musculoskeletal modalities (4) Flashcards
what are purposes of casting?
-IMMOBILIZE FRACTURE
-CORRECT/PREVENT DEFORMITY
-SUPPORT WEAKENED JOINTS
what are complications of casting?
-pressure ulcers
-compartment syndrome
what are the 6 Ps of a n/v assessment
pain, pallor, paresthesia, pulse, paralysis, poikilothermia
what are causes of compartment syndrome?
-trauma
-fracture
-severely bruised muscle
-severe pain
-cast/bandage
what happens in compartment syndrome?
-fascia covers muscle (doesn’t expand)
-swelling occurs with nowhere to go
-increased BP, bloodflow compromised
-worst case = ischemia / limb death
what is pain disproportionate to injury and n/t to extremity usually a sign of?
compartment syndrome
is compartment syndrome relieved with analgesics?
no
what are interventions for compartment syndrome?
-remove cast
-fasciotomy
can an immobilized fracture hurt?
it shouldn’t
what is a bone infection that is a complication of a fracture?
osteomyelitis
what are causes of osteomyelitis
-bloodstream (often staph)
-nearby tissue infection
-open fracture (ORIF)
-complicated DM
-immunocompromised / poor circulation
how will a client present with osteomyelitis present?
-asymptomatic
-VS changes
-swelling, warmth, redness
-pain
-fatigue
lab tests for osteomyelitis
-CT/MRI!!!! (definitive)
-CBC & blood cultures
-ESR
what meds can help osteomyelitis
-strong IV antibiotics
-oral antibiotics
(long term (3-6 weeks for both))
what acute interventions can be done for osteomyelitis
-surgery (removal of dead bone)
-ORIF reversal / treatment
-strong IV antibiotics
what are complications of osteomyelitis?
-avascular necrosis
-amputation
-sepsis -> death
what is when surgical pins are inserted through skin to bone to hold proper alignemnt?
external fixation
what are indications of external fixation
-fractures with soft tissue damage / wounds
-complicated fractures
what are benefits of external fixation?
-immediate stabilization
-minimize blood loss
-increased comfort
-improved wound care
-early mobilization
what are complications of external fixation
-pin loosening
-infection / osteomyelitis
-compartment syndrome
what are the steps of pin cleaning for external fixation
-gather supplies and wash hands
-gently massage skin so it moves
-directly clean with swab (half saline half peroxide) @ pin site in circular motion
-dry site with dry swab
-clean pins with swabs or gauze
-wrap gauze loosely around site
-gently press down
-clean entire fixator and dry
what is short term fx management to decrease spasms/pain, maintain alignment, and correct/prevent deformity
skeletal traction
what is used to immobilize a fracture with soft tissue damage / wounds
skeletal traction
explain traction/countertraction in skeletal traction
pts weight is countertraction and the weight is traction, the pulling reduces muscle spasms
what is important to consider while a patient has skeletal traction?
-pain control
-prevent skin breakdown (can’t turn)
-prevent shearing
-pin care
-DONT REMOVE WEIGHT
what are some complications of skeletal traction
-atelectasis/pneumonia
-constipation
-anorexia
-infection
-VTE
-CAUTI
what kind of skin traction is sued most frequently?
Buck’s (lower leg)
what is short-term stabilization without pins/wires, with weights attached by velcro, tape, straps, boots, or cuffs
skin traction : Buck’s
what is the weight tolerance of skin?
4.5-8 lbs per extremity
what are indications of orthopedic surgery?
-unstable fracture
-deformity
-joint disease
-necrotic or infected tissue/tumors
-amputation
what are the goals of orthopedic surgery
-improve function
-restore motion
-improve QOL
what are complications of orthopedic surgery
-blood loss (up to 1500 ml)
-acute post-op bleeding
-post op anemia
-infection
what are the most common ortho surgeries
hip& knee
what is the mechanism of action of ortho surgery
remove bad and replace with new
IV antibiotics are given ____ prior to an incision for ortho surgery
60 mins
what is sued to help after a hip surgery
abductor pillow
