ortho and radiology basics Flashcards
acute injuries
- less than 6 weeks
chronic injuries
- greater than 6 weeks
provocative tests
- recreate mechanism of injury to reproduce pts pain
stress tests
- apply load to test ligament stability
functional test
- assess injury severity and ADLs
open fracture
- break in skin and underling soft tissue
- surgical tx within six hours
why would you immobilize a joint after a fracture?
- maintain anatomic position
- prevent movement of fx and further injury
- limits NV injury
- pain control
methods of immobilization
- splint
- cast
- closed reduction percutaneous pinning (CRPP)
- open reduction internal fixation (ORIF)
- external fixator
- intramedullary rodding
how long does it take for fx to heal? phases of healing?
- 6 weeks
- inflammatory phase- hematoma
- reparative phase- callus that lasts 3-4 months
- bone remodeling
splinting a fracture
- splint for 2-3 days to allow swelling to decrease
- refer to ortho for possible cast
- splints allow soft tissue swelling
- minimize NV compromise
- immobilize joint above and below injury
- eval distal circulation, motor function and sensation before AND after splinting**
casting a fracture
- usually on for 4-6 weeks
- changed at about 3 week mark if no fx movement
- treatment of choice for most non-operative fx
what do you use short arm casts for?
- wrist fx
what do you use long arm casts for?
- forearm fx
- unstable wrist fx to prevent pronation and supination
what do you use thumb spica casts for?
- scaphoid or radial styloid fx
what is the best immobilization option for LE fxs?
- splint/ walking boot
what do you use short leg casts for?
- foot fx
- ankle fx
- achilles injury
- server’s syndrome
what do you use long leg casts for?
- tib/fib fx
- quad tendon repair
closed reduction
- reduce bone to near anatomic position
- “recreate the fx” to align
- MUST be a stable fx
closed reduction percutaneous pinning
- reduce/hold stable closed fx if cannot cast
- decreases need for ORIF
- risk if skin or nerve/vessel damage
ORIF
- holds unstable fx
- “internal splint”
- restores length
- needs 6 cortices above and below
- rod- prevents ant/post mvmt
- locking screws- prevent bone from rotation around rod
external fixator
- used when major non-lifesaving procedures must be avoided
- “bridge” to ORIF
sprain
- stretching/ tearing of ligaments
- inversion vs/ eversion injury
- ankle most common d/t inversion and plantar flexion
strain
- injury to muscle or muscle and tendon
- muscle fibers tear
- usually caused by overextension or over stretching
- pain worse with use
- cramping, muscle spasm/ weakness, swelling
treatment for sprains/strains
- RICE
- splinting
- NSAIDs
- early ROM
- PT