Orthopaedic Flashcards

Question

WEBER B Mx

Answer 1

Traditional cast compared to foot orthosis is just as effective for ankle function and fracture healing as the conventional 6 week immobilisation in a cast --> shorter immobilisation could be viable option for patients (short term is close enough in effectiveness to the long term)

Answer 2

No twisting of the leg Leg to not cross the midline of the body No hip flexion past 90º No hip extension past netural PWB no excessive hip ABD Avoid reaching across Must get in and out of bed on the operated side --> 6 weeks usually

Answer 3

FASF 2WF Pick up frame Crutches stick

Answer 4

THR - WBAT from day 1 ORIF - NWB (6-8/52) - PWB (8-10/52) - FWB (10-12/52)

Answer 5

NICE and AAOS guidelines do not recommend traction as pre-surgery Tx due to lack of efficacy and surgeons can now get more stability in the Sx itself

Answer 6

Must: Log roll Wear cervical collar if told for 2/52 Wear Philadelphia collar or soft collar 48hrs unless an exception Sleep on the firm pillow to support the neck Change positions regularly See a Dr if red flags become present DO NOT: Get the surgical site wet lift arms above 90º Do not lift anything heavier than 1.5kg Do not bend, twist, lift Do not sleep with arms overhead Do not spend all your time in bed Do not drive until cleared Do not perform strenuous activities

Answer 7

At the 2-year mark, there is no significant difference between arm pain and function in the conservative group. Surgery has massive improvements in pain and neck disability index in the first year but evens out by year 2. Surgery = speed recovery and reduce pain faster (comes with complications)

Answer 8

Do Not Do: No bending, lifting or twisting No lifting more than 5kg No driving unless cleared No over extending No prolonged sitting for >30-60mins Must: Incorporate log rolling Gradual Ambulation Stabilisation exercises for breathing and relaxation (extensor spinal muscle)

Answer 9

Inadequate unloading to allow healing to occur in the fusion site or because of a delay in diagnosis. Interrupts the bones ability to heal, creating a scar tissue to form in between like a fibrous joint. - can have axial radicular pain - widespread pain around the abdomen - strange and persistent neurological pain

Answer 10

Blood clot that forms within the deep veins due to immobilisation 9can travel proximally - Odema - red and hot skin with a dilated vein tenderness - Wells scoring ≥2

Answer 11

Pain (insidious 1 month post-op swelling or erythema at the incision wound dehiscence and purulent drainage from wound

Answer 12

Spinal cord is so compressed --> lower region (lumbar spine) - urinary retention - radicular pain down the back of legs - Reduced anal sphincter tone severe low back pain - Sensory loss - Sexual dysfunction

Answer 13

Surgery is preferred as it provides faster pain relief, improved QOL, and functional improvement and is essential for those with severe conditions. Conservative treatment can be used for low severity patients --> will clinically see more improvement with fusion.

Answer 14

No pushing, pulling or lifting No shoulder extension, abduction or IR No overhead movements No excessive stretching or sudden movements Sling must be worn 24/7 for the first 6 weeks No sleeping on the affected side Wound Mx keep the incision dry/ use shower sling No BW through arms or hands or leaning on both elbows No muscle activation for 6-8/52

Answer 15

Surgery group had better outcomes in terms of functionality, pain compared with no treatment but was not clinically significant--> surgery is a quick fix at the end of the day Either surgery does the job and neither are superior of each other.

Answer 16

PRE was not sueprior Corticosteroid injections had no long term benefit

Answer 17

Conservative treatment is a reasonable option for the primary initial treatment for isolated, symptomatic, non-traumatic, supraspinatus tears in older patients. --> There was no clinical difference between the three interventions

Answer 18

The bigger the mean difference the better = will depend on what the clinically significant number is

Answer 19

Determine how much of a change is needed

Answer 20

The smaller the confidence interval, the better, as it means there is a smaller chance the researchers have got it wrong for which outcome is better

Answer 21

1. Surgical approach 2. Size of tear 3. tissue quality 4. fixation method 5. location of tear 6. type of tear 7. mechanism of failure 8. timing of surgery 9. characteristics of the patient 10. RC tissue quality anterior and posterior of tear site 11. Access to care 12. Physiotherapy philosophical approach

Answer 22

Wear Cam boot 24/7 for 2 weeks 2cm heel lift for 6-8 weeks, reducing the height. Cam boot must be worn for 3 months total

Answer 23

On for 24/7 for the first 6 weeks Can remove sling when resting or sitting with the arm by side Remove arm from the sling 3-4x/day to bend and straighten your elbow → arm needs to be supported however throughout