Upper Extremties Fx Flashcards
What is “Stable” in regards to fracture healing terms?
can w/stand AROM w/o movement at the fx site
8) How do you control Edema? Name 5
- Elevation (Hand above elbow elbow above heart)
- Ice pacs
- Gentle A/P ROM of uninvolved joint
- Overhead fisting
- Light non-resistive occupations
Which type of healing skips callus formation
Primary healing
What is the process of Secondary healing?
- Inflammation Phase ( Soft Callus formation)
- Repair Phase (Ossification of Soft Callus)
- Remodeling Phase ( Maturation of bony union)
If a bone is compressed, what type of healing takes place?
Primary
In Primary healing has how many stages?
2 stages
1) inflammation (repair) 2) Remodeling
What is “Healed” in regards to fracture healing terms?
Radiographic evidence can w/stand more aggressive PROM/dynamic splinting and resistive strengthening and Normal ADL stresses
What is “Clinically healed” in regards to fracture healing terms?
Not tender to pressure w/stand GENTLE PROM
9) If a person can do AROM why then PROM is part of the treatment?
To ensure full pain free ROM is being met (a person may have a wider PROM compared to AROM)
10) What ROM can be done for Inflammatory phase (soft callus formation)
A/P ROM of Uninvolved joint
What is the difference between inflammatory phase for primary healing and secondary healing?
Soft Callus formation for primary healing only
What are some guidelines during secondary inflammatory phase?
Full Time casting/splinting/pinning of fracture site Edema Control A/P ROM of uninvolved joints Precautions ADL compensation
When would you not do A/PROM of all non-immobilized joints?
When there is tendon/nerve involvement
During Ossification what is the cast schedule generally?
Initially cast/splint full time, AFTER 4-5 weeks, Interval splinting begins (all times EXCEPT therapy and shower)
When full time cast is removed, what is the ROM protocol in the Repair phase of Secondary Bone healing?
4-5 weeks “Fracture is stable”
When might you initiate PROM protocol in the Repair phase of Secondary Bone healing
6-7 weeks “ Fracture is clinically healed”
When might you initiate gentle strengthening in the Repair phase of Secondary Bone healing?
8-9 weeks
During remodeling phase, stress (strength training ), use for ADLs, and progressive weight bearing at fx site does what?
Encourages bony deposits.
During Secondary healing: Remodeling Phase, specifically maturation of bone union phase, when is the bone usually healed and how would you know?
Fracture is usually considered “Healed” around 12 weeks radio-graphic imaging
During Primary healing: why is the bone almost immediately stable? When can AROM begin?
within few days- Fracture is immediately as strong as fixation device.
During Primary healing: when can PROM start?
4 weeks when remodeling begins
When can gentle strengthening be initiated in Primary healing?
6 weeks post op
