Orthopedics Flashcards
(180 cards)
1
Q
What are the 3 types of bones?
A
- Long bones
- Short bones
- Flat bones
2
Q
What are the 3 layers of the bone?
A
- Periosteum: The outside layer/membrane where muscles, tendons, and nerve endings attach
- Compact bone layer: Mineralized; Provide strength and integrity
- Sponge bone: Bone marrow; Contains blood vessels
3
Q
What are alternative terms for bone growth?
A
Ossification or osteogenesis
4
Q
When does bone growth start after conception?
A
8 weeks after conception
5
Q
What are the 3 cell types involved in bone growth?
A
- Osteoblasts: Bone-forming
- Osteocytes: Mature cells
- Osteoclasts: Break down and reabsorb bone
6
Q
What kind of hip fractures are good candidates for hip replacement surgery?
A
Fractures on the neck of the femur or subtrochanteric fractures.
7
Q
What kind of hip fractures are not good candidates for hip replacement surgery?
A
Trochanteric fracutres (greater or lesser trochanters)
8
Q
What are the 3 phases of bone growth post-fracture?
A
- Reactive phase (Acute): Inflammation and granulation (formation of new bone)
- Reparative phase (weeks to months): Periosteum forms osteoblasts, which forms new tissue
- Re-modelling phase (3-5 years): Thickening of the fracture site and remodelling of the vasculature
9
Q
What are the main treatments for fractures?
A
Immobilization and surgical intervention Sufficient blood supply (nutrition and sleep) Energy (depleted by healing) Protein supplement Weight bearing (appropriate)
10
Q
What is the only type of fractures that are non-surgical?
A
Undisplaced fractures
11
Q
How are stable undisplaced fractures (e.g. minor spinal fracture) treated?
A
Managed by protection alone with the need for reduction or immobilization.
12
Q
How are unstable undisplaced fractures (e.g. radius fracture) treated?
A
Require positioning/immobilization but not reduction.
13
Q
What is the goal of surgical treatment of fractures?
A
Effective and precise stabilization for optimal recovery and resolution of function.
14
Q
When do fractures require surgical intervention?
A
When bony fragments cannot be approximated accurately in a closed manner
15
Q
What is open reduction internal fixation?
A
Open surgery of the fracture, where the bony fragments are internally fixed using pins and screws
16
Q
What is the Ilizarov procedure?
A
A leg-lengthening procedure where the bone is cut surgically and the body is encouraged to close the gap between the bones, 1 mm of bone distraction/lengthening per day
17
Q
What level of weight-bearing is prescribed for patients going through the Ilizarov procedure?
A
Weight bear as tolerated (WBAT) – Required to stimulate osteogenesis
18
Q
What are the OT roles in caring for patients going through the Ilizarov procedure?
A
- Fabrication of foot plate – High risk for foot drop and plantar-flexion contracture
- Wound care
- Compression to manage edema
- Aid with body image acceptance
- Clothing modifications
19
Q
What is arthroscopy?
A
Using small cameras to investigate or assist in surgical repair
20
Q
What is arthroplasty?
A
Joint replacements
21
Q
When is an arthroplasty required?
A
- When conservative treatments have failed
2. Patient continues to have pain, stiffness, and functional impairments
22
Q
The number of total hip replacement surgeries are [decreasing/increasing].
A
Increasing, due to the increasing aging population.
23
Q
What is the most common responsible diagnoses for total hip replacement surgeries?
A
Arthritis and hip fracture
24
Q
What is the most common responsible diagnoses for knee replacment surgeries?
A
Arthritis
25
In total arthroplasty, which structures are replaced?
Both articulating surfaces, e.g. part of the femur, the femoral head, and the acetabular in total hip replacement
26
In hemi-arthroplasty, which structures are replaced?
Only one articular surface is replaced, e.g. Just the acetabulum or the femoral head (Austin Moore prosthesis)
27
When is cemented hip hardware used?
For people who have osteoporosis or osteopenia, and have weak bones
28
What are the pros and cons of cemented hip hardware?
More stability in the beginning
| Increases risk of infection
29
What are the weight-bearing recommendations for cemented hip implant?
Weight-bear as tolerated (WBAT)
30
What are the weight-bearing recommendations for cementless hip implant?
Depends on the growth of the porous bone stability -- Possibly initially non-weight bearing (NWB), and/or 6-12 weeks of partial weight bearing (PWB)
31
What are hybrid hip implants?
Femoral portion cemented, acetabulum uncemented
32
What are the weight-bearing recommendations for hybrid hip implants?
4-6 weeks of partial weight bearing (PWB)
33
What types of walking aids would a non-weight bearing (NWB) individual need?
Bilateral gait aids, e.g. 2WW, 4WW, crutches.
34
What is toe-touch weight bearing (TTWB) or touch-down weight bearing (TDWB)?
Allowed to put part of the affected lower extremity on the ground for balance or proprioception only. i.e. Touching down only for sensation purposes.
35
What types of walking aids would a toe-touch or touch-down weight bearing (TTWB/TDWB) individual need?
Bilateral gait aids, e.g. 2WW, 4WW, crutches.
36
What condition could arise from TTWB?
Tight gastrocnemius muscles
37
What is a precaution for TDWB?
Not putting too much weight on lower extremity
38
Which activity allows weight bearing of 50% of the body weight?
Standing with body weight evenly supported by both feet
39
What is partial weight bearing (PWB)?
Supporting < 50% or 50% of body weight with the affected limb. No walking.
40
What is weight bearing as tolerated (WBAT)?
Placing up to full body weight on the affected limb but not all the time, due to pain, endurance, and ROM. May use gait aid to reduce the load.
41
What are the 3 topics to cover in pre- and post-surgical education for hip replacement?
1. Weight bearing precautions
2. Movement precautions
3. Activity restriction
42
What is the most common approach for hip arthroplasty, and why?
Posterolateral approach
| Simplest technique and does not interfere with hip abductors.
43
What are the disadvantages of anterior approach for hip arthroplasty?
Takes longer
A more complex surgery
A newer approach with less given information
44
What is the disadvantage of posterolateral approach?
High rate (9.5%) of posterior hip dislocation due to nonadherence to hip precautions
45
What are the hip precautions for posterolateral approach?
1. No hip flexion beyond 90 degrees -- No reaching down to the floor or lifting the knee up when sitting
2. No internal hip rotation or twisting
3. No hip adduction beyond midline -- No crossing legs at the knee or ankles, sleep with a pillow between knees
46
What are the OT roles pre-operatively to hip replacement?
1. Educate the client precautions and functional implications
2. Take environmental history, home Ax, etc.
3. Arrange equipment and/or home care needs
4. Discuss hip/knee kit and provide information for purchase
47
What are the OT roles post-operatively to hip replacement?
1. Weight bearing as early as 4 hours post-op, 10 steps or more with a walking aid
2. Reinforce precautions
3. Foot and ankle exercises every hour
48
What are the OT roles post-operative day 1 to hip replacement?
1. Teach correct transfer techniques
2. Confirm home support and equipment
3. ADL practice with equipment
4. Encourage walking 3-5 times during the day
49
What are the OT roles post-operative day 2 to hip replacement?
1. Ensure independence with self-care, dressing, and transfers
2. Ensure maintenance of hip precautions during functional tasks
3. Review car transfers
50
What are the OT roles post-operative day 3 to hip replacement?
1. Ensure independence with self-care, dressing, transfers while maintaining precautions
2. Discharge from acute care if medically stable
51
What is the ideal number of post-op days that an individual will need before discharge?
3 days
52
Describe the correct chair/toilet transfer for an individual with hip precautions?
1. Back up until they feel the chair/toilet at the back of their legs.
2. Slide operated leg forward.
3. Reach back and grasp the armrests for support, as both kneeds bend to sit.
4. Reverse to stand.
53
Describe the correct bed transfer for an individual with hip precautions?
1. Sit on the bed as per the chair/toilet transfer method.
2. Slide buttocks back as far as possible
3. Pivot as they lift their legs up onto the bed.
54
How high must the bed height be to make bed transfers safe for individuals with hip precautions?
At or slightly above knee level.
55
What are some assistive equipment that an individual with hip precautions may need to transfer onto a bed?
Abduction wedge between legs to ensure no adduction
Leg lifter to ensure no flexion beyond 90 degrees
Reacher to adjust covers
56
What types of beds are safe for individuals with hip precautions?
Hard mattresses; No water beds or soft mattresses.
57
True or False: Shower doors make bathtub transfers easier.
False. Sliding doors make it difficult for swiveling on the stool, so shower curtains are better.
58
True or False: Individual with hip precautions may reach forward for the faucet once in the bathtub.
False. They need assistance to reach forward to the faucet without breaking their hip precautions.
59
True or False: Individuals with hip precautions do not often need the back rest for their tub stool.
True. Not having a back rest gives them more space to pivot. Individuals with trunk instability may need back rest.
60
Which cars should be avoided with hip precautions?
Small cars with low seats
61
How should the car seat be arranged to be the safest for car transfers for individuals with hip precautions?
In the front passenger seat, with the seat back as far as it can go and the back recliend slightly.
62
When dressing with hip precautions, the [operated/unaffected] side should be dressed first.
Operated
63
When dressing with hip precautions, the [operated/unaffected] side should be undressed first.
Unaffected
64
Can individuals with hip precautions return to driving?
Yes, when cleared by the surgeon.
65
When is it usually safe for individuals with hip replacement to return to sexual activities?
4-6 weeks post-op, depending on healing and pain, with all hip precautions
66
What is slipped capital femoral epiphysis?
When the capital femoral epiphysis slips off the femoral neck as a result of shearing failure of the cartilaginous growth plate in the proximal femur, i.e. growth plate fracture.
67
Which conditions usually cause slipped capital femoral epiphysis?
Growth spurt -- Weakening of the growth plate
| Increased body weight
68
Which population experiences slipped capital femoral epiphysis the most?
Boys 10-16 years old
69
Slipped capital femoral epiphysis is usually [unilateral/bilateral.]
Unilateral, but can be bilateral
70
What is the treatment for slipped capital femoral epiphysis?
Surgical treatment required -- Pins through the neck of the femur into the femoral head
71
What kinds of precautions are needed for slipped capital femoral epiphysis post-op?
No hip precautions necessary.
| Need home ADL equipments (i.e. hip kit -- raised toilet seats, transfer benches, etc.)
72
What are the movement precautions for knee replacement?
1. No twisting the knee, kneeling, or squatting
| 2. Keep toes pointing the same direction as their nose -- Sleep with pillow between kneeds, no pivoting to turn
73
Which conditions increase the risk for ankle fractures?
Diabetes
Peripheral vascular disease
Metabolic bone disease
Chronic use of corticosteroids
74
What shape do the structures of the ankle form?
A ring
75
An ankle with fracture/rupture of a single part is [stable/unstable].
Stable
76
An ankle with fracture/rupture of more than one part is [stable/unstable].
Unstable
77
What is the Weber classification?
Classification of ankle fractures based on which part(s) of the ankle "ring" are affected.
78
Describe the Weber A classification?
Fracture on the fibula inferior to the syndesmosis between the fibula and the tibia. Medial malleolus may be fractured.
79
Which interventions are usually needed for Weber A ankle fractures?
Reduction (occasionally ORIF) and cast.
80
Describe the Weber B classification?
Fracture on the fibula at the level of the syndesmosis between the fibula and the tibia. Syndesmosis is intact or partly torn. Possible medial malleolus fracture or deltoid ligament damage.
81
Which interventions are usually needed for Weber B ankle fractures?
Reduction (occasionally ORIF) and cast.
82
Describe the Weber C classification?
Fracture above the level of the ankle joint. Tibiofibular syndesmosis is damaged, and the tibiofibular joint is widened. Medial malleolus fracture and/or deltoid ligament disruption.
83
How stable is a Weber A fracture?
Usually stable if medial malleolus is intact.
84
How stable is a Weber B fracture?
Variable -- Weight bearing to inability to weight bear due to joint instability or pain.
85
How stable is a Weber C fracture?
Very unstable
86
Which interventions are usually needed for Weber C ankle fractures?
ORIF required.
87
What are pilon fractures?
Fracture of the distal tibial metaphysis and disruption of the talar dome
88
What are Maisonneuve fractures?
Proximal fibular fracture with a medial malleolar fracture or disruption of the deltoid ligament. Partial or complete disruption of the syndesmosis
89
Which interventions are usually needed for Maisonneuve fractures?
Surgical repair with immobilization with a cast for 6-8 weeks
90
What are Tillaux fractures?
Fracture in the lateral portion of the distal tibia, where the anterior tibiofibular ligament attaches.
91
How are Tillaux fractures caused?
Extreme eversion and lateral rotation of the ankle
92
In what population is the incidence of Tillaux fractures highest, and why?
Adolescents aged 12-14 ages
Fracture occurs after the medial aspect of the epiphyseal plate of the tibia closes bue before the lateral aspect arrests.
93
Which interventions are usually needed for Tillaux fractures?
Closed reduction if displacement is < 2 mm. Long leg cast for 4 weeks, short leg case 2-3 weeks.
Open reduction if displacement is > 2 mm after closed reduction attempt.
94
What are the complications of Tillaux fractures?
```
Premature growth arrest
Early arthritis (high risk with articular displacement)
```
95
What is arthrodesis?
Fusion
96
When is ankle arthrodesis primarily indicated?
Severe pain or deformity
97
What is ankle arthrodesis?
Reconstructive surgical procedures where an injured ankle joint is converted into an immobile segment of bone
98
What are the weight bearing recommendations post-op to ankle arthrodesis?
6-12 weeks of non-weight bearing (NWB)
99
What are the risks of ankle arthrodesis?
```
Functional issues (NWB and casting for up to 6 months)
Long-lasting or unresolved edema
```
100
What is congenital hip dysplasia (CHD)?
Congenital laxity of the hip joint capsule
101
What are some causes of congenital hip dysplasia?
Larger femoral head than the acetabulum
Breech birth
Small uterus of the mom
Poorly formed hip socket
102
Incidence of congenital hip dysplasia is higher in [males/females].
Females (80% of cases)
103
What are the symptoms of congenital hip dysplasia?
Reduced movement on the affected side
Affected leg may appear shorter
Asymmetry in thigh folds
104
What are some treatment options for congenital hip dysplasia?
Conservative treatment -- Diaper splint/Pavlik harness in a position of stability (hips flexed and abducted)
Aggressive treatment -- Surgery (osteotomy of pelvis/femur/both) + Hip spica cast
105
What are the OT roles for congenital hip dysplasia?
Educate parents
Assess & modify stroller fit
Assess car seat fit and ensure safety
Encourage continued engagement in play activities
106
What is the most common congenital deformity?
Club foot
107
What is club foot deformity?
Intrinsic abnormality of the foot occurring in the 2nd-3rd trimester
108
What are the 4 characteristics of club foot deformity?
1. Plantarflexion
2. Inward turning at the ankle
3. Inward turning of the forefoot
4. Dropped 1st metatarsal head
109
What are the treatment options for club foot deformity?
Serial casting -- Casting into more and more proper alignment over time
Achilles tenotomy or lengthening of the Achilles tendon
Boots and bar cast
110
Why is the shoulder joint considered to be the most challenging part of the body to rehabilitate?
The shoulder joint is unstable and complex.
111
What are the 4 joints in the shoulder complex?
1. Glenohumeral joint
2. Acromioclavicular joint
3. Scapulothoracic joint
4. Sternoclavicular joint
112
What are the four rotator cuff muscles and their functions?
1. Supraspinatus: Shoulder abduction
2. Infraspinatus & Teres minor: External rotation
3. Subscapularis: Internal rotation
113
Which rotator cuff muscle is the most frequently torn?
Supraspinatus
114
What are the treatment options for rotator cuff tears?
1. Conservative management
2. Orthotherapy
3. Subacromial corticosteroid injections
4. Surgical repair
115
What are the criteria for rotator cuff surgical candidates?
```
< 60 year old
Fail to improve with conservative interventions for > 6 weeks
Full passive ROM
Full thickness tear in the rotator cuff
Needs to use shoulder overhead
```
116
What are the 3 types of rotator cuff surgical methods?
1. Open
2. Arthroscopic
3. Combination
117
In rotator cuff surgery, what are two ways in which the repair can be done?
1. Anchor torn tendon to another intact tendon
| 2. Anchor torn tendon to bone
118
True or False: Even with shoulder arthroplasty, the individual will not gain full ROM.
True. The goal of shoulder arthroplasty isn't to gain full ROM back, it's for pain control and some functional improvement.
119
What are 3 common reasons for shoulder arthroplasty?
1. Severe fractures
2. Avascular necrosis
3. Osteoarthritis/rheumatoid arthritis
120
What are precautions to be taken 0-6 weeks after shoulder arthroplasty?
1. No resisted or active internal rotation.
| 2. No lifting anything heavier than a dinner plate.
121
What are exercise recommendations for 0-6 weeks after shoulder arthroplasty?
Isometric shoulder exercise except for internal rotation.
| Pendulum exercises
122
Why is exercise important after shoulder arthroplasty?
Prevent adhesive capsulitis
Maintain ROM in joint
Promote blood flow for quicker healing
123
What are the ROM restrictions for 0-6 weeks after shoulder arthroplasty?
AROM in hands and elbow
| AAROM in the shoulder, progressing to AROM except for IR
124
What are the recommendations for sling use for 0-6 weeks after shoulder arthroplasty?
Always worn at night or for comfort.
| After 2 weeks, may be removed for simple ADLs.
125
What are the ROM restrictions for 6-12 weeks after shoulder arthroplasty?
No movement restrictions.
| AROM allowed for internal rotation.
126
What are exercise recommendations for 6-12 weeks after shoulder arthroplasty?
Strengthening exercises using thera-tubing.
127
What are exercise recommendations for 6-12 weeks after shoulder arthroplasty?
Passive ROM to stretch joint as indicated.
| Strength training for internal rotation with thera-tubing.
128
What types of clothing are the most convenient for individuals with shoulder arthroplasty?
Shirts with front closures.
Elastic waist pants.
Sports bra, or use bra angel.
No-tie shoes/elastic laces
129
How should an individual with shoulder arthroplasty sleep?
Wearing sling
Pillow below operated arm for support
Reclining chair may be helpful
130
What is reverse total shoulder replacement?
Putting the humeral head component in the place of the existing glenoid cavity, and the glenoid cavity on the humeral shaft
131
What are the benefits of reverse total shoulder replacement?
Better functional outcome
| Prevent deltoid slackening
132
What are the contraindications for reverse total shoulder replacement?
Nonfunctional deltoid muscle
Severe neurologic deficiencies
Refusal to modify post-op physical activities
133
What are the indications for reverse total shoulder replacement?
Irreparable rotator cuff tear associated with glenohumeral arthritis or instability
Failed hemiarthroplasty or total arthroplasty associated with rotator cuff deficiency (which pushes the humeral head slides upwards)
134
What is Colles' fracture?
Transverse fracture of the distal radius. In 60% of cases, the tip of the ulna is also fractured.
135
What usually causes Colles' fracture?
Extension of the hand to decrease the impact from a fall
136
What is the treatment for Colle's fracture?
Casting or ORIF
137
What usually causes scaphoid fracture?
A fall onto an outstretched hand -- Axial load across hyper-extended and radially deviated wrist
138
What are the symptoms of scaphoid fracture?
Pain and tenderness just below the base of the thumb. No visible deformity nor difficulty with motion.
139
Why is scaphoid fracture difficult to heal?
Limited blood supply
Fracture often disrupts the blood flow
Prone to avascular necrosis
140
What is the non-operative treatment option for scaphoid fracture?
Thumb spica cast immobilization for 6-8 weeks or more.
141
What is the indication for operative treatment for scaphoid fracture?
If the displacement is > 1 mm.
142
What are the operative treatment options for scaphoid fracture?
ORIF
Bone grafting
Proximal row carpectomy
143
What are the OT roles in back pain?
Assess ergonomics of posture and/or environment
| Core strengthening exercises
144
What are the 2 roles of the vertebral discs?
Allow spine to flex
| Shock absorption
145
True or False: Disc degeneration is a disease.
False.
146
What are the normal changes in the spinal discs with age?
Dehydration -- stiff and rigid
Lose shock absorbing abilities
Restrict movement
147
Degenerative disc disease is most commonly found in people who do what kind of work?
Heavy lifting or misuse their backs repetitively
148
What is herniated disc?
Part of the disc pushes through towards the spinal canal, compressing the spinal nerves.
149
What are the symptoms of herniated disc?
Pain, numbness, weakness
150
What are non-surgical treatments for herniated disc?
Gentle physical acitivty
| Education on body mechanics
151
What are surgical treatments for herniated disc?
Laminectomy -- Removal of lamina
| Discectomy -- Removal of the herniated disc fragment
152
What is spinal stenosis?
Narrowing of spinal canal
153
What are the symptoms of spinal stenosis?
Pain (back, sciatica), weakness in the lower body, numbness
154
What are some causes of spinal stenosis?
```
Degeneration
Bone growth due to wear and tear
Herniation
Ligament thickening
Tumors
Spinal injuries
```
155
What are the non-surgical interventions for spinal stenosis?
```
Stretching and strengthening
Cortisone
NSAIDs
Acupuncture
Chiropractice
```
156
What are the surgical interventions for spinal stenosis?
Laminectomy and decompression
| Spinal fusion
157
What are possible consequences of scoliosis/kyphosis/lordosis?
Back pain
Decreased lung volume (can lead to pneumonia)
Heart compression
158
What are the 3 phases of surgical treatment of scoliosis or other spinal curvature issues?
1. Observation -- Assess the curve.
2. Bracing -- Thoracic lumbar sacral orthosis (TLSO).
3. Surgery -- Only if bracing ineffective; Growth rods/Vertical Expandable Prosthetic Titanium Rib; Spinal instrumentation.
159
What percentage of the adult populations experiences low back pain some time in their lives?
80%
160
What are the most common causes of low back pain?
Poor sleeping or sitting posture
Lifting/reaching with rounded back
Prolonged sitting/standing
161
What percentage of people with low back pain develop chronic pain?
1%
162
How long does it take for people with low back pain to return to work?
Usually within 6 weeks
163
What are the OT roles in low back pain?
Acute treatments -- Activity and early return to work
Chronic treatments -- graded exercise and resumption of ADLs, cognitive behavioural therapy, progressive muscle relaxation, education on body mechanics
164
When standing for a prolonged amount of time, what posture is recommended for people with low back pain?
Posterior pelvic tilt -- Place one foot on a stool
165
For bending and reaching tasks, what movements are recommended for people with low back pain?
Move body closer and reach less. Walking with the broom/vacuum instead of reaching with it.
166
For sitting, what movements are recommended for people with low back pain?
Flex at the knees and hips, and not at the spine
Raised seats put less pressure on the back
Slightly reclines posture for prolonged sitting
167
What are the common causes of spinal fractures?
Trauma
Osteoporosis
Tumor
168
What are the non-surgical treatments for spinal fractures?
Flat-bed rest
Thoracic lumbar sacral orthosis (TLSO)
Philadelphia collar
169
What are the back restrictions and precautions?
No lifting, pushing, or pulling objects over 5-10 lbs
No twisting (wiping when toileting, log rolling in bed, no driving)
No spinal forward flexion, side flexion, extension
Avoid straight leg lifts
Avoid activities that will jar the back (contact sports, crowds, sexual activity, riding in vehicles)
Avoid staying in one position for too long
170
Why is osteoporosis prevalent in menopausal women?
Limited production of estrogen
171
What is osteoporosis?
Loss of bone mass because bone is being broken down faster than it can be replaced
172
What are the 2 types of osteoporosis?
1. Primary: e.g. Post-menopausal women
2. Secondary: Young and middle-aged people due to medications, malnutrition, or too much exercise (can lead to amenorrhea)
173
What are some risk factors for osteoporosis?
```
Menopause
Family history
Body type (skinny and thin-boned)
Lifestyle (smoking and drinking)
Lack of exercise
Lack of calcium and vitamin D
```
174
What are the OT roles for osteoporosis?
Education for falls prevention
Safety precautions
Encourage exercise
175
What are the possible complications of falls in seniors?
Loss of confidence -> Decrease in activities -> Decline in health and function -> Increased risk for future falls with more serious outcomes
176
What is osteogenesis imperfecta?
"Imperfectly formed bone"; Inability to make strong bones due to disordered Type 1 collagen synthesis
177
What are the causes of osteogenesis imperfecta?
Hereditary or spontaneous mutation
178
What are the symptoms of osteogenesis imperfecta?
Short stature
Frequent fractures with abnormal healing
Respiratory problems
Occasionally blue sclera
179
What are the 4 types of osteogenesis imperfecta?
Type 1: Most common and most mild. Small quantities of Type 1 collagen. Blue sclera.
Type 2: Fatal. Abnormal collagen structure
Type 3: Fractures present at birth. Short stature.
Type 4: Incidence of fractures decrease as child ages but may increase again with menopause or age.
180
What are the OT roles for osteogenesis imperfecta?
Prevent fractures -- Identify safety risks and reduce potential for injury
Positioning and modifications after surgical interventions
