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LL Ox > Q4: Fracture Orthoses > Flashcards

Q4: Fracture Orthoses Flashcards

1
Q

Historical Background

Fracture Ox

A
  • casts are heavy (sublux/dislocation)
  • Ox can allow access to wounds (hygiene)
  • Joint stiffness
  • increased rehab time with casts
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2
Q

Principles

Ox Fracture Management

A
  • Compress soft tissue for stability/alignment
  • maintain joint mobility
  • Total Contact
  • 3 point pressures
  • micromotion (promotes osteogenesis)
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3
Q

Contraindications (general)

Ox Fracture Management

A
  • Non-compliance
  • soft tissue loss
  • instable phase of healing
  • insensate/dysvascular/neuro- pt
  • polymer sensitivity
  • angulation
  • open fx
  • intraarticular (or close) fx
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4
Q

Phases of Healing

A
  1. Onset (14 days)
  2. Periosteal bridging callous (2-3 wks)
  3. Rubbery to hard callous (6 wks)
  4. Original Fx line fades
  5. Bone remodeling (may last years)
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5
Q

Protocol for Tibial Fx

A
  1. Closed reduction, LL cast; 48 hr observation
  2. 3rd week intiate PWB
  3. Radiograph - alignment
  4. Follow up in 1-2 weeks
  5. Remove LL cast; apply Ox
  6. WB with crutches as tolerated
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6
Q

Indications

Tibial Fx - Ox management

A
  • Post-cast, determine angulation values
  • 10 degrees varus/valgus
  • 20 degrees ant/post angulation
  • Malunion
  • Diaphyseal Fxs of Tibia
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7
Q

Design

Tibia Fx Ox

A
  • Prefab (multiple sizes)
  • Height - tibial tubercle to medial malleolus
  • Shoe size
  • Two interfaces (socks)

Allows full ankle and knee motion (encourages joint motion and osteogenesis)

Custom Fit to Pt

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8
Q

Contraindications

Tibial Fx Ox

A
  • Tibial Plateau Fx
  • Segmental Bone Loss
  • Open Fx
  • Soft Tissue Loss

Other general contraindications as well

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9
Q

Favorable Outcomes

Tibial Fx Management

A
  • No more than 8 degrees angulation (any plane)
  • No more than 12 mm shortening
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10
Q

Protocol

Femoral Fxs

A
  1. Closed intramedullary nailing
  2. Traction (4-6 wks)
  3. Casting
  4. Ox applied when traction is complete
  5. PWB and extremity exercise
  6. Ox in x-ray to confirm alignment
  7. Follow up, increased WB
  8. Clinical Union
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11
Q

Indications

Femoral Fx - Ox Management

A
  • Distal 1/3 of femur
  • non-displaced intraarticular fx
  • post traction
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12
Q

Contraindication

Femoral Fx - Ox Management

A
  • Unstable Fx
  • Mid and Prox. 1/3 of Femur
  • Displaced Intraarticular Fx
  • Obese thighs
  • Neurovascular impairment
  • Noncompliance
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LL Ox (24 decks)

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