Soft Tissue Injuries, Fx Rehab, Surgical Intervention, s/p Intervention Flashcards
What is tendonitis?
Minor tears and inflammation.
What is a strain?
Overstretching or overuse.
What is a sprain?
Severe stress or tearing of soft tissues involving capsule, ligament, and tendon.
What is bursitis?
Inflammation of bursa.
What are contusions?
Bruising with bleeding.
What are dislocations?
Complete or partial loss of anatomical alignment.
What is subluxation?
Incomplete or partial dislocation.
What is chronic inflammation/chronic pain disorder?
A state of prolonged inflammation—injured tissue continually stressed beyond its ability to repair.
Condition persists longer than 3–6 months typical for tissue healing following injury.
What are the symptoms of chronic pain disorder?
Symptoms last > several hours after activity
increased stiffness after rest
loss of ROM 24 hours after activity.
What may cause chronic pain disorder?
May be a result of central sensitization (amplification of neural signals in the CNS = widespread hypersensitivity).
What are the pros of inflammation?
Controls bleeding, repairs, ultimately restores function.
What are the cons of inflammation?
Secondary tissue injury, pain, incomplete healing with chronic inflammation.
What is the normal healing time for general soft tissue injury?
3 months.
What is the normal healing time for ligamentous injury?
3 months.
What is the normal healing time for herniated disc (conservative treatment)?
3-6 months.
What is the normal healing time for shoulder arthroscopy?
3 months.
What is the normal healing time for most other shoulder operations?
3-6 months.
What is the normal healing time for knee arthroscopy?
3-6 weeks.
What is the normal healing time for knee arthrotomy?
3 months.
What is the normal healing time for knee ligament injury?
3-6 months.
What is the normal healing time for ankle ligament repair?
3-6 months.
What is the normal healing time for flexor tendon repair?
3-6 months.
What is the normal healing time for extensor tendon repair?
3 months.
What is the normal healing time for tendon release?
3 months.
What is the composition of ligaments?
75% collagen, 1-3% elastin, H2O.
What is the function of ligaments?
Connects bone to bone.
What factors lead to ligament injury?
Ligament size, age, joint position at injury.
What are the grades of ligament tears?
Grade I: Stretching or minor tearing of a few fibers without loss of integrity.
Grade II: Partial tearing of muscle tissue or ligament with clear loss of function.
Grade III: Complete loss of structural and biomechanical integrity.
What are the symptoms of Grade I ligament tear?
Minor swelling and discomfort; no/minimal loss of strength and ROM.
What are the symptoms of Grade II ligament tear?
Pain, point tenderness, swelling with local hemorrhaging, moderate loss of function, slight-moderate loss of ROM.
What are the symptoms of Grade III ligament tear?
Marked swelling; usually requires surgical repair; common sites include ankle, knee, and fingers.
What is the rehabilitation process for ligament injuries?
Surgery: Instability leads to decreased function. Every ligamentous surgery has its own protocol.
Rehabilitation usually involves aggressive ROM, strengthening, and return to function.
What are the effects of immobilization on soft tissue?
causes loss in connective tissue strength
changes in collagen fibers and ground substances
decreased elasticity
muscle atrophy
articular cartilage degeneration
decreased circulation.
What is the composition of tendons?
Dense, closely packed parallel fibers; 30% collagen, 2% elastin, 68% water.
What is the function of tendons?
Transmits forces from muscle to bone; connects muscle to bone.
What factors contribute to tendon injury?
Acute excessive loading, intrinsic/extrinsic factors, repetitive excessive loading,
inadequate healing, degenerative changes, inflammation.
Where do muscle injuries commonly occur?
Muscle injuries commonly occur at the myotendinous junction and muscle belly.
What are the types of muscle injuries?
The types of muscle injuries include contusions, hematomas, and myositis ossificans.
What are some contributory factors to muscle injuries?
Contributory factors include flexibility, age, immobilization, temperature, and strength.
What are indications for surgery?
pain at rest or with functional activities,
chronic joint swelling,
severe limitation of AROM or PROM,
gross instability,
abnormal joint alignment/deformity,
significant tissue damage,
gross loss of function,
unsuccessful conservative management,
significant structural degeneration, and significant loss of function.
What are some complications of surgery?
include infection or poor wound healing,
DVT/PE,
poor healing of bone, loosening of prosthesis/hardware, subluxation/dislocation of joint surfaces/implants, wear and tear of prosthesis,
pulmonary complications, muscle function deficits secondary to tourniquet compression, nerve entrapment from scar tissue formation, adhesions/scarring leading to contractures of soft tissues & hypomobility, and rupture of incompletely healed tissue after repair/reconstruction.
What is an arthrotomy?
An arthrotomy is a surgical procedure where the joint capsule is incised and joint structures are exposed.
What is arthroscopy?
Arthroscopy involves several very small incisions in the skin, muscle, and joint capsule, using motorized surgical tools to repair soft tissues, remove loose bodies, and debride joint surfaces.
What are the benefits of arthroscopy?
Benefits of arthroscopy include quicker recovery, less invasiveness, and it is commonly performed on an outpatient basis often with local anesthesia.
What are examples of procedures performed via arthroscopy?
Examples include ligament & tendon repairs, joint debridement, and synovectomy.
What are articular cartilage procedures?
Articular cartilage procedures involve repair, which is difficult due to limited healing capacity, and stimulate a bone-marrow-based response for fibrocartilage ingrowth.
What is robotic-assisted surgery?
Robotic-assisted surgery uses 3-D robotic arms controlled by a surgeon at a console, improving precision and consistency while being minimally invasive.
What is an osteotomy?
An osteotomy is a surgical procedure involving the cutting and realignment of bone to shift weight-bearing loads and reduce pain.
What are common sites for osteotomy?
Common sites for osteotomy include the hip and knee.
What is arthrodesis?
Arthrodesis is the fusion of bony surfaces of a joint with internal fixation to alleviate severe pain, arthritis, or instability.
What is arthroplasty?
Arthroplasty is any reconstructive joint procedure, with total joint replacement being a common type.
What are the fixation options for implants in arthroplasty?
Fixation options include cemented (for older adults) and non-cemented (for younger, more active adults) methods.
What is synovectomy?
Synovectomy is the removal of the synovial lining of a joint due to chronic inflammation, typically performed arthroscopically.
What is the purpose of soft tissue release procedures?
Soft tissue release procedures aim to improve ROM, prevent/minimize progressive deformity, and relieve pain.
What are the signs and symptoms of a fracture?
Hx of falls, direct blow, twisting injury or accident; localized pain aggravated by movement and on weight bearing; muscle guarding with passive movement; decreased functional use of the part; swelling, deformity, or abnormal movement; sharp, local tenderness at site.
What are the phases of bone healing post-fracture?
Inflammatory Phase: Hematoma formation & cellular proliferation; Reparative Phase: Callus formation; Remodeling Phase: Consolidation and remodeling of bone.
What are the local responses to immobilization?
Connective tissue weakening; articular cartilage degeneration; muscle atrophy; contracture formation; decreased circulation.
What occurs during bed immobilization?
If bed rest is required, secondary physiological changes will occur.
What are functional adaptations during rehabilitation?
Assistive Device (AD) training may be used due to weight-bearing (WB) restrictions; MD determines WB status; PT determines AD and gait pattern.
What impairments may be seen during the post-immobilization exam?
Decreased ROM, joint play, and muscle flexibility; muscle atrophy with weakness + poor endurance; pain with initiation of movement; inelastic scar restricts tissue mobility if soft tissue damage exists.
What is included in PT management post-immobilization?
Confirmation of fracture healing; joint mobilization techniques; PNF stretching; progress WB activities to FWB; decrease AD use; scar tissue mobilization; muscle performance usually occurs 2–3 weeks post-immobilization.
What are normal fracture healing times for children, adolescents, and adults?
Children: 4–6 weeks; Adolescents: 6–8 weeks; Adults: 10–18 weeks.
What are the types of abnormal healing of fractures?
Malunion: Heals in an unsatisfactory position; Delayed Union: Healing takes longer than normal; Non-Union: Fracture fails to unite with a bony union.
What factors influence post-operative rehabilitation?
Extent of tissue pathology or damage; type of surgery; patient-related factors (age, pre-op impairments, health history, medications, lifestyle, smoking status, social support, motivation); stage of healing; characteristics of tissues involved & adjacent tissues; philosophy of the surgeon.
What should be inspected in a post-surgical incision?
Check for signs of redness or necrosis; palpate for pain, tenderness, edema, signs of heat; note drainage color and amount; check integrity of incision across joint; assess mobility of the scar as it heals.
What precautions should be considered post-operatively?
All precautions related to stages of healing; avoid positions, movements, or WB that could compromise the repair; keep wound clean; avoid vigorous stretching or resistance exercise with repaired soft tissues (at least 6 weeks); modify level of physical activities.
