Soft Tissue Injury and Healing 1

Question 1

trauma to joints includes

Answer 1

dislocation

subluxation

overstretch

Question 2

dislocation

Answer 2

after trauma joint surfaces not in contact w/ each other

Question 3

what does dislocation commonly involve

Answer 3

overstretch or tearing of joint capsule

Question 4

what could happen when a joint dislocates

Answer 4

could dislocate and relocate spontaneously or stay dislocated

Question 5

subluxation

Answer 5

joint surfaces move out of position, but are still in contact, partially

Question 6

overstretch

Answer 6

joint is stretched maximally

but doesn’t sublux or dislocate

Question 7

what does overstretch involve

Answer 7

overstretch or tearing of tissue

but joint surfaces do not lose contact w/ each other

Question 8

medical tx of dislocation

Answer 8

relocate and immobilize

usually for 2-3 weeks

Question 9

rehab for dislocations

Answer 9

maintain ROM and strength surrounding structures

PROM, AROM, AAROM, progressive strengthening w/in ranges that do not stress the overstretched part of the capsule

Question 10

what should we look for with dislocation injuries

Answer 10

injury to other tissues

Question 11

subluxation tx

Answer 11

usually immobilization for 2-3 weeks

Question 12

rehab for subluxation

Answer 12

same as dislocation

usually could progress faster

Question 13

overstretch tx

Answer 13

immobilization for less than 1 week

Question 14

rehab for overstretch

Answer 14

could move along faster but similar to dislocation and subluxation

Question 15

fx around joint could be

Answer 15

intra-articular

extra-articular

Question 16

extra-articular fx around joint

Answer 16

closer to joint

worse prognosis for full ROM

Question 17

synovial membrane injury

Answer 17

repetitive trauma

post-traumatic synovitis

Question 18

repetitive trauma causes

Answer 18

vascularity to increase

number of surface cells to increase

gradual fibrosis of sub synovial tissue

surface becomes more granular

synovial fluid changes composition

Question 19

post-traumatic synovitis causes

Answer 19

capillaries to dilate

proteins leak out

changes in osmotic pressure gradient

water reabsorption to slow down

edema and exudates stay in joint

synovial membrane thickens

Question 20

if trauma to the synovial membrane is repetitive

Answer 20

the changes remain

enzymes attack normal joint structure

joint structures are destroyed

Question 21

initial tx to synovial membrane injury

Answer 21

RICE

early weight bearing (partial)

avoid irritation

anti-inflammatories

Question 22

48 hours –> tx to synovial membrane injury

Answer 22

gentle PROM

Question 23

5 days –> tx to synovial membrane injury

Answer 23

begins progressive exercise

Question 24

how long does a synovial membrane injury take to heal

Answer 24

3 weeks

Question 25

other tx to synovial membrane injury

Answer 25

aspiration steroid injection

Question 26

if the synovial membrane injury is chronic --> tx

Answer 26

synovectomy

Question 27

a disruption of the meniscus could be

Answer 27

complete or partial

Question 28

what does healing and tx of a meniscal tear depend on

Answer 28

where it was torn

Question 29

vascularization --> meniscus

Answer 29

menisci are fully vascularized in children as we age --> centra area loses its vascularization but peripheral area retains some of its blood supply

Question 30

if the meniscal tear is in the periphery and there is enough blood supply

Answer 30

meniscal repair

Question 31

if the meniscal tear is central w/ lack of blood flow

Answer 31

meniscectomy meniscus is shaved down

Question 32

why are arthroscopies decreasing

Answer 32

conservative care works just as well

Question 33

injuries to ligs are called

Answer 33

sprains

Question 34

sprains

Answer 34

partial or complete rupture of a ligament

Question 35

how many grades of sprains are there

Answer 35

3

Question 36

stage 1 sprain

Answer 36

few fibers torn stability is unaffected

Question 37

stage 2 sprain

Answer 37

more fibers torn but not complete slight increase in joint laxity

Question 38

grade 3 sprain

Answer 38

complete tear joint instability

Question 39

tx of a ligament injury is dependent on

Answer 39

severity which ligament pt's lifestyle

Question 40

medical tx for lig sprains

Answer 40

could be surgery for grades 2-3

Question 41

if there is surgery to a ligament --> what is the rehab

Answer 41

follow MD guidelines

Question 42

if there is no surgery for a ligament injury --> rehab

Answer 42

there may be immobilization or splinting

Question 43

conservative care of ligament injury

Answer 43

modalities to decrease edema strengthening muscles gentle stretching proprioception exercises maintain range and strength of surrounding structures

Question 44

what happens to ligaments that are immobilized for several weeks after an injury

Answer 44

tend to have decreased tensile strength weaker at the bony insertion

Question 45

what do we need to do to avoid the effects of immobilization

Answer 45

minimize immobilization carefully stress the lig strengthen muscles around the joint to support the lig