Principles of orthotics pt 2 & Orthosis in PT Flashcards
Early in the middle life period, both _____________and _______________
enter a period of gradual ________________ _______________ loss that
appears to be ________________ determined.
-both men and women
- gradual endochondral bone loss
- genetically determined
List factors that influence the rate of bone loss
- hormonal status
- nutrition
- smoking
- alcohol use
- activity level
Which population has the greatest vulnerability to bone fracture?
- postmenopausal women
For which conditions are hip orthoses indicated?
- inadequate development of acetabulum and head of femur
- avascular necrosis of femoral head and inadequate blood supply to it
- loss of cartilage and abnormal bone deposition (OA)
- loss of bone strength and density in osteoporosis
- developmental dysplasia of the hip
- Legg-Clave Perthesis disease
- recurrent hip dislocations
List two important functions of the hip
- must support weight of head, arms, trunk during functional activities
- effectively transmit forces from pelvis to LE during quiet standing, gait, and CC activities
The proximal femur, comprised primarily of trabecular bone, is designed to
withstand significant ________________while also permitting
_______________
through large excursions of ___________________
- loading
- permitting movement
- excursions of ROM
How long does clinical union of a fracture take in the repair phase post
injury and what is recommended during this timeframe?
up to 3 months post injury
- long period of immobilization recommended
How long does the process of callus maturation last, particularly with
complex fractures?
1 yr +
What are intertrochanteric fractures?
extracapsular, linear, oblique, through or between the trochanters
How are fractures of the pelvis classified?
stable or unstable
What are persons with unstable fractures of the pelvis at risk for?
- life threatening hemorrhage
- residual genitourinary or neurological complications
What is a pathological fracture?
- occur when there is an underlying disease that compromises bone density or metabolism
(osteoporosis, charcot osteopathy, neoplasm) - trabeculae overwhelmed by magnitude of force exerted through bone and bone is compressed and fractured
What factors/issues does the orthopedist consider when choosing an
appropriate immobilization strategy?
- stability of fracture site and how well a device can maintain fracture reduction to achieve desired anatomical result
- Limb volume: how will limb size change overtime in device
- Length of immobilization time: short term vs long; removable for hygiene?
- Availability
What are 2 reasons a bent knee cast is chosen for immobilization?
- when non-weight bearing for ambulation
- to aid in controlling rotation of the tibia
What are custom-fabricated/fit fracture orthoses designed to do?
- maintain a body part in optimal anatomical position,
- limit joing motion,
- unload weight bearing forces.
What is the major advantage of fracture orthoses vs cast brace?
orthosis can be removed for wound or skincare
What might be added to an AFO fracture orthosis to compensate for
limited heel, ankle and toe rocker motion during gait?
- cushion heel and rocker sole
What structures of the distal LE require adequate clearance of the trimlines of an AFO fracture orthosis?
- head of fibula
- peroneal nerve
What does a PTB fracture orthosis do for the tibia during weight bearing activities?
protection from bending and rotatory torque for the tibia during weight bearing activities
What is the purpose of a knee/ankle/foot fracture orthosis?
- long term protection for fractures of the distal to middle femur or for fractures about the knee
If axial unloading is desired (loading of the femur, tibia, foot) what must be used to achieve this during ambulation with a fracture orthosis?
assisted devices (crutches or walkers)
What type of device is used when the fracture disrupts pelvic stability?
external fixation devices
In what period of time after a fracture or dislocation must the blood supply and nutrition to the distal muscle and bone be restored before significant
tissue death occurs?
less than 6-8 hours
-Name one of the most important considerations for LE fractures regarding
mobility.
- weight bearing status
