLs independently within precautions
- emphasize maintaining or increasing joint motion
- increase strength of surrounding musculature
- compensatory strategies and AE PRN
- PAMs as appropriate
