test2finalsemester Flashcards
survive
subluxation definition and intervention
displacement of bone from its normal joint position to the extent that articulating surfaces partially lose contact
intervention is to reduce the frx
dislocation definition and intervention
complete seperation or displacement of articulating surfaces - tx is urgent intervention due to decreased blood flow and risk of nerve injury
orthopedic fracture classification:
commuinuted
bone breaks in two or splinter into more than two fragments
displaced fracture
bone break in two or more parts and two ends don’t line up
non displaced fracture
bone breaks but stays aligned
avulsion:
bone fragment tears away from the main mass secondary to physical trauma
compression frx
bone collapses generally in the vertebrae
buckle
compression of 2 bones driven into eachother
butterfly-
2 oblique fractures line meeting to create a large triangle or wedge shaped fragment between the proximal and distal fragments- looks like a butterfly
greenstick or incomplete
bone is bent but not broken all the way through
pathologic fracture
caused by disease
articular
fracture that crosses the joint
transverse
fracture line is perpendicular to the shaft of the bone
spiral
break is on an angle through the bone
stellate
lines of break radiate from a point at the sight of the injury
stress or fatigue frx
hairline crack
segmental
2 or more fracture lines that isolate a portion of the bone
intraarticular fracture
extends into the joint
intracapsular fracture
fracture within the joint capsule
extracapsular fracture
fracture extends outside capsule
supracondylar fracture
above condyles
grade one fracture
wound is <1cm, minimal contamination
grade two fracture
wound is >1cm moderate contamination
grade three fracture
wound is greater than 6-8 cm, extensive damage to the soft tissue, nerve, and tendon, high degree of contamination.
things seen on ortho exam
edema, discoloration, decreased ROM, deformity, crepitus, muscle spasm, protruding bone
diagnostics for ortho
plain film of injury and joint above and below injury
then CT, MRI and Labs
Ortho management is depends on if frx is…..
open or closed
ortho surgical intervention for closed reduction
manual manipulation to restore alignment of bone ends, followed by casts, splints, slings, swathes(?)
casting 4 points
immobilize and support injured deformed and postoperative extremities,
it protects and re-aligns bone
it promotes healing and early weight bearing
you can cast serially to prevent or correct deformities
orthopedic frx sx intervention- traction types and countertraction
traction is - application of pulling force to injury or diseased part of body while countertraction- generally weight from the pt pulls i the other direction
manual- using hands
skin- pulling force on the skin
skeletal- pulling on the bone itself
external fixation
an immobilization that employs percutaneous transfixing pins or wires in bone attached to a rigid external frame - it allows a wide range of anatomic correction for congenital and aquired injuries
ORIF
open reduction and internal fixation - surgical re-alignment of fragments and internal placement of pins, wires, plats screws etc
frx healing process hematoma formation
1-3 days
frx healing process granulation
3days to 2 weeks
frx healing process callus formation
2-6 weeks
frx healing process consolidation and ossification with remodeling
3 weeks to 6 months
compartment syndrome definition
cause
increased pressure in muscle compartment of an extremity- cause by frx, hematoma, crush injuries , anabolic steroid use, constrictive bandages, re-established blood flow (sleeping on arm or post op vessel sx
5 P’s of compartment syndrome
pain pallor paresthesia pulselessness paralysis
compartment syndrome
history
physical
eval
management
compartment syndrome
History -known frx
Physical- pain, palor, paresthesia, pulselessness, paralysis
eval- compartment pressure managemnt with needle check pressure, have pt walk or run and recheck pressure.
management is fachiotomy
avascular necrosis
lack of blood to the bone causing death
avascular necrosis causes
injury, racture, long term steroid use, excessive ETOH, fatty deposits in the blood vessels, sickle cell anemia, gauchers diseas
risk factors for avascular necrosis
trauma, excessive steroid use, ETOH, biphosonate use, radiation therapy, pancreatitus, DM, HIV/Aids, gauchers disease, SLE, Sickel cell anemia
avascular necrosis, prevention / complication
limit ETOH,
monitor cholesterol, monitor steroid use,
dont smoke
complications -severe arthritis, bone collapse
avascular necrosis
H/P
H/P- determine cause and risk factors
Physical - examine bones and joints, assess ROM
avascular necrosis Evaluation
x-ray- normal in early stages, bone change in late stages
MRi, CT scan, Bone scan- damage shows up as bright spots
Med management of avascular necrosis
Nsaids, alendronate- slows progression of disease,
cholesterol lowering meds- decreases blockage- increasing the blood flow
blood thinners, rest, exercise
sx management -
core decompression, bone graft, osteotomy - reshapes the bone, joint replacement, regenerative med treatment- bone marrow aspirate and stem cells
DJD- osteoarthritis- due to wear and tear
mainly in
high risk group
mainly in knees, hands, hips and spine
increased risk in women over 55
risk factors of DJD
repetitive motion, infection, RA, Muscular dystrophy, osteoperosis, hormone disorders, onbesity, sickle cell, bone disorders
DJD H/P
pt complains of pain, limited ROM, stifffness, loss of flexibility and swelling, releived with rest initially and when progressed you get no relief with rest
physical- muscle and joit strength decreased
obvious deformity
decreased self care
s/s of depression
DJD eval
x-ray
MRi/CT
bone scan
joint aspiration fro fluid analysis, arthroscopy to view joint.
DJD management
pain management- Nsaids, narcs, cortisone, lube injection, weight loss, PT/OT, Joint replacement .
