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Orthopedics > Post-op > Flashcards

Post-op Flashcards

(51 cards)

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1
Q

rotator cuff tear/TSR

A

-return to FROM/fn 6-12mths

-2 wks
-remove suture, PROM (wall climb/pendulum)
-light duty prn, Sling use for 6 post-op
-6wks
-PT for AROM, shoulder strengthening exercises
-remove sling, light duty 6wks more
12wks
-return to work plan and PT.

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2
Q

cubital tunnel syndrome

A

-3-5days
-gentle ROM
-14days
-remove sutures
-6wks
-start PT and strengthening with gradual return to activities

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3
Q

carpel tunnel syndrome

A

6mths to return to function

-7days
-start hand therapy (LEGO’s)
-14 days (Pathi like 3wks)
-remove sutures
-tape wound closed
-4wks
-check motion and wound, progress to normal activity prn
-remove splint

5mths: b/l xray

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4
Q

meniscus tear A/D

A

-14days
-remove sutures
-WB as tolerate, crutches prn, bike or quad exercises
-No need formal PT
-4 wks
-return to activities

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5
Q

TFCC repair

A

-2wks
-remove sutures
-apply removable wrist splint
-gentle wrist motion therapy
-6wks
-remove splint
-gradually return to activities

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6
Q

Hip fx

A

14 day
-remove sutures
-continue PT
-WB as tolerating with gait training
6 wk
-ap/lat pelvis xray
-full WB
12wks
-ap/lat pelvis xray
-return to normal if pain free
-if pain, do MRI for osteonecrosis/nonunion

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7
Q

Trigger finger

A

2wk
-remove sutures
-pt, stretch, massage scar,
4wk
-wound check and check motion

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8
Q

Lateral epicondylitis

A

14 days
-remove sutures
-gentle PT, NO LIFTING
6wks
-

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9
Q

Nonoperative Phalanx fix

A

Weekly xray

0-3 wk
-RICE
-splint
-distal: aluminum splint middle/distal with free PIP
-middle/proximal: hand/wrist splint with mcp joint flexed in intrinsic position

3-6wk
-splint
-distal: remove splint and start ROm
-proximal/middle: protected ROM with intermittent splint or buddy tape
-can do hand PT if requested

6wk
-hand is healed and return to regular duty.
-stiffness is expected and therapy help

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10
Q

Nonoperative Distal radius fx

A

-6-8wk of cast and nonWB,
-2-3mths = healed,
-weekly xray wks 1-3

mc need pt after healed

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11
Q

Distal radius fx postoperative

A

2wk
-suture remove, start gentle Pt 5 days after
-xray for next visit
6wk
-xray for next visit , motion check
-start active strength pt and WB, wean off splint

3mth
-motion and tenderness check
Return without restrictions

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12
Q

Nonop Metacarpal fx

A

-Weekly X-rays
-splint mcp but pip can be free

4wk
-xray,
- immobilize longer if smoking

6-8wks
-PT with no restrictions start when xray show healing and nobtender
-Typically considered healed

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13
Q

Metacarpal fx postoperative

A

2wk
-suture remove
-check/order xray and pt for next visit

4wks
-review xray
-remove splint

4-6wk
-Pin removal
-PT start

6-8 wk
-check xray

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14
Q

Phalanx fx post op

A

2wk (Dr likes 3wk)
-Suture removal
-move non-affected joints
(Order 1wk f/u with xray)

4wk:
-review X-rays ordered last visit
- 4-6wk k wire removal

6wks
-dc splint
-remove k-wie
-start PT

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15
Q

CMC join fusion

A

2wk
-suture removal
-order X-rays
-splint @ all times but can remove for gentle cleaning
-gentle ROM of other joints

4wk
-check xray and order again
-verify joint rom

8mth
-check X-rays and should be complete healed and dc splint

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16
Q

Total knee postoperative

A

2-3 day hospital stay

0-3wk
-remove sutures
-continues passive motion 0-90degrees for 8hr daily and progress as tolerated
-rice for pain control
-wb as tolerated and ambulate with AD
-PT started in hospital and continue
-order X-rays

3-6wks
-full ROM
-ambulate indoors without AD
-goal at this time is FROM
-review and order X-rays

3mtha
-no AD
-review X-rays

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17
Q

De quervain tenosynovitis nonoperative

A

Splint, IRAN, PT for tendon gliding and stretching.

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18
Q

De quervain tenosynovitis postoperative

A

2 wk
-suture removal
-splint and PT or return to normal activities
4 wks
-all splints stop
-doing PT
6-8wk
-no restrictions

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19
Q

Gamekeeper thumb

A

3wks
-sutures removed
-X-rays if wires present

4wks
-start therapy with gradual strengthening over weeks
-Remove wires

3months
-return to activity unrestricted
-remove splint

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20
Q

Ankle fracture postoperative

A

2wk
-suture removal
-X-rays and boot ordered
-NonWB 6 wks

6wks
- wb full time be in boot
-remove boot for daily ROM

8-10wks
-dc boot for regular shoe with ankle brace
-syncretic screw removed at minimum 3-4mths but no diff if stay or remove on clinical outcome

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21
Q

Ankle fx no operative

Study These Flashcards
A

Weber a: nearly all nonop. Cast or walking boot, WB operated. Heal in 6 wks

Weber b (spiral fx):
-ORIF if unstable, nonop if stable ( <4-5mm of central clearing
-Cast or walking boot, WB operated. Heal in 6 wks
-brace and PT after 6 wks

Weber C (prox fib): need ORIF unless small avulsion

22
Q

Total hip replacement

Study These Flashcards
A

2 wks
-staple removal
-WB as tolerated
-start PT
-X-rays ordered

6 wks
-review X-rays and order
-continue PT and wean AD

3,6, 12 months
- review and order X-rays
-check for bursitis and LLD
-continue PT for 1 year and order shoe lift if LLD continues

23
Q

Olecranon bursitis nonoperative

Study These Flashcards
A

IRAN, elbow brace, nsaids. Aspiration and steroids not recommended

24
Q

Metatarsal fractures nonop

Study These Flashcards
A

1st MT: cast and wb as tolerated 6wks
- ORIF. If any displacement
2-5MT:
-avulsion(MC 90%): hard sole shoe/short cast 4-6 wks, WB as tolerated
-jones: cast nonWB 6-8 wk
-shaft fx: ORIF D/T high nonunion risk

25
Feet phalangeal fx
All nonoperative: -nondisplaced big toe Hard shoe/boot 2-3 wks WB as tolerated -displaced lesser toes Closed reduction with traction Then, buddy tape 2-4 wks. WB as tolerated hard shoe 4-6 wks
26
Humerus fracture
Indication: displaced neck, displace 3-4 part in young health, greater tuberosity > 5mm 2wks -sutures and X-rays ordered -sling use 6 wks -X-rays reviewed -gentle PT -light duty with no bad arm use -earliest DC sling 12 wk -X-rays reviewed -advance PT active -possible future prn
27
Ankle fusion
Post 2 weeks -suture removal -X-rays ordered -continue nonWB for 6 weeks post op 6 weeks -review X-rays and order -progress to WB with walking boot or cast 12 weeks -review X-rays and transition to show
28
Splint sizes
Ulnar: 4-5in Thumb spica: 3-4in Volar: 3-4in Long arm posterior: 4-5in Sugar tong: 3in Short leg posterior: 4 in
29
Mallot finger
Nonop txt unless distal joint subluxation or articulation surface fragment >40% -splint dip in hyperextension (free pip) continuously 6-8wks ( if remove, restart time) -if swan neck: dorsal splint to fix PIP hyperextend -may splint up to 3months after injury -if extensor lag after 6 wks, night splint for 2 extra weeks -if lag persists, <15 deg is acceptable and normal for 40% pts -6wks: PT and Dec splint use Untreat = swan neck deformity
30
Extensor tendon repair
3 weeks -wound check -suture removal 6 wks -k wires removed if present -CONTINUOUS splint use (restart time if bend) -start PT with intermittent and night time slinging for 2-4 additional wks 12wks -motion check -continue PT prn
31
Tfcc nonop treatment
1st: Brace or splint if acute, nsaids, rest for 6 weeks 2nd: steroid injections and OT
32
Scaphoid fracture nonop
Indications: Nondisplaced/distal 1/3 Txt -nondisplaced:8-12wks splint with 80-90% healing if txt within 3wks -distal 1/3: 6-8wks splint with 95% heal -5-10% non-union of all fx if nonop txt -otc wrist support to transition after -nonWB until fx heal and pain free -OT after
33
Achilles tendon
34
Kienbock disease
35
Patella fracture post op
0-6wks -knee immobilization extension -WB as tolerated -xray and review -suture removal 2wks 6-12wks -X-rays to check union -ROM advancement 12wks + -continue ROM and strengthening -full sport and activity 5-6months
36
Forearm shaft fracture
37
IP digit arthroplasty
2wks -remove sutures -X-rays ordered -continue splint 4wks -check X-rays -motion check 8wks -remove splint -should be fused
38
39
Triquetrum fracture
-X-rays show “pooping duck sign” if dorsal fx on IR oblique/lateral. Get radial deviation for palmar fx -Get MRI if palmar fx -Splint 4-6wks -ORIF if instability or displaced
40
41
42
Proximal tib/distal femur fx nonop
Indications 1: isolated lateral tib <3mmstep off and 10 degree angle -locked hinge knee brace 6-12 wks -PT start at 2-4wks -serial X-rays
43
TiB plateau/distal femur fx post op
0-6wk -nonWB in hinged knee brace -sutures removal at 1 wks and confirm reduction with X-rays 6-12 wks -review 6 wk xray -prog to toe-touch if adequate callus formed 12wks+ -review xray at 12 wks -Full WB if adequate callus formed
44
45
Scaphoid fx post op
Indications -displaced/proximal fx (Proximal fx is highest risk nonunion) 2wks -suture removal, continue splint -order xray -OT: gentle rom with nonWB 6wks -review and order X-rays -splint until healing on X-rays -active OT, gradual WB and wean splint if healing on X-rays 3months -check X-rays and ttp -review and order X-rays -release to full activity if healed and nonttp -bone stim and CT if not healing on X-rays Nonunion def: no healing 6 months after Sx
46
47
48
Radial head fracture
History -ttp and crepitus with forearm rotation Imaging -Greenspan view Nonop -posterior splint 21 days max to minimize permanent stiffness -hinged brace for 6-8 weeks and nonWB -release if healed
49
50
51
Patella fx nonop
-long leg splint or immobilization extension -WB as tolerated with crutches or walker -Conservative management

Orthopedics (3 decks)

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