ortho- rehab

Question 1

reduction + immobilization: define the 3 types

Answer 1

Closed techniques – 3 point reduction. Casting, splinting, and fracture bracing.
Open techniques – ORIF i.e. plates, screws and intramedullary nails and wiring.
Mixed techniques – Percutaneous pins and external fixators

Question 2

bone healing: what are the 3 steps

Answer 2

inflammatory, reparative, remodeling

Question 3

step 1 bone healing- inflammatory

Answer 3

the cellular and vascular response to injury, includes release of wbc’s and macrophages, hematoma formation, coagulation and necrosis of bone ends.

Question 4

step 2 bone healing- reparative

Answer 4

replacement of necrotic or damaged tissue by new cells and matrix via hematoma organization to fibrin scaffold, cellular differentiation to osteoblasts and form callus (disorganized bone formation)

Question 5

step 3 bone healing- remodeling

Answer 5

the reshaping & reorganizing of tissue by removing, replacing and reorganizing cell and matrix

Question 6

infection is typically a complications of what 2 types of ortho injuries

Answer 6

open fractures + surgery

*always culture before starting antibiotics! (for penetrating injuries especially)

Question 7

complications of healing: define delayed union, nonunion, malunion, and avascular necrosis

Answer 7

Delayed union – fx is healing at a slower rate than expected
Nonunion – fx not showing signs of healing at 4-6 months post injury; hypertrophic vs. atrophic, often 2nd to poor blood supply.
Malunion – healed w/rotational or shortening deformities
Avascular necrosis – death of a bone. (femoral head, scaphoid)

Question 8

what is RSD (aka complex regional pain syndrome )?

Answer 8

a vague, ill-defined, widespread painful condition observed after trauma. Characterized by pain, hyperesthesia and tenderness out of proportion to the physical findings

Question 9

what can RSD progress to?

Answer 9

atrophy of the skin and muscle and severely limited use of involved extremity.