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PTA - Pathology > PTA135-Unit 3-4-Hip > Flashcards

PTA135-Unit 3-4-Hip Flashcards

1
Q

state the 3 main types of Hip Fracture as described by their location

A
  • Intertrochanteric
  • Subtrochanteric/Proximal Femoral Shaft
  • Femoral Neck
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2
Q

state the most significant Complication of Hip Fractures and its implications to the patient

A
  • Deep Vein Thrombosis

- potentially life threatening

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3
Q

discuss the medical management and treatment of Non-displaced Hip Fracture

A
  • non-displaced or displaced < 1cm

- bed rest, traction

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4
Q

discuss the medical management and treatment of Displace Hip Fracture

A
  • displace is > 2cm
  • surgery, ORIF
  • hemiarthroplasty - elderly, comminuted, severe femoral neck
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5
Q

decision to perform Surgery for Hip Fracture is based on what 7 factors?

A
  • Age of patient
  • Location of fracture
  • Quality of bone
  • Severity of fracture: simple/displaced/comminuted
  • Activity level of pt
  • Associated soft tissue injuries
  • Goals for pt’s return to activity
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6
Q

discuss Rehab Goals for Hip Fracture treatment

A
  • Protect healing structures from internal and external forces that can impede healing
  • Increase muscular strength
  • Improve overall conditioning
  • Increase ROM if affected hip
  • Enhance aerobic fitness
  • Increase local muscular endurance
  • Reduce pain and swelling
  • Reestablish normalized gait mechanics
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7
Q

discuss ORIF for Hip Fracture treatment

A
  • Complete healing may take up to 3-6 months
  • Use of walked 8-10 weeks
  • TDWB or as MD orders
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8
Q

WB acronyms

A 
NWB
TTWB
PWB
WBTT
FWB
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9
Q

discuss the progression of rehabilitation and precautions that need to be taken for an individual who has had a Hip Fracture - Maximum Protection Phase

A 
1-21 days post op
• Protect fracture site
• Control pain/swelling
• Isometric strengthening initially
• Anti-embolism exercises
• Active supine hip IR/ER
• Limited weight bearing (TDWB-PWB)
• ROM precautions per MD
• No combined diagonal or rotational forces
• No active SLR or hip bridges in first 6-8 wks
• Gait training
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10
Q

discuss the progression of rehabilitation and precautions that need to be taken for an individual who has had a Hip Fracture - Moderate Protection Phase

A

3-6 wks post op
• Progress exercises to regain hip/knee motion and strength
• General strengthening/conditioning UE/LE
• Can begin standing “four” position hip strengthening without added resistance
• Gluteus max and medius strengthening
• Closed chain exercises added as FWB allowed and achieved
• Gait training variable surfaces
• Transfer training all levels

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11
Q

discuss the progression of rehabilitation and precautions that need to be taken for an individual who has had a Hip Fracture - Minimal Protection Phase

A

6-8 wks post op
• Pt should have normalized gait mechanics
• Reduced use of assistive device for amb
• More advanced hip strengthening exercises
• Still avoiding high forces & torque (bridge, SLR)

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12
Q

describe Trochanteric Bursitis

A

Excessive compression and repeated friction as the ITB snaps over the bursa

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13
Q

describe treatment for Trochanteric Bursitis

A
  • Relieve pain/inflammation
  • Rest/ice; ice massage
  • NSAIDs/injection
  • Modify activities
  • Stretch ITB, TFL, hams, quads, hip adductors
  • ITB release/STM
  • Strengthen hip abductors
  • Cane/crutch
  • US
  • Education on weight loss
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14
Q

describe Ischial Bursitis

A

Pain over ischial tuberosity underlying glute max; caused by direct contusion or prolonged sitting; may mimic hamstring strain

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15
Q

describe treatment for Ischial Bursitis

A
  • Manage like other bursitis
  • Rest from irritating activity
  • Hamstring stretching, quads strengthening
  • Padded seat cushion
  • Injection
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16
Q

describe Iliopectineal Bursitis

A

Tenderness over the iliopsoas musculature or diffuse pain radiating into anterior thigh; caused by tightness of the iliopsoas musculature or excessive hip extension

17
Q

describe treatment for Iliopectineal Bursitis

A
  • Modify activities during acute inflammation
  • Strengthen quads
  • Stretch iliopsoas carefully
  • Stretch ITB, hip adductors, hamstrings
18
Q

describe the strain of the Hamstrings

A
  • Challenging to treat as is 2 jt muscle
  • Cold packs 20 mins, 3-5 X day
  • Compression wrapping
  • Avoid motions that produce pain
  • Use of crutches to rest limb
  • Sleep supine with pillows under both knees to keep muscle relaxed
  • Avoid stretching hamstring group during maximal protection phase to allow torn tissue to scar and reorganize
  • Flexibility addressed during moderate/minimal protection phase
  • Strengthening starts with submaximal isometrics and increases as tolerated
19
Q

describe strain of Ilipsoas

A
  • Hip flexor pull, caused by sudden forceful extreme hip extension or by forced hip flexion against resistance
  • Follow same initial protocol as for hamstring
  • Gentle active hip flexion/tension once maximal protection phase is ended
  • Avoid strong extensor patterns
  • Avoid strong hip flexion
  • Gentle stretch of hip flexor later
20
Q

describe strain of Adductor

A
  • Groin pull
  • Classic initial program: ice, compression, protected WB
  • Avoid early aggressive stretching
  • Begin active hip flexion, abduction, adduction motion and knee ROM
21
Q

identify the 8 complications related to the pelvis or acetabular fractures

A
  • Hemorrhage
  • GI injury
  • Diaphragm rupture
  • Bony malunion
  • Non-union
  • Neurological damage (S1-S4)
  • DJD (degenerative joint disease)
  • Infection

PTA - Pathology (7 decks)

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