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Ortho final

Precautions

QuestionAnswer
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