Orthoses For Trauma And Post-Op Flashcards
Spondylitis (definition)
Inflammation of vertebrae
Spondylosis (definition)
Abnormal cervical cartilage wear
Spondylolysis (definition)
Unilateral stress fracture of pars interarticularis (L4, L5)
Spondylolisthesis (definition)
Bilateral fracture of pars interarticularis with anterior slip (Meyerding grading system 1-4)
Spondyloptosis (definition)
Complete slip of vertebrae (Meyerding grade 5 spondylolisthesis)
Ankylosing Spondylitis (definition)
Eventual ossification of vertebral joints around discs (Marie-Strumpell disease, bamboo appearance on X-ray)
Anterior compression fracture MOI
Excessive flexion load on anterior vertebral body (pathologic or traumatic)
Burst Fracture MOI
High energy axial load causing burst of vertebrae into fragments (risk of Neuro injury, often with ligamentous injury)
Teardrop fracture MOI
Forced flexion w/axial compression causing complete shearing of anterior/inferior aspect of vertebral body (may have displacement of posterior body into spinal canal, more common in C-spine)
Chance fracture MOI
High energy anterior flexion with posterior distraction, intrabdominal injuries common (seatbelt injury)
Transverse process fracture MOI
Rotation or extreme lateral bending
Spinous process fracture MOI
Avulsion injury from sudden exertions of muscular attachment, hyper flexion (clay shoveler’s fracture)
Holdsworth fracture MOI
Fracture dislocation from flexion-rotation
Anterior compression fracture orthosis
Maintain neutral or extension of vertebrae (CASH, Jewett), generally stable
Burst fracture orthosis
If neurologically stable, rigid CTO, TLSO, LSO (also require ORIF if unstable)
Teardrop fracture orthosis
Halo for cervical, rigid TLSO for lower (unstable and requires ORIF)
Chance fracture orthosis
Semirigid LSO or TLSO
Spinous process fracture orthosis
CO, CTO, TLSO, LSO (usually stable)
Holdsworth fracture orthosis
Unstable, requires ORIF and rigid TLSO
Level of control for Halo
Occiput to C2
Level of control for CO
C3 -C5
Level of control for CTO
C4 - T7
Level of control for TLSO
T8 - L5
Level of control for CASH/Jewett
T10 - L3 (T11 - L2)
Level of control for LSO
L1 - L5
Treatable grades for spondylolisthesis
Grade 1 and 2 (50% or less slip)
Nuclear herniation (definition)
Bulging of disc
Disc protrusion (definition)
Nucleus into annulus
Disc extrusion (definition)
Nucleus exits annulus
Sequestration (definition)
Nucleus completely exits disc
Jefferson fracture (definition)
Fracture of ring of C1 (atlas)
Jefferson fracture MOI
Hyperextension or axial load
Jefferson fracture orthosis
Soft collar, CTO, Halo (stable or unstable)
Hangman’s fracture (definition)
Bilateral pedicle fracture of C2, axis (type 1-3 Levine classification)
Hangman’s fracture MOI
Hyperextension with distraction
Hangman’s fracture orthosis
CTO, halo (stable or unstable)
Odontoid / Dens fracture (definition)
Fracture of odontoid of C2, axis (type 1-3 Anderson and D’Alonzo classification)
Odontoid / dens fracture MOI
Combo of shear and compression
Odontoid / dens fracture orthosis
Semi rigid collar, halo (stable or unstable)
Facet joint dislocation MOI
Lateral flexion w/rotation
Facet joint dislocation orthosis
Hard collar (unilateral) ORIF with Halo (bilateral)
Halo adult pin vs pediatric pin number
Adult: 4 pins
Pediatric: 6-8 pins
Halo adult vs pediatric pin torque
Adult: 6-8 inch pounds
Pediatric: 4 inch pounds
Halo ring clearance from skull
3/8” from skull
3/8” proximal to ear tip
Halo pin placement
1/2” proximal to brown in lateral 1/3 ‘safe zone’
Contraindications for HALO
Skull fracture within 1” of pin site
Chairback control planes
LSO sagittal
Knight control planes
LSO sagittal-coronal
Williams control planes
LSO extension-coronal (allows flexion, spondy)
Taylor control planes
TLSO sagittal
Knight-Taylor control planes
TLSO sagittal-coronal
Contraindications for 2-poster and 4-poster COs
Patient intubated