Surgical Considerations Flashcards
timing of acute/inflammatory phase
0-2 weeks
immediately after injury/onset
associated losses of acute/inflammatory phase
loss of function
- ROM, muscle tolerance, weightbearing, PLOF
timing of subacute phase
2-6 weeks
what happens in the subacute/proliferation phase
decline of inflammation
influx of fibroblasts and capillaries
explain the tissue that is laid down during subacute phase
thin and disorganized
can be damaged easily
needs to be appropriately loaded to direct growth and alignment
what is the indicator of remodeling phase
no inflammation
tissue strengthen and returning towards prior level of strength
instead of being limited by pain, those in the remodeling phase typically are held back by
weakness
poor endurance / NM control
what indicates centralization / nociplastic pain
generalization of the pain
pain not being linked to direct tissue harm
maximal protection phase goals
protect surgical repair
achieve ROM goals
education on post-op restrictions
minimize pain/inflammation
ensure adequate regional function
functional phase goals
achieve ROM goals
- normalize PROM and AROM
minimize pain
begin increases to strength and endurance
increase functional activities
normalization phase goals
normalize
- strength, endurance, NM control and power
build up of stress on involved tissue (indirect and direct)
gradual return to ADLs, work and recreational activities
what are return to sport/work requirements
clearance from physician
no report of pain at rest/activity
no or minimal sense of fear/instability with activity
sufficient ROM/flexibility to perform desired tasks
adequate strength and endurance
fracture precautions
WB restriction
cemented joint replacements precautions
precautions but mobilize
non-cemented joints precautions
WB restrictions
precautions
mobilize
meniscectomy precautions
minimal limitations
restore PLOF
cartilage repairs
+/- WB restrictions
bracing (ROM limits)
minimize HS activation
tendon or ligament repair precautions
WB/ROM – use precautions
bracing
posterior hip replacement
90° flexion
hip IR
hip adduction
anterior hip replacement precautions
excessive hip extension
spine surgery precautions
bending
lifting
twisting
reverse total shoulder precautions
limit shoulder extension
WB while arm is across the body
s/s of a DVT
redness
swelling of whole limb
significant pain increase
tenderness to palpation
pulmonary embolism s/s
chest pain
SOB
increased HR
for those at risk of a clot, what is the best management
interventions should start immediately
include leg exercise and ambulation in conjunction of medical management
benefits of mobilization after DVT
minimize deconditioning
shorten hospital stay
reduce occurrence of pressure ulcers
5 w’s of post operative fever
wind
water
wound
walking
wonder drugs
