Post-op Flashcards
rotator cuff tear/TSR
-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.
cubital tunnel syndrome
-3-5days
-gentle ROM
-14days
-remove sutures
-6wks
-start PT and strengthening with gradual return to activities
carpel tunnel syndrome
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
meniscus tear A/D
-14days
-remove sutures
-WB as tolerate, crutches prn, bike or quad exercises
-No need formal PT
-4 wks
-return to activities
TFCC repair
-2wks
-remove sutures
-apply removable wrist splint
-gentle wrist motion therapy
-6wks
-remove splint
-gradually return to activities
Hip fx
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
Trigger finger
2wk
-remove sutures
-pt, stretch, massage scar,
4wk
-wound check and check motion
Lateral epicondylitis
14 days
-remove sutures
-gentle PT, NO LIFTING
6wks
-
Nonoperative Phalanx fix
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
Nonoperative Distal radius fx
-6-8wk of cast and nonWB,
-2-3mths = healed,
-weekly xray wks 1-3
mc need pt after healed
Distal radius fx postoperative
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
Nonop Metacarpal fx
-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
Metacarpal fx postoperative
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
Phalanx fx post op
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
CMC join fusion
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
Total knee postoperative
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
De quervain tenosynovitis nonoperative
Splint, IRAN, PT for tendon gliding and stretching.
De quervain tenosynovitis postoperative
2 wk
-suture removal
-splint and PT or return to normal activities
4 wks
-all splints stop
-doing PT
6-8wk
-no restrictions
Gamekeeper thumb
3wks
-sutures removed
-X-rays if wires present
4wks
-start therapy with gradual strengthening over weeks
-Remove wires
3months
-return to activity unrestricted
-remove splint
Ankle fracture postoperative
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
Ankle fx no operative
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
Total hip replacement
Olecranon bursitis nonoperative
IRAN, elbow brace, nsaids. Aspiration and steroids not recommended
Metatarsal fractures nonop
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
Feet phalangeal fx
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
Humerus fracture
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
Ankle fusion
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
Splint sizes
Ulnar: 4-5in
Thumb spica: 3-4in
Volar: 3-4in
Long arm posterior: 4-5in
Sugar tong: 3in
Short leg posterior: 4 in
Mallot finger
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
Extensor tendon repair
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
Tfcc nonop treatment
Scaphoid fracture
Achilles tendon
Kienbock disease
Patella fracture
Forearm shaft fracture
IP digit arthroplasty
2wks
-remove sutures
-X-rays ordered
-continue splint
4wks
-check X-rays
-motion check
8wks
-remove splint
-should be fused
