Week 8 Terms: UE Orthopedics Flashcards by Kiara S

What are the two goals of fracture treatment?

Achieve a precise and effective stabilization
Optimal Recovery and return to function

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What is part of fracture treatment?
A. Mobilization
B. Rest
C. Both

B. Rest
Immobilization for long periods after stabilization.

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True/False
You should mobilize the injured structures as quickly as is compatible with healing.

True

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Closed Fractures

Non-Displaced and Stable
may be managed by protection alone
Non displaced but Unstable
requires positioning and immobilization by external fixation
e.g., sling, cast, fracture brace

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Open Reduction Internal Fixation (ORIF)

Open Fractures
Unstable AND Displaced
Cannot be manually reduced
Surgically Stabilized (Pin, Screw, Rod or Plate)

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Estimated Fracuture Healing Timeline:
Uncomplicated Upper Extremity

Callus formation 2 to 3 weeks
Union 4 to 6 weeks
Consolidation 5 to 8 weeks

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Estimated Fracuture Healing Timeline:
Uncomplicated Lower Extremity

Callus formation 2 to 3 weeks
Union 8 to 12 weeks
Consolidation 12 to 16 weeks

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Phases of Fracture Healing

Inflammation
Reparative
Remodeling

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Estimated Fracture Healing Timeline:
What does timing, amount, and type of therapy depend on?

Location and Type of Fracture
Method of Reduction
Age of Patient

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What are some types of shoulder fractures?

Clavicle Fracture
Scapula Fracture
Proximal Humerus Fracture

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What are some types of elbow fractures?

Olecranon Fracture
Radial Head Fracture
Distal Humerus Fracture

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What are the joints of the shoulder?

Glenohumeral (GH)
Acromioclavicular (AC)
Sternoclavicular (SC)
Scapulothoracic (ST; articulation more than a joint)

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What fracture is the most challenging to rehabilitate?
A. Elbow
B. Knee
C. Shoulder
D. Both A and C

C. Shoulder
A shoulder fracture is the most challenging to rehabilitate.

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What are the therapy goals for a shoulder fracture?

Relieve Pain
Allow callus formation and approximation of bony fragments
Restore movement and muscle strength
Return to maximal functioning

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How does PROM differ from Passive Stretching?

PROM finding the PROM of a joint
Passive Stretching you are passively stretching out the muscle

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What are the types of elbow fractures?

Olecranon Fracture (Fx)
Radial Head Fx
Distal Humerus Fx

A wrist fracture makes up approx. what percentage of all broken bones?
A. 0-15%
B. 15-25%
C. 25-50%
D. 50-85%

C. 25-50%

What are the distal radius fractures called?

Colle’s Fracture
Smith’s Fracture
Barton’s Fracture

What are common shoulder pathologies?

Scapular Instability
Subluxation
Impingement
Rotator Cuff Tear
Adhesive Capsulitis
Arthritis
Shoulder Replacement

Winged scapula and scapular instability leads to?

Scapular Instability

*Winged Scapula
serratus anterior weakness
generalized weakness

Scapular instability
leads to shoulder instability
decreases arm function*

Scapulohumeral rhythm helps to…
A. Prevent Impingement
B. Maintain muscles’ optimal length-tension relationship
C. facilitate fluid movement anf for full overhead ROM
D. All of the above

D. All of the above

What is an example of subluxation in the shoulder?

Humerus comes out of the glenoid fossa

Results in instability, weakness or trauma

Shoulder Impingement

Reduction in sub-acromial space leading to compression of structures:
supraspinatus tendon
long-head of biceps
subacromial bursa
joint capsule

Can lead to a rotator cuff tear

What are some causes of shoulder impingement?

Repetitive overhead use
Arthritis
Structural Abnormalitites
Calcification
Instability (weakness)

**Symptoms of Shoulder Impingement**

Pain Weakness Loss of Active/Passive Motion

**What four muscles make up the rotator cuff?**

Supraspinatus Infraspinatus Teres Minor Subscapularis

**The rotator cuff acts as a BLANK stabilizer of the glenohumeral joint.**

The rotator cuff acts as a dynamic stabilizer of the glenohumeral joint.

**Causes of Rotator Cuff Tears**

Impingement Trauma Degenerative Changes | Can be partial or full-thickness tears

**Symptoms of Rotator Cuff Tears**

Loss of AROM Weakness Night Pain

**Pathology of Adhesive Capsulitis**

Thickening of the joint capsule *Adhering to the humeral head*

**Symptoms of Adhesive Capsulitis**

Diffuse shoulder pain Night Pain Progressive multidirectional loss of A/PROM at shoulder

**Causes of Adhesive Capsulitis**

Primary- Unknown Secondary- Surgical Event Immobilization | Typically in patients >40; more common in women

**Shoulder arthritis usually occurs in people over the age of...** A. 30 B. 40 C. 50 D. 60

C. 50

**Symptoms of Shoulder Arthritis**

Pain during and after movement Swelling Bone Spurs

**What happens in a total shoulder replacement?**

Humeral head is replaced Glenoid is reshaped and resurfaced | Typically done for a fracture

**Post-Op Treatment for a Total Shoulder Replacement**

Therapy to begin right away (Gentle ROM) Sling all the time for approx. 6 weeks to protect soft tissue *Functional Expectation: Full ROM Good pain relief Return to all daily activities*

**What happens in a Reverse Total Shoulder Arthroplasty?**

The “ball” of the joint is placed on the socket side of glenoid The “socket” of the joint is placed on the humerus | Typically performed when rotator cuff is deficient

**Post-Op Treatment for a Reverse Total Shoulder Arthroplasty**

Similar to TSA No therapy initially Protocol for ROM may vary Sling at all times for approx. 6 weeks *Functional Expectations: Goal is pain relief and “functional ROM”*