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ORTHO
Part 2
| Term | Definition |
|---|---|
| inflammatory stage (0-3 days) | Damage is repaired, dead cells removed Emphasis on rest Healing tissue requires support & immobilization Static splints used Serial static may also be used |
| proliferative/ fibroplasia stage (4 days- 3/4 weeks) | Increased activity at healing sites with cells multiplying and realigning Controlled stress can prevent long term stiffness Good stage to get change Use dynamic traction splints, static progressive, serial static |
| dynamic traction | Effective in early reorganization Tension not constant Line of pull elastic |
| static progressive during proliferative | Sustained force at end range, but don't stress beyond that Line of pull is static As person gets ROM, the 90 deg needs to be changed & moved |
| serial static during proliferative | Used if prolonged inflammatory response Alternated with periods of movement |
| chronic/ maturation stage (3/4 weeks- 6months/year) | Collagen is more organized Strength of wound increases Collagen is produced & destroyed Cell realign, create new bonds that resist movement (hard end feels) |
| chronic/ maturation stage splints | Serial static & static progressive give prolonged stress Highly resistive joints needs serial static constantly Serial casting effective |
| low load- prolonged stress | Most effective way to get change in tissue Serial splinting/ casting, static progressive Hold tissues for long time Collagen is laid down in different pattern Growth occurs, not stretch |
| low load prolonged stress rules | Remodel needs low gentle constant tension Increase PROM should not be painful |
| how long prolonged stress? | Increase ROM in stiff joints Daily over 6 hours/ day Depends on activities Start with 20-30 min, gradually increase time Wear overnight |
| end feel | Based on how it feels, assess stiffness Stretch tissue to maximum PROM and held Gives indication if gains will be quick or slow Subjective method |
| torque angle curves | Joint passively moved through avaliable range, goni readings at intervals with increasing force Readings plotted on graph (tension-elongation curve) Gentle slope more compliant, sharper is stiffer tissue More objective |
| modified weeks test | More objective test Provide clinicians with plan of splinting after determining if joint stiffness is significant problem |
| modified weeks test steps | 1. No exercise/ splint on day 2. Cold measurement 3. Thermal modality w/ exercise 20 min 4. Overpressure 10 min 5. Preconditioned reading 6. Compare readings |
| PROM increase 1. 20 2. 15 3. 10 4. 0-5 | 1. No splint, just exercises 2. Static splint. Joint is slightly stiff. No overpressure 3. Dynamic splint, joint is stiff. Escape from mobilizing force 4. Static progressive splint at end range overpressure, joint is very stiff |
| night splinting | Tissues held greatest length overnight will move more easily during day Distractions, movement of hand during day allow clients to tolerate greater day splinting forces than night forces Ext splinting better tolerated at night |
| splinting to mobilize stiffness | Block proximal joints so distal joints encouraged to move Cast/ splint blocks movement to allow normal power Cast causes change within 10 days |
| MCP arthroplasty | Bulky dressings and cast removed, drain removed Light compressive dressing applied Resting splint- MCP in neutral/ slight radial alignment with dividers- 6 mo |
| dynamic wrist extension for MCP arthroplasty | Ext outriggers positioned in radial direction on splint Distal end outriggers lined with proximal phalanges Guided ROM Traction should keep MCP in neutral ext at rest Wear for 3 mo |
| crush injury | Stiff hands, esp MCP CMMS casting for MCP MCP blocking & exercise splint for interosseous tightness |
| MCP blocking & exercise splint | Worn at all times except for hygiene 10-20 reps of hook-fist exercises every 2 hours |
| lampshade extension splint pattern | Decrease/ resolve digital flexion contractures |
| painful thumb joints | Client can't tolerate rigidity of thermoplastic Neoprene splint with outside plastic support Gives warmth to help with pain & swelling Padding Thermoplastic gives support |
| orfit | Flexible material You have to remove the coating Stuff will stick to it Classic orfit is even stickier & can attach things to |
| polyflex | Blue material Super flexible and stretchy Used to make thumb hole |
| orfit classic | Thin material 1.6 mm |
| sansplint | Has some stretch, not as much as polyflex Controlled stretch Medium strength Good for MCP extension |
| ezeform | When hard, its harder than sansplint |
Created by:
craftycats_
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