Week 8 Terms: UE Orthopedics Flashcards
What are the two goals of fracture treatment?
- Achieve a precise and effective stabilization
- Optimal Recovery and return to function
What is part of fracture treatment?
A. Mobilization
B. Rest
C. Both
B. Rest
Immobilization for long periods after stabilization.
True/False
You should mobilize the injured structures as quickly as is compatible with healing.
True
Closed Fractures
Non-Displaced and Stable
may be managed by protection alone
Non displaced but Unstable
requires positioning and immobilization by external fixation
e.g., sling, cast, fracture brace
Open Reduction Internal Fixation (ORIF)
Open Fractures
Unstable AND Displaced
Cannot be manually reduced
Surgically Stabilized (Pin, Screw, Rod or Plate)
Estimated Fracuture Healing Timeline:
Uncomplicated Upper Extremity
Callus formation 2 to 3 weeks
Union 4 to 6 weeks
Consolidation 5 to 8 weeks
Estimated Fracuture Healing Timeline:
Uncomplicated Lower Extremity
Callus formation 2 to 3 weeks
Union 8 to 12 weeks
Consolidation 12 to 16 weeks
Phases of Fracture Healing
Inflammation
Reparative
Remodeling
Estimated Fracture Healing Timeline:
What does timing, amount, and type of therapy depend on?
Location and Type of Fracture
Method of Reduction
Age of Patient
What are some types of shoulder fractures?
Clavicle Fracture
Scapula Fracture
Proximal Humerus Fracture
What are some types of elbow fractures?
Olecranon Fracture
Radial Head Fracture
Distal Humerus Fracture
What are the joints of the shoulder?
Glenohumeral (GH)
Acromioclavicular (AC)
Sternoclavicular (SC)
Scapulothoracic (ST; articulation more than a joint)
What fracture is the most challenging to rehabilitate?
A. Elbow
B. Knee
C. Shoulder
D. Both A and C
C. Shoulder
A shoulder fracture is the most challenging to rehabilitate.
What are the therapy goals for a shoulder fracture?
Relieve Pain
Allow callus formation and approximation of bony fragments
Restore movement and muscle strength
Return to maximal functioning
How does PROM differ from Passive Stretching?
PROM finding the PROM of a joint
Passive Stretching you are passively stretching out the muscle
What are the types of elbow fractures?
Olecranon Fracture (Fx)
Radial Head Fx
Distal Humerus Fx
A wrist fracture makes up approx. what percentage of all broken bones?
A. 0-15%
B. 15-25%
C. 25-50%
D. 50-85%
C. 25-50%
What are the distal radius fractures called?
Colle’s Fracture
Smith’s Fracture
Barton’s Fracture
What are common shoulder pathologies?
Scapular Instability
Subluxation
Impingement
Rotator Cuff Tear
Adhesive Capsulitis
Arthritis
Shoulder Replacement
Winged scapula and scapular instability leads to?
Scapular Instability
*Winged Scapula
serratus anterior weakness
generalized weakness
Scapular instability
leads to shoulder instability
decreases arm function*
Scapulohumeral rhythm helps to…
A. Prevent Impingement
B. Maintain muscles’ optimal length-tension relationship
C. facilitate fluid movement anf for full overhead ROM
D. All of the above
D. All of the above
What is an example of subluxation in the shoulder?
Humerus comes out of the glenoid fossa
Results in instability, weakness or trauma
Shoulder Impingement
Reduction in sub-acromial space leading to compression of structures:
supraspinatus tendon
long-head of biceps
subacromial bursa
joint capsule
Can lead to a rotator cuff tear
What are some causes of shoulder impingement?
Repetitive overhead use
Arthritis
Structural Abnormalitites
Calcification
Instability (weakness)
Symptoms of Shoulder Impingement
Pain
Weakness
Loss of Active/Passive Motion
What four muscles make up the rotator cuff?
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
The rotator cuff acts as a BLANK stabilizer of the glenohumeral joint.
The rotator cuff acts as a dynamic stabilizer of the glenohumeral joint.
Causes of Rotator Cuff Tears
Impingement
Trauma
Degenerative Changes
Can be partial or full-thickness tears
Symptoms of Rotator Cuff Tears
Loss of AROM
Weakness
Night Pain
Pathology of Adhesive Capsulitis
Thickening of the joint capsule
Adhering to the humeral head
Symptoms of Adhesive Capsulitis
Diffuse shoulder pain
Night Pain
Progressive multidirectional loss of A/PROM at shoulder
Causes of Adhesive Capsulitis
Primary- Unknown
Secondary- Surgical Event
Immobilization
Typically in patients >40; more common in women
Shoulder arthritis usually occurs in people over the age of…
A. 30
B. 40
C. 50
D. 60
C. 50
Symptoms of Shoulder Arthritis
Pain during and after movement
Swelling
Bone Spurs
What happens in a total shoulder replacement?
Humeral head is replaced
Glenoid is reshaped and resurfaced
Typically done for a fracture
Post-Op Treatment for a Total Shoulder Replacement
Therapy to begin right away (Gentle ROM)
Sling all the time for approx. 6 weeks to protect soft tissue
Functional Expectation:
Full ROM
Good pain relief
Return to all daily activities
What happens in a Reverse Total Shoulder Arthroplasty?
The “ball” of the joint is placed on the socket side of glenoid
The “socket” of the joint is placed on the humerus
Typically performed when rotator cuff is deficient
Post-Op Treatment for a Reverse Total Shoulder Arthroplasty
Similar to TSA
No therapy initially
Protocol for ROM may vary
Sling at all times for approx. 6 weeks
Functional Expectations:
Goal is pain relief and “functional ROM”
