Orthoses For Trauma And Post-Op

Question 1

Spondylitis (definition)

Answer 1

Inflammation of vertebrae

Question 2

Spondylosis (definition)

Answer 2

Abnormal cervical cartilage wear

Question 3

Spondylolysis (definition)

Answer 3

Unilateral stress fracture of pars interarticularis (L4, L5)

Question 4

Spondylolisthesis (definition)

Answer 4

Bilateral fracture of pars interarticularis with anterior slip (Meyerding grading system 1-4)

Question 5

Spondyloptosis (definition)

Answer 5

Complete slip of vertebrae (Meyerding grade 5 spondylolisthesis)

Question 6

Ankylosing Spondylitis (definition)

Answer 6

Eventual ossification of vertebral joints around discs (Marie-Strumpell disease, bamboo appearance on X-ray)

Question 7

Anterior compression fracture MOI

Answer 7

Excessive flexion load on anterior vertebral body (pathologic or traumatic)

Question 8

Burst Fracture MOI

Answer 8

High energy axial load causing burst of vertebrae into fragments (risk of Neuro injury, often with ligamentous injury)

Question 9

Teardrop fracture MOI

Answer 9

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)

Question 10

Chance fracture MOI

Answer 10

High energy anterior flexion with posterior distraction, intrabdominal injuries common (seatbelt injury)

Question 11

Transverse process fracture MOI

Answer 11

Rotation or extreme lateral bending

Question 12

Spinous process fracture MOI

Answer 12

Avulsion injury from sudden exertions of muscular attachment, hyper flexion (clay shoveler’s fracture)

Question 13

Holdsworth fracture MOI

Answer 13

Fracture dislocation from flexion-rotation

Question 14

Anterior compression fracture orthosis

Answer 14

Maintain neutral or extension of vertebrae (CASH, Jewett), generally stable

Question 15

Burst fracture orthosis

Answer 15

If neurologically stable, rigid CTO, TLSO, LSO (also require ORIF if unstable)

Question 16

Teardrop fracture orthosis

Answer 16

Halo for cervical, rigid TLSO for lower (unstable and requires ORIF)

Question 17

Chance fracture orthosis

Answer 17

Semirigid LSO or TLSO

Question 18

Spinous process fracture orthosis

Answer 18

CO, CTO, TLSO, LSO (usually stable)

Question 19

Holdsworth fracture orthosis

Answer 19

Unstable, requires ORIF and rigid TLSO

Question 20

Level of control for Halo

Answer 20

Occiput to C2

Question 21

Level of control for CO

Answer 21

C3 -C5

Question 22

Level of control for CTO

Answer 22

C4 - T7

Question 23

Level of control for TLSO

Answer 23

T8 - L5

Question 24

Level of control for CASH/Jewett

Answer 24

T10 - L3 (T11 - L2)

Question 25

Level of control for LSO

Answer 25

L1 - L5

Question 26

Treatable grades for spondylolisthesis

Answer 26

Grade 1 and 2 (50% or less slip)

Question 27

Nuclear herniation (definition)

Answer 27

Bulging of disc

Question 28

Disc protrusion (definition)

Answer 28

Nucleus into annulus

Question 29

Disc extrusion (definition)

Answer 29

Nucleus exits annulus

Question 30

Sequestration (definition)

Answer 30

Nucleus completely exits disc

Question 31

Jefferson fracture (definition)

Answer 31

Fracture of ring of C1 (atlas)

Question 32

Jefferson fracture MOI

Answer 32

Hyperextension or axial load

Question 33

Jefferson fracture orthosis

Answer 33

Soft collar, CTO, Halo (stable or unstable)

Question 34

Hangman’s fracture (definition)

Answer 34

Bilateral pedicle fracture of C2, axis (type 1-3 Levine classification)

Question 35

Hangman’s fracture MOI

Answer 35

Hyperextension with distraction

Question 36

Hangman’s fracture orthosis

Answer 36

CTO, halo (stable or unstable)

Question 37

Odontoid / Dens fracture (definition)

Answer 37

Fracture of odontoid of C2, axis (type 1-3 Anderson and D’Alonzo classification)

Question 38

Odontoid / dens fracture MOI

Answer 38

Combo of shear and compression

Question 39

Odontoid / dens fracture orthosis

Answer 39

Semi rigid collar, halo (stable or unstable)

Question 40

Facet joint dislocation MOI

Answer 40

Lateral flexion w/rotation

Question 41

Facet joint dislocation orthosis

Answer 41

``` Hard collar (unilateral) ORIF with Halo (bilateral) ```

Question 42

Halo adult pin vs pediatric pin number

Answer 42

Adult: 4 pins Pediatric: 6-8 pins

Question 43

Halo adult vs pediatric pin torque

Answer 43

Adult: 6-8 inch pounds Pediatric: 4 inch pounds

Question 44

Halo ring clearance from skull

Answer 44

3/8” from skull | 3/8” proximal to ear tip

Question 45

Halo pin placement

Answer 45

1/2” proximal to brown in lateral 1/3 ‘safe zone’

Question 46

Contraindications for HALO

Answer 46

Skull fracture within 1” of pin site

Question 47

Chairback control planes

Answer 47

LSO sagittal

Question 48

Knight control planes

Answer 48

LSO sagittal-coronal

Question 49

Williams control planes

Answer 49

LSO extension-coronal (allows flexion, spondy)

Question 50

Taylor control planes

Answer 50

TLSO sagittal

Question 51

Knight-Taylor control planes

Answer 51

TLSO sagittal-coronal

Question 52

Contraindications for 2-poster and 4-poster COs

Answer 52

Patient intubated