Precautions

Question 1

Who are weight bearing/general precautions given by?

Answer 1

• Doctor or surgeons typically give precautions following surgery

Question 2

Total Knee Arthroplasty (TKA) precautions

Answer 2

• if there is a weight bearing precaution it would initially be WBAT moving towards FWB
• Patient with recent TKA would be WBAT due to pain following surgery and limited ROM in joint

Question 3

Total Hip Arthroplasty (THA) precautions

Answer 3

• If there is weight bearing restriction it would be WBAT initially moving towards FWB
• Lateral approach
• Anterior approach: minimally invasive, no extension past neutral, no ER, no hip add
• Posterior approach: no IR, no hip flexion past 90 degrees, no adduction past midline

Question 4

THA Anterior approach precautions

Answer 4

• No ER
• No extension past neutral
• No adduction past midline
• Transfer patient AWAY from surgical side

Question 5

THA posterior approach precautions

Answer 5

• No IR
• No hip flexion past 90 degrees
• No adduction past midline
• Transfer patient towards surgical side

Question 6

Open reduction internal fixation (ORIF)

Answer 6

• Pins, rods, screws put in place following hip fracture
• Almost always has weight bearing precautions set by surgeon (typically NWB, or PWB)
• Weight bearing precautions are normally stated in the order or in the chart, if not stated ask a nurse or find out from doctor

Question 7

Coronary Artery Bypass Graft (CABG) surgery

Answer 7

• Surgeon saws sternum in half to allow access to the hear and then the sternum is wired back together
• Important to abide by sternal precautions because you want proper healing of sternal bone and eliminates excessive pulling on the incision or possible sternal incision

Question 8

Traditional Sternal Precautions

Answer 8

• to be maintained for 4-6 weeks
• Precautions abided by and given by most cardiac surgeons
• No shoulder flexion/abduction past 90
• No extension past neutral
• No lifting more than 5-8 lbs
• No pushing (pushing self up out of chair)
• Beneficial to hold onto a pillow with arms during functional tasks of rolling, supine to sit and sit to stand
• Beneficial to hold onto a pillow during a cough or a sneeze

Question 9

Cervical Spinal Precautions

Answer 9

• If in place, no lifting more than 10lbs
• Aspen Collar in place all the time
• ROM restrictions per surgeon
• No shoulder flexion past 90

Question 10

Lumbar Spinal Precaitons

Answer 10

• Primarily after spinal laminectomy, or decompression surgery
• if precautions are in place: No twisting, no forward bending past 90, minimize side bending
• Utilize log roll technique when moving from supine to sit or sit to supine

Question 11

What are the types of spinal orthosis?

Answer 11

• LSO (lumbar sacral orthosis)
• TLSO (thoracic lumbar sacral orthosis)