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Orthopedics > Post-op > Flashcards

Post-op Flashcards

1
Q

rotator cuff tear/TSR

A

-return to FROM/fn 6-12mths

-2 wks
-remove suture, PROM (wall climb/pendulum)
-light duty prn, Sling use for 6 post-op
-6wks
-PT for AROM, shoulder strengthening exercises
-remove sling, light duty 6wks more
12wks
-return to work plan and PT.

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2
Q

cubital tunnel syndrome

A

-3-5days
-gentle ROM
-14days
-remove sutures
-6wks
-start PT and strengthening with gradual return to activities

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3
Q

carpel tunnel syndrome

A

6mths to return to function

-7days
-start hand therapy (LEGO’s)
-14 days (Pathi like 3wks)
-remove sutures
-tape wound closed
-4wks
-check motion and wound, progress to normal activity prn
-remove splint

5mths: b/l xray

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4
Q

meniscus tear A/D

A

-14days
-remove sutures
-WB as tolerate, crutches prn, bike or quad exercises
-No need formal PT
-4 wks
-return to activities

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5
Q

TFCC repair

A

-2wks
-remove sutures
-apply removable wrist splint
-gentle wrist motion therapy
-6wks
-remove splint
-gradually return to activities

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6
Q

Hip fx

A

14 day
-remove sutures
-continue PT
-WB as tolerating with gait training
6 wk
-ap/lat pelvis xray
-full WB
12wks
-ap/lat pelvis xray
-return to normal if pain free
-if pain, do MRI for osteonecrosis/nonunion

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7
Q

Trigger finger

A

2wk
-remove sutures
-pt, stretch, massage scar,
4wk
-wound check and check motion

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8
Q

Lateral epicondylitis

A

14 days
-remove sutures
-gentle PT, NO LIFTING
6wks
-

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9
Q

Nonoperative Phalanx fix

A

Weekly xray

0-3 wk
-RICE
-splint
-distal: aluminum splint middle/distal with free PIP
-middle/proximal: hand/wrist splint with mcp joint flexed in intrinsic position

3-6wk
-splint
-distal: remove splint and start ROm
-proximal/middle: protected ROM with intermittent splint or buddy tape
-can do hand PT if requested

6wk
-hand is healed and return to regular duty.
-stiffness is expected and therapy help

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10
Q

Nonoperative Distal radius fx

A

-6-8wk of cast and nonWB,
-2-3mths = healed,
-weekly xray wks 1-3

mc need pt after healed

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11
Q

Distal radius fx postoperative

A

2wk
-suture remove, start gentle Pt 5 days after
-xray for next visit
6wk
-xray for next visit , motion check
-start active strength pt and WB, wean off splint

3mth
-motion and tenderness check
Return without restrictions

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12
Q

Nonop Metacarpal fx

A

-Weekly X-rays
-splint mcp but pip can be free

4wk
-xray,
- immobilize longer if smoking

6-8wks
-PT with no restrictions start when xray show healing and nobtender
-Typically considered healed

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13
Q

Metacarpal fx postoperative

A

2wk
-suture remove
-check/order xray and pt for next visit

4wks
-review xray
-remove splint

4-6wk
-Pin removal
-PT start

6-8 wk
-check xray

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14
Q

Phalanx fx post op

A

2wk (Dr likes 3wk)
-Suture removal
-move non-affected joints
(Order 1wk f/u with xray)

4wk:
-review X-rays ordered last visit
- 4-6wk k wire removal

6wks
-dc splint
-remove k-wie
-start PT

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15
Q

CMC join fusion

A

2wk
-suture removal
-order X-rays
-splint @ all times but can remove for gentle cleaning
-gentle ROM of other joints

4wk
-check xray and order again
-verify joint rom

8mth
-check X-rays and should be complete healed and dc splint

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16
Q

Total knee postoperative

A

2-3 day hospital stay

0-3wk
-remove sutures
-continues passive motion 0-90degrees for 8hr daily and progress as tolerated
-rice for pain control
-wb as tolerated and ambulate with AD
-PT started in hospital and continue
-order X-rays

3-6wks
-full ROM
-ambulate indoors without AD
-goal at this time is FROM
-review and order X-rays

3mtha
-no AD
-review X-rays

17
Q

De quervain tenosynovitis nonoperative

A

Splint, IRAN, PT for tendon gliding and stretching.

18
Q

De quervain tenosynovitis postoperative

A

2 wk
-suture removal
-splint and PT or return to normal activities
4 wks
-all splints stop
-doing PT
6-8wk
-no restrictions

19
Q

Gamekeeper thumb

A
20
Q

Ankle fracture postoperative

A

2wk
-suture removal
-X-rays and boot ordered
-NonWB 6 wks

6wks
- wb full time be in boot
-remove boot for daily ROM

8-10wks
-dc boot for regular shoe with ankle brace
-syncretic screw removed at minimum 3-4mths but no diff if stay or remove on clinical outcome

21
Q

Ankle fx no operative

A

Weber a: nearly all nonop. Cast or walking boot, WB operated. Heal in 6 wks

Weber b (spiral fx):
-ORIF if unstable, nonop if stable ( <4-5mm of central clearing
-Cast or walking boot, WB operated. Heal in 6 wks
-brace and PT after 6 wks

Weber C (prox fib): need ORIF unless small avulsion

22
Q

Total hip replacement

A
23
Q

Olecranon bursitis nonoperative

A

IRAN, elbow brace, nsaids. Aspiration and steroids not recommended

24
Q

Metatarsal fractures nonop

A

1st MT: cast and wb as tolerated 6wks
2-5MT:
-avulsion(MC 90%): hard sole shoe/short cast 4-6 wks, WB as tolerated
-jones: cast nonWB 6-8 wk
-shaft fx: ORIF D/T high nonunion risk

25
Q

Feet phalangeal fx

A

All nonoperative:

-nondisplaced big toe
Hard shoe/boot 2-3 wks
WB as tolerated

-displaced lesser toes
Closed reduction with traction
Then, buddy tape 2-4 wks.
WB as tolerated hard shoe 4-6 wks

26
Q

Humerus fracture

A

Indication: displaced neck, displace 3-4 part in young health, greater tuberosity > 5mm

2wks
-sutures and X-rays ordered
-sling use

6 wks
-X-rays reviewed
-gentle PT
-light duty with no bad arm use
-earliest DC sling

12 wk
-X-rays reviewed
-advance PT active
-possible future prn

27
Q

Ankle fusion

A

Post 2 weeks
-suture removal
-X-rays ordered
-continue nonWB for 6 weeks post op

6 weeks
-review X-rays and order
-progress to WB with walking boot or cast

12 weeks
-review X-rays and transition to show

28
Q

Splint sizes

A

Ulnar: 4-5in
Thumb spica: 3-4in
Volar: 3-4in
Long arm posterior: 4-5in
Sugar tong: 3in
Short leg posterior: 4 in

29
Q

Mallot finger

A

Nonop txt unless distal joint subluxation or articulation surface fragment >40%

-splint dip in hyperextension (free pip) continuously 6-8wks ( if remove, restart time)
-if swan neck: dorsal splint to fix PIP hyperextend
-may splint up to 3months after injury
-if extensor lag after 6 wks, night splint for 2 extra weeks
-if lag persists, <15 deg is acceptable and normal for 40% pts
-6wks: PT and Dec splint use

Untreat = swan neck deformity

30
Q

Extensor tendon repair

A

3 weeks
-wound check
-suture removal

6 wks
-k wires removed if present
-CONTINUOUS splint use (restart time if bend)
-start PT with intermittent and night time slinging for 2-4 additional wks

12wks
-motion check
-continue PT prn

31
Q

Tfcc nonop treatment

A
32
Q

Scaphoid fracture

A
33
Q

Achilles tendon

A
34
Q

Kienbock disease

A
35
Q

Kienbock disease

A

Orthopedics (3 decks)

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