Orthopedics

Question 1

Fractures two critical factors involved

Answer 1

1. Amount of force applied to bone (MVA vs stress fractures)
2. Strength of bone- normal or weakened from pathologic conditions
   Tumors, osteoarthritis, osteoporosis
   Age and size of bones

Question 2

Pathologic fracture

Answer 2

Bone weakened by conditions such as osteoarthritis and osteoporosis that can’t sustain normals forms and therefore fractures during daily activities

Question 3

Leading cause of non fatal injuries and fractures in older adults

Answer 3

Falls

Question 4

Types of fractures

Answer 4

Closed
Open 
Comminuted 
Displaced 
Greenstick

Question 5

Closed

Answer 5

Fracture has not broken through the skin

Question 6

Open (compound)

Answer 6

Bone breaks skin surface, increased chance of infection

Question 7

Comminuted

Answer 7

Fractures with 2+ fragments

Question 8

Displaced

Answer 8

Segments that have become separated or shifted from the bone

Question 9

Greenstick

Answer 9

Children (soft, still growing)

Bone breaks on one side and bends on the other (think twig)

Question 10

Types of fracture lines

Answer 10

Complete
Incomplete
Transverse 
Oblique 
Spiral

Question 11

Complete

Answer 11

Break in full continuity of the bone

Question 12

Incomplete (hairline)

Answer 12

Involves partial disruption in continuity of bone

Question 13

Transverse

Answer 13

Occurs when fracture line is at a right angle to the longitudinal axis of the bone

Question 14

Oblique

Answer 14

involves fracture line that is diagonal or slanted

Question 15

Spiral

Answer 15

Torsional stress causing twisting fracture line

Question 16

Colle’s fracture

Answer 16

Dorsal displacement, dorsal comminuting, radius shortening, dinner fork deformity, resembles upside down fork

Question 17

Smith’s fracture

Answer 17

Reverse colle’s, deformity replaces tower the volar or palmar of wrist

Question 18

Hip fractures

Answer 18

Proximal femur, unable to bear weight, intracapsular (femoral neck) or extracapsular (trochanters)
Surgical management

Question 19

Humeral fractures

Answer 19

Supracondylar fractures (distal end of humerus)
Volkmann’s deformity, severe damage to tissues and muscles

Question 20

Volkmann’s deformity

Answer 20

Caused by increased pressure, ischemia, bleeding, tight bandages

Question 21

Abnormal healing factors

Answer 21

Open fractures, soft tissue damage,nerve damage, infections,
Result in deflated union (more time to heal)

Question 22

Malunion

Answer 22

Fracture heals in abnormal position,

Factors include muscle imbalance, inadequate positioning or protection

Question 23

Nounion

Answer 23

Bone is not healing, deficits in ROM, strength and coordination
Factors- vascular/tissue damage, poor alignment, stress to fracture site, infection, scaphoid @ high risk

Question 24

Osteoarthritis

Answer 24

Degenerative joint disease, non-inflammatory joint disease resulting in deterioration of articular cartilage and formation of new bones (osteophytes) on joint surface

Question 25

Signs and symptoms of osteoarthritis

Answer 25

``` Joint pain, inflammation, stiffness, tenderness, limited ROM, crepitus (crunching or pooping sound in the joint) Gradual Arthritis (joint inflammation) ```

Question 26

Osteoporosis

Answer 26

Low bone density and deterioration of bone, (less estrogen risk factor), post-menopausal women, may fracture bone through normal movement,

Question 27

Signs and symptoms of osteoporosis

Answer 27

Gradual, few symptoms -> advanced symptoms Clinical signs- skeletal fractures, recurring pathologic fractures

Question 28

Osteopenia

Answer 28

Reversible weakening of bone, | Balance diet, supplements, WBE, bone density screenings to decrease risk of progression into osteoporosis

Question 29

Signs and symptoms of osteopenia

Answer 29

Predecessor to osteoporosis with no signs, diagnosed through bone density scans

Question 30

Heterotopic ossification

Answer 30

Orthopedic condition- bone formation in soft tissue Unclear exact cause Associated with traumatic injuries (burns, SCI, TBI) Creates response and fibroblasts start forming bone near joints- stiffness, and loss of movement

Question 31

Signs and symptoms of heterotrophic ossification

Answer 31

Pain, joint warmth, swelling, decreased ROM, palpable mass

Question 32

Impact on OT

Answer 32

ADL’s, IADL’s , sleep, education , work, play, leisure, social Equipment Important to continually assess and address persons values and beliefs during healing process