Upper Extremties Fx

Question 1

What is “Stable” in regards to fracture healing terms?

Answer 1

can w/stand AROM w/o movement at the fx site

Question 2

8) How do you control Edema? Name 5

Answer 2

• Elevation (Hand above elbow elbow above heart)
• Ice pacs
• Gentle A/P ROM of uninvolved joint
• Overhead fisting
• Light non-resistive occupations

Question 3

Which type of healing skips callus formation

Answer 3

Primary healing

Question 4

What is the process of Secondary healing?

Answer 4

• Inflammation Phase ( Soft Callus formation)
• Repair Phase (Ossification of Soft Callus)
• Remodeling Phase ( Maturation of bony union)

Question 5

If a bone is compressed, what type of healing takes place?

Answer 5

Primary

Question 6

In Primary healing has how many stages?

Answer 6

2 stages

1) inflammation (repair) 2) Remodeling

Question 7

What is “Healed” in regards to fracture healing terms?

Answer 7

Radiographic evidence can w/stand more aggressive PROM/dynamic splinting and resistive strengthening and Normal ADL stresses

Question 8

What is “Clinically healed” in regards to fracture healing terms?

Answer 8

Not tender to pressure w/stand GENTLE PROM

Question 9

9) If a person can do AROM why then PROM is part of the treatment?

Answer 9

To ensure full pain free ROM is being met (a person may have a wider PROM compared to AROM)

Question 10

10) What ROM can be done for Inflammatory phase (soft callus formation)

Answer 10

A/P ROM of Uninvolved joint

Question 11

What is the difference between inflammatory phase for primary healing and secondary healing?

Answer 11

Soft Callus formation for primary healing only

Question 12

What are some guidelines during secondary inflammatory phase?

Answer 12

Full Time casting/splinting/pinning of fracture site
Edema Control
A/P ROM of uninvolved joints
Precautions
ADL compensation

Question 13

When would you not do A/PROM of all non-immobilized joints?

Answer 13

When there is tendon/nerve involvement

Question 14

During Ossification what is the cast schedule generally?

Answer 14

Initially cast/splint full time, AFTER 4-5 weeks, Interval splinting begins (all times EXCEPT therapy and shower)

Question 15

When full time cast is removed, what is the ROM protocol in the Repair phase of Secondary Bone healing?

Answer 15

4-5 weeks “Fracture is stable”

Question 16

When might you initiate PROM protocol in the Repair phase of Secondary Bone healing

Answer 16

6-7 weeks “ Fracture is clinically healed”

Question 17

When might you initiate gentle strengthening in the Repair phase of Secondary Bone healing?

Answer 17

8-9 weeks

Question 18

During remodeling phase, stress (strength training ), use for ADLs, and progressive weight bearing at fx site does what?

Answer 18

Encourages bony deposits.

Question 19

During Secondary healing: Remodeling Phase, specifically maturation of bone union phase, when is the bone usually healed and how would you know?

Answer 19

Fracture is usually considered “Healed” around 12 weeks radio-graphic imaging

Question 20

During Primary healing: why is the bone almost immediately stable? When can AROM begin?

Answer 20

within few days- Fracture is immediately as strong as fixation device.

Question 21

During Primary healing: when can PROM start?

Answer 21

4 weeks when remodeling begins

Question 22

When can gentle strengthening be initiated in Primary healing?

Answer 22

6 weeks post op