Orthopedic Surgical Conditions 1 Flashcards
for what condition do we perform a laminectomy
with the presence of a disk protusion or spinal stenosis
what is a complete laminecotmy
the completed removal of the
lamina
SP
or ligament flavum
the vert seg is much less stable
what is a partial lamiectomy
the removal of only one lamina
what are is the normal approach for a laminectomy
posterior approach
what is normally limited following laminecotomy
ext and weight lifting
spinal fusion - indication
axial pain with unstable spinal segments
advance arthritis
uncontrolled peri pain
spinal fusion - procedure
bone is harvested from another part of the body (iliac crest) and is used to help fuse to vert together
instrument are often used to fuse segments together until a boney callus forms
total shoulder arthroplasty - why
joint component have become arthy
seondayr to fx
RC arthropathy
what is RC arthropathy
a type of arthritis that can develop in the shoulder after a large or long-term rotator cuff tear
what occur with total shoulder arthroplasty
replaces both the glenoid and the head of the humerous
what occurs with a shoulder hermiarthroplasty
one of the gleniod or the humeral components
what happens with a reverse should arthoplasty
reverse the concave and convex component
vex: glenoid
cave: humeral hea d
when do we perform a reverse shoulder arthroplasty
when the pt has a dysfunction of the RC
what muscle of the RC is impacted by shoulder arthoplasty
subscaulris is detached for easier ascess to the joint
muscle and tendon repair impact on shoulder arthoplasty rehab
in a sling for longer
subacromial decompression - when perfromed
shoulder impingment that does not response to conservative rehab
subacromial decompression - open
deltoid is detached
subacromial decompression - mini- open
deltiod is split
subacromial decompression - recovery time
quick
sling for 1-2 weeks
rotator cuff repair - small tear
<1 cm
rotator cuff repair - medium tear
1-3 cm
rotator cuff repair - large tear
3-5 cm
rotator cuff repair - massive
> 5 cm
rotator cuff repair - small partial thickness tear treatment
debridement
this is the only type of injury that can be fixed with this
shoulder stabilization - capular shoft procedure is performed when
presence of chronic should instabiity
shoulder stabilization - what is involved with the procedure
tightening of the joint capsule by cutting the capsule and overlapping the ends to reduce capsule redundancy
the portion of the capsule that is tightened depends on the area of instability
what is the most common form od shoulder instability
anterior
two disorders associated with anterior shoulder dislocation
bankart
hillsachs
what is a bankart lesion
humerus is compressed against the labrum as happens anterior shoulder dislocations or subluxations
anteroinferior aspect of the glenoid labral
what is a hillsachs lesion
osseous defect or “dent” of the postero-supero-lateral humeral head that occurs in association with anterior instability or dislocation of the glenohumeral joint.
SLAP repair rehab - what should be avoided
contracting or stretching the biceps becasue the biceps insert into the superior larbumm
hip ORIF - method used depends on
previous activity level
fx location
amount of displacement
for proximal hip fracture what area are normally injured
femoral neck
intertrocahntieric region
what can proximal fx lead to in the femur
cut off of blood supply leading AVN
what muscle can be affects with a ORIF hip
TFL
glute med
vastuas lateralis
what is a ORIF
open reduction and internal fixation
our surgeon will insert metal fasteners into your bone to hold the pieces together.
what are signs of fixation failure
persistant thigh or groin pain
leg length discrepancy - not initially present
positioning of the limb in ER
trandelenburg that does not improve with strengthening
what is a osteochrondral autograph transplantation
cart is retrieved from several non-weight bearing areas that form a plug for the osteochondral defect
ACL reconstruction - performed on what pts
pt’s with a ACL tear that is causing pain and insatbility
ACL reconstruction - autograft or allograftperfered
autograft
what is a allograft
is tissue, cells, or an organ that is transplanted from one person to another who is not an identical twin
what standard ACL grafting
bone-patellar tendon graft
b/c it uses bone to bone healing
ACL repair - when is the brace unlocked
when the patient demonstrates quad control
during what period of rehab is the graft material most vunerable
6-8 weeks after surgery
what time is the graft mature
12-26 months
what are some of the requirement to return to sport with a ACL injury
no pain
no effusion
full ROM
no instability
quad strength that is 85-90% of contralateral side
hamstring strength that is 90 -100% on contra side
functional testing that is 85-90% of opposite side
meniscus injuries - two ways to surgically repair
partial menisectomy
men suturing
partial men is used in what population
older person
tear is in 2/3 on men - where men healing is poor
what is the procedure fro partial men
the torn pieces of the men is removed
men suturing is used in what pop
young pop
tear is in out 3rd of the men
when is lateral ankle reconstruction done
tear of anterior talofibular or the CFL or chronic ankle instability
what are the two methods to repair the ankle
both use open approach
acute repair of the torn lig - sutured back together
harvesting of a autogrpah
what autograph is often used of lateral ankle reconstruction
peroneus brevis
why do we perform autograph reconstruction
when the original ligament cannot be repair due to deteration
what is the progression of protective braces following lateral ankle instability recontruction
protective brace - NWB
walking boot - PWB>FWB
brace
achilles tendon repair - how is the srugery perfromed
suture the tendon back together
sometime a graft is needed to augment missing tissue
what is the progression of protective braces following achilles tendon repair
brace in PF
cast or boot - foot in neutral
hip anterior lateral approach - precaution
ext
ER
add
what are standard hip precuations - posterior lateral approach
no
IR
crossing the legs
flexion past 90
what are the hip precautions for the direct lateral approach
hip flex >90
ext
ER
add
abd - if going through glute med
what are the most popular options for ACL recontruction graft
patellar bone tendon
semitendinosis
gracilius
achilles tendon when graft is commonly used
flexor hallucis longus
peronus brevis
plantaris
what muscle do we go through for PL THR
the glute max
