Orthopedics Flashcards
Fractures two critical factors involved
- Amount of force applied to bone (MVA vs stress fractures)
- Strength of bone- normal or weakened from pathologic conditions
Tumors, osteoarthritis, osteoporosis
Age and size of bones
Pathologic fracture
Bone weakened by conditions such as osteoarthritis and osteoporosis that can’t sustain normals forms and therefore fractures during daily activities
Leading cause of non fatal injuries and fractures in older adults
Falls
Types of fractures
Closed Open Comminuted Displaced Greenstick
Closed
Fracture has not broken through the skin
Open (compound)
Bone breaks skin surface, increased chance of infection
Comminuted
Fractures with 2+ fragments
Displaced
Segments that have become separated or shifted from the bone
Greenstick
Children (soft, still growing)
Bone breaks on one side and bends on the other (think twig)
Types of fracture lines
Complete Incomplete Transverse Oblique Spiral
Complete
Break in full continuity of the bone
Incomplete (hairline)
Involves partial disruption in continuity of bone
Transverse
Occurs when fracture line is at a right angle to the longitudinal axis of the bone
Oblique
involves fracture line that is diagonal or slanted
Spiral
Torsional stress causing twisting fracture line
Colle’s fracture
Dorsal displacement, dorsal comminuting, radius shortening, dinner fork deformity, resembles upside down fork
Smith’s fracture
Reverse colle’s, deformity replaces tower the volar or palmar of wrist
Hip fractures
Proximal femur, unable to bear weight, intracapsular (femoral neck) or extracapsular (trochanters)
Surgical management
Humeral fractures
Supracondylar fractures (distal end of humerus) Volkmann’s deformity, severe damage to tissues and muscles
Volkmann’s deformity
Caused by increased pressure, ischemia, bleeding, tight bandages
Abnormal healing factors
Open fractures, soft tissue damage,nerve damage, infections,
Result in deflated union (more time to heal)
Malunion
Fracture heals in abnormal position,
Factors include muscle imbalance, inadequate positioning or protection
Nounion
Bone is not healing, deficits in ROM, strength and coordination
Factors- vascular/tissue damage, poor alignment, stress to fracture site, infection, scaphoid @ high risk
Osteoarthritis
Degenerative joint disease, non-inflammatory joint disease resulting in deterioration of articular cartilage and formation of new bones (osteophytes) on joint surface
Signs and symptoms of osteoarthritis
Joint pain, inflammation, stiffness, tenderness, limited ROM, crepitus (crunching or pooping sound in the joint) Gradual Arthritis (joint inflammation)
Osteoporosis
Low bone density and deterioration of bone, (less estrogen risk factor), post-menopausal women, may fracture bone through normal movement,
Signs and symptoms of osteoporosis
Gradual, few symptoms -> advanced symptoms
Clinical signs- skeletal fractures, recurring pathologic fractures
Osteopenia
Reversible weakening of bone,
Balance diet, supplements, WBE, bone density screenings to decrease risk of progression into osteoporosis
Signs and symptoms of osteopenia
Predecessor to osteoporosis with no signs, diagnosed through bone density scans
Heterotopic ossification
Orthopedic condition- bone formation in soft tissue
Unclear exact cause
Associated with traumatic injuries (burns, SCI, TBI)
Creates response and fibroblasts start forming bone near joints- stiffness, and loss of movement
Signs and symptoms of heterotrophic ossification
Pain, joint warmth, swelling, decreased ROM, palpable mass
Impact on OT
ADL’s, IADL’s , sleep, education , work, play, leisure, social
Equipment
Important to continually assess and address persons values and beliefs during healing process
