From Textbook (Treatment) - Unit 4: The Skeletal System

cast

Procedure in which a cast of plaster or fiberglass is applied around a fractured bone and adjacent areas to immobilize the fracture in a fixed position to facilitate healing (see Figures 8-27 and 8-28). For fractures of the leg, the physician may order the patient to be nonweight bearing (putting no weight on the affected leg), toe touch (partial weight bearing), or full weight bearing (with a walking cast). Patients with leg casts are instructed in the use of crutches.

closed reduction

Procedure in which manual manipulation of a displaced fracture is performed so that the bone ends go back into normal alignment without the need for surgery. Then a cast is applied.

extracorporeal shock wave therapy (ESWT)

Procedure in which sound waves produced outside the body (extracorporeal) are used to break up bone spurs and treat other minor but painful problems of the foot

goniometry

Procedure in which a goniometer is used to measure the angle of a joint and its range of motion (ROM) (see Figure 8-29)

orthosis

Orthopedic device such as a brace, splint, or collar that is used to immobilize a body part and keep it straight or correct an orthopedic problem. It is often custom-made to fit the patient.

physical therapy

Procedure that uses exercises to improve a patient's range of motion, joint mobility, strength, and balance. Active exercises are done by the patient. Passive exercises are done by the therapist who moves the patient's body.

prosthesis

Orthopedic device such as an artificial leg for a patient who has had amputation of a limb (see Figure 8-30). It is known as a prosthetic device. An implanted artificial joint is also a prosthetic device.

traction

Procedure that uses a weight to pull the bone ends of a fracture into correct alignment. Skin traction uses elastic wraps, straps, halters, or skin adhesives connected to a pulley and a weight. Skeletal traction uses pins, wires, or tongs inserted into the bone during surgery. Halo traction uses pins inserted into the cranium and attached to a circular metal frame that forms a halo around the patient's head (see Figure 10-32). Bars connect the halo to a rigid vest that immobilizes the chest and back while exerting upward traction on the head to straighten a fracture of the spine.

amputation

Procedure to remove all or part of an extremity because of trauma, cardiovascular disease, or diabetes mellitus. A below-the-knee amputation (BKA) is at the level of the tibia and fibula. An above-the-knee amputation (AKA) is at the level of the femur. A muscle flap is wrapped over the end of the amputated limb to provide a cushion and bulk so the patient can be fitted with an artificial limb (prosthesis). A patient who has had an amputation is an amputee.

arthrocentesis

Procedure to remove an accumulation of fluid from an injured joint by using a needle inserted into the joint space. It is also done to inject a drug to control inflammation and pain.

arthrodesis

Procedure to fuse the bones in a degenerated, unstable joint

arthroscopy

Procedure that uses an arthroscope inserted into the joint to visualize structures inside the joint (see Figure 8-31). Other instruments can be inserted through the arthroscope to scrape or cut damaged cartilage or smooth sharp bone edges.

bone graft

Procedure that uses whole bone or bone chips to repair fractures with extensive bone loss or defects due to bone cancer. Bone taken from the patient's own body is an autograft. Frozen or freeze-dried bone taken from a cadaver is an allograft.

bunionectomy

Procedure to remove the prominent part of the metatarsal bone that is causing a bunion in patients with hallux valgus.

cartilage transplantation

Procedure that replaces damaged cartilage as an alternative to a total knee replacement. It is used to treat middle-aged adults (as opposed to older adults) with degenerative joint disease of the knee who have an active lifestyle.

external fixation

Procedure used to treat a complicated fracture. An external fixator orthopedic device has metal pins that are inserted into the bone on either side of the fracture and connected to a metal frame. This immobilizes the fracture. A similar device is used to perform a leg lengthening to treat a congenitally short leg. It has screws that are turned daily, pulling the cut ends of bone apart so new bone grows in the gap and lengthens the leg.

joint replacement surgery

Procedure to replace a joint that has been destroyed by disease or osteoarthritis. A metal or plastic joint prosthesis is inserted (see Figure 8-32). This surgery is done on the hips as a total hip replacement (THR), or on the knees, shoulders, or even on the small joints of the fingers. For a total hip replacement, the head of the femur is sawn off. The stem (long metal projection) of the prosthesis is hammered into the cut end of the femur. The head (ball) of the prosthesis is matched to the size of the patient's acetabulum. The cup of the prosthesis is used to replace the acetabulum, and the ball is inserted into the cup. This is also known as an arthroplasty.

open reduction and internal fixation (ORIF)

Procedure to treat a complicated fracture. An incision is made to open the skin and visualize the fracture, the fracture is reduced (realigned), and an internal fixation procedure is done using screws, nails, or plates to hold the fracture fragments in correct anatomical alignment (see Figure 8-33).