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Ortho final
Precautions
| Question | Answer |
|---|---|
| THR, post op complications | DVT, infection, heterotopic ossifications, sciatic nerve injury, periprosthetic fracture, dislocation/subluxation of the femoral head, pulmonary embolis |
| THR post op precations, posterior approach | use abd pillow, maintain approp WBing status, avoid hip add, IR (med rot), AVOID HIP FLEX > 90 deg, do not sit on low surfaces, don't bend to get up frm chair or tie shoes, don't pivot to surgical side,don't cross legs, use pillow betw legs when sidelying |
| PT tx for THR | maintain appr WBing status, mobility training using hip precautions, early ambulation training, initiage stg'g w/isometric ex & progress as tolerated, implement gentle stretching using hip precautions |
| cemented TKR | cemented - immediate WBing as tolerated, used w/older & sedentary patients |
| hybrid type of TKR | toe touch WBing for up to six wks |
| noncemented TKR | toe touch WBing up to 6 wks, longer life expectancy than cemented |
| TKR post op complications | DVT, infection, chronic joint effusion, periprosthetic fracture, restricted ROM, pulmonary embolus, peroneal nerve palsy |
| TKR post op precautions | maintain approp WBing, mobility trg, early amb trng w/knee immob, use continuous passive motion machine (CPM), initiate strg'g w/isom exercises compression stocking for edema, wean from knee immob |
| THR -what motion to avoid? (posterior approach) | flexion > 90 deg, adduction across midline, avoid IR 6-12 wks |
| THR motions to avoid -anterior approach | avoid hip ext, ER, adduction |
| THR - very important part of max phase? | Education! |
| avoid what motions after subluxing peroneal tendon surgery | DF & eversion |
| avoid what motions with shoulder anterior dislocation? | full ABD, ER, Extension, worst position 90 deg abd w/ER, avoid stg in abd |
| after should anterior capsular surgery, avoid? | abduction over 90 deg, ER beyond 45 deg |
| patellar compression forces raise sharply after ______ deg of knee flexion | 30 deg |
| patella compression....most forces occur at ________ degrees! | 60-90 deg...mini squats, not a lot of full squats |
| Hip fx avoid motions of ? | avoid diagonal or rotary forces, no active SLR, no supine bridges |
| what causes bicipital tendonitis? | overhead movement, reaching, lifting, recurrent, repetitive activity |
| If someone falls on their shoulder, what is likely to happen | dislocate AC jt |
| area of relative transient hypovasularity | proximal of insertion on greater tubercle of the supraspinatus |
| what occurs in a slap lesion? | long head bicep tendon peels away from labrum |
| avoid what motions w/bicipital tendonitis | overhead reaching, lifting and until out of acute state - bicep strengthening and stretching, supination (wrist stg), AROM shoulder flexion |
| what tx for bicipital tendonitis? | initially pendulum exercises, modalities to dec inflam & stim healing,ion/phonophorsis, when out of accute stage stg to imp stability, CKC, proprioception |
| shoulder capsular pattern indicative of lesion | ER most limited, ABD, next, IR next |
| cause of adhesive capsulitis? | trauma, immob, insidios onset, |
| rehab for adhesive cap | ice if consistant pain, heat later to lengthen, jt mobs into abd, strengthen the available RO |
| what range to stay within for adhesv cap? | resting position 55 deg abd, 30 hor add |
| who is most likely to sustain lesion ( Bankart, SLAP) or instability? | younger, active adults |
| what structures offer shoulder stability? | subscapularis, GH ligament, LH bicep |
| what is most commonly dislocated jt in body? | glenohumeral |
| aprehension test is for? | anterior shoulder instability |
| avoid what motions with dislocated shoulder? | full ABD, ER, extension, 90 deg abd w/ER is the worst keep elbow ER at side not over 45 deg, shoulder in resting position abd 55 deg, horz add 30 deg, DON'T WORK ON ROM |
| MAX ph tx for shoulder dislocation | ice, etim, elboy, wrist & hand stg/motion, |
| MOD ph for shoulder dislocation | pulleys, codman's, sub max isometrics (add & IR), ROM, isometrics (0 deg of abduction) |
| avoid what motion in mod ph shoulder disclocation? | strengthening in abduction |
| tx for anterior dislocation? | strengthen anterior compartment - pec major, teres major, latissimus dorsi, subscapularis |
| MOD/MIN ph shoulder dislocation | maintain jt play, avoid anterior glide, isotonics, theraband to beging, shoulder ABD, IR for anterior, UBE, CKC stg |
| avoid what with soulder disl? | limit ER to 50 deg initially |
| surgical anterior capsular shift, restrict? | avoid abd over 90 deg, ER beyond 45 deg |
| MAX - tx for surgical ant cap shift | (stg immediately GH & scap stabilizers), splint 1-2 wks, AAROM flex & abd (wand) -gradually gain motion, isom contractions IR, ER, flexion, extension, abd GOAL;;;;; SCAPTION OF 135 DEG, 35 ER |
| MOD tx for surgical ant cap shift | 3wk-3 mo, IR/ER w/tubing, ext in prone, proprioception, GOAL; FULL AROM (NOT EXCESSIVE) RETURN TO SEDENTARY WK, 60% RETURN OF STG |
| MIN tx for surgical ant cap shift | advance PRE's, eccentric, isokinetics, sport specific, adv CKC |
| avoid what motions with impingment? | 60-120 deg forward flex, IR w/90 deg ABD |
| causes of impingment | musc imbalances, faulty biomechanics, trauma, poor posture, SICK scapula |
| painful arc 60-120 flex or abd, pain w/resistance or stretch, tenderness to palpation at distal insertions, limited IR is indicative of? | shoulder impingment |
| shoulder imp rehab & what mm's to stg? | stretch external rotators, strg external rotators, & scapulothoracic mms (Serratus ant, trap, levator scap, rhomboid) |
| avoid_____with imp. | avoid ABD below 45 deg, flexion above 90 deg (watershed) |
| MAX ph imp | modify ADL's, rest - aviod painful motions, painfree motion, ice, codman's, ionophoresis/phono, cross-friction massage, ice, PROM, TREAT SHLDR SUPPORTED AT 45 DEG ABD |
| MOD ph imp | scap ex - rowing-rhomboids, scapular plane elevation - scaption elev w/ER, press ups (seated) - traps, push ups at end push up plus. AROM limted to 90 deg abd, stretch (restore normal internal rot w/90 deg ABD, strg (painfree) isometrics, isot, isok |
| why is scaption plane preferrable? | less muscle effort required to raise the arm in scaption plane |
| MOD cont, imp | posture, biomechanics functional |
| MIN ph imp | full functional activ, above 90 deg rotator cuff, supraspinatus, infraspin, teres minor, subscap (concen & eccen), stretch bilateral, stg in available range ASAP! CONCENTRATE ON SCAP RETRACTORS & STABILIZERS - RHOMB, SERRATUS ANT, TRAPS, LEVATOR SCAPULAE |
| if one medial malleoli appears to lengthen or shorten as patient does long sit-uo, could be? | SI jt |
| what causes MCL injury? | valgus force to the knee |
| what mm to stg for MCL injury? | gracilis, sideline hip adductors, knee extended |
| tx for MCL injury MAX | isomentric, quad set, SLR |
| MCL injury MOD | wall slides, SLR w/wts |
| MCL injury MIN | leg press, step ups w/wts, adductor w/theraband, GRACILIS IS STABILIZER |
| avoid? w/MCL injury? | avoid valgus str, valgus forces - rotational stresses, |
| symptoms of Meniscus lesion | giving way, may lack extension, joint line pain |
| Meniscus repair rehab precaution | limited knee flex 0-100 4-6 wks, isom stg for first 3-4 wks, NWB 4-6 wks, no vertical compressive loads, no full squats 3-6 mo, CKC after 8 wks, OKC 4-8 wks |
| long term effects of meniscectomy | degeneration, narrowing of the tibiofemoral jt space, bone spurs, degenerative articulate surface |
| difference betw meniscus repair & meniscectomy | meniscus repair needs time to heal by limiting loads & stresses, meniscectomy is early wb'ing as tolerated |
| avoid w/meniscus repair? | knee flex 90-100, wtb'ing 4-6 wks, NO WT'D FULL SQUATS 3-6 MONTHS!! |
| Ober test, you should work on which muscle? | IT band |
Created by:
djbari
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