Orthopedic

Question 1

Orthopedic Description and Definitions

Answer 1

-Injury / disease of bones, joints, muscle, tendons, ligaments
* Osteoarthritis; wear / tear on joint
* Osteoporosis; loss of bone density
* Fracture most common condition

Question 2

Fractures

Answer 2

 Trauma / disease of bone or joint
 Stress fracture; force applied to bone
 Pathologic fracture

Question 3

Osteoarthritis

Answer 3

 Degenerative joint disease; non-inflammatory disease
 No inflammatory white blood cells in the joint fluid
 Deterioration of articular cartilage; formation of
osteophytes

Question 4

Osteoporosis

Answer 4

 Loss of bone density
 Menopause
 10 million

Question 5

Osteopenia

Answer 5

 Reversible weakening of the bone
 Diet, exercise, bone density tests

Question 6

Heterotopic ossification

Answer 6

-abnormal bone formation in
extraskeletal soft tissues
 Often associated with traumatic injuries

Question 7

Incidence and Prevalence
* Fractures

Answer 7

 Unintentional falls leading cause of injury
 44% involve distal radius
 Older adult women 80% of hip fractures
 1.6 million older adults fall-related fracture

Question 8

Osteoarthritis incidence and Prevalence

Answer 8

 ~ 27 million people age 25 and older in US
 One of the leading cause of disability due to loss of ROM
 Affects: knee, distal interphalangeal joints, proximal
interphalangeal joints, and the first carpal metacarpal joint

Question 9

signs and Symptoms
* Fractures

Answer 9

 Ecchymosis (a discoloration of the skin resulting from
bleeding, i.e. bruising)
 Edema
 Localized pain
 Deformity

Question 10

Signs and Symptoms
* Fractures

Answer 10

closed and open
 Increased chance of infection
 Comminuted-Fractures that have two or more fragments
 Displaced-Segments that have become separated or shifted
from the bone
 Greenstick-Bone breaks on one side and bends on the
other

Question 11

Fracture Lines

Answer 11

 Complete-A break in full continuity of the bone
 Incomplete (hairline fracture)
 Transverse (right angle)
 Oblique (diagonal)
 Spiral- Torsional stress applied to bone causes a twisting fracture line
 Distal radial
- May cause loss of sensation, strengt

Question 12

Hip fracture

Answer 12

 Generally refers to a fracture of the proximal femur.
 Intracapsular fractures involve the femoral neck such as a subcapital or transcervical fracture.
 Extracapsular fractures involve the trochanters such as a subtrochanteric or
intertrochanteric fracture

Question 13

Humeral Fracture

Answer 13

 Humeral displacement / malposition of distal limb
 Radial nerve injury (18%)

Question 14

Supracondylar fractures (distal end of humerus)

Answer 14

 “Elbow fracture”
 Malunion-Healed in a less than optimal position
 Volkmann’s deformity
 Severe damage to tissues and muscles caused by increased pressure

Question 15

Scaphoid fractures

Answer 15

 Most common fractured bone in wrist
 Frequent among young males, sports injury
 Susceptible to avascular necrosis because of its poor
blood supply

Question 16

Signs and Symptoms Osteoarthritis

Answer 16

 Inflammation / joint pain
 Limited ROM
 Pain with movement
 Crepitus
 Stiffness

Question 17

Signs and Symptoms
* Osteoporosis

Answer 17

• Gradual and somewhat silent as it emerges
• pain, height loss, and kyphosis
• Skeletal fractures and recurring pathological fractures
• Osteopenia is a predecessor to osteoporosis

Question 18

HO

Answer 18

• Begins with pain, joint warmth, swelling, and decreased ROM
  approximately 1 to 4 months after an injury
• May be a palpable mass, which becomes harder as the bone forms

Question 19

Fracture dependent factors:

Answer 19

 Type of Fx
 Person age
 Fx location
 Premorbid health status
 Intrinsic motivation
 Severity of Fx

Question 20

Way bone heals

Answer 20

6-12 weeks to heal
* Immediate vascular circulation + immobilization = optimal healing

Question 21

5 stages to healing a Fx:

Answer 21

1. Hematoma forms and seals the damaged blood vessels
    Osteoclasts reabsorb the damaged bone and tissue
2. Formation of fibrocartilage
    Increases Stability of bone fragments
   3.Formation of a callus
   4.Ossification; bony union
    Remodeling / consolidation
    6 weeks to 1 year

Question 22

Abnormal healing risk factors

Answer 22

Open fracture, severe soft tissue damage, infection, poor vascularization, nerve
damage, phlebitis (vein inflammation), or compartment syndrome

Question 23

Delayed union

Answer 23

Bone takes more time to heal than is expected

Question 24

Malunion fracture

Answer 24

• Heals in an abnormal or deformed position.
• Functional implications as the person will often experience limited, ROM, strength, and coordination.

Question 25

Nonunion fractures

Answer 25

• A fracture in which the bone is not healing
• The scaphoid bone has a high risk for nonunion due to its limited blood
  supply.

Question 26

Bone Spurs

Answer 26

• These may become painful and inflamed, limiting functional use.
• Arthroplasty may be warranted.
• Most common in the carpometacarpal joint of the thumb

Question 27

Heberden’s nodes and Bouchard’s nodes

Answer 27

-Distal interphalangeal joints
-Proximal interphalangeal joints

Question 28

Orthopedic Impact on Occupational Performance

Answer 28

• Dressing
• Leisure pursuits
• Home management
• Work performance
• Meal preparation
• Mobility / driving