Gen Med Exam 1 --> Inpatient Orthopedics (3/8)

how is postoperative rehab divided up?

- into 3 phases

> maximum protection phase

> moderate protection phase

> minimum protection phase

what is postoperative rehab focus influenced by?

stages of healing of soft tissue and bone

what is the maximum protection phase of postoperative rehab?

- protection of operated tissues is paramount in the presence of tissue disruption or repair, inflammation, pain

- may involve immobilization or low-level stress

- typically lasts days-6 weeks

what is the moderate protection phase of postoperative rehab?

- inflammation has subsided

- pain and tenderness are minimal

- tissues are able to withstand gradually increasing levels of stress

- typically begins 4-6 weeks post-op and lasts another 4-6 weeks

what is the minimum protection phase of postoperative rehab?

- little to no protection of operated tissues is required

- typically begins 6-12 weeks post-op and can last up to 6 months

what is a joint replacement arthroplasty? what are the 2 types?

- reconstructive procedure to relieve pain and improve function

> total joint = resection of both articular surfaces and replacing both with artificial components

> hemireplacement = resection and replacement of only one of the articular surfaces

what are posterior hip precuations following a THA?

- AVOID:

> hip flexion >90º

> hip adduction last neutral

> hip IR

what are the 3 different types of total shoulder arthroplasties?

- total shoulder arthroplasty

- hemiarthroplasty

- reverse total shoulder arthroplasty

what is a discectomy/microdiscectomy?

- spinal surgery

- removal or protruding or herniated disc material

what is a laminectomy?

- spinal surgery

- removal of bone at laminary space

what is a decompression/foraminotomy?

- spinal surgery

- removal of spinous process and entire lamina to level the pedicle, widening the foramen

what is a fusion?

- spinal surgery

- fusion of unstable spinal segments at facet joints using hardware and bone grafts

- can be anterior or posterior approach (or both)

what are examples of spinal precautions? (4)

- limit excessive spine flexion/extension

- lifting restrictions

- avoid rotation

- avoid extended periods of sitting

depends on the procedure (check with surgical team for movement precautions and bracing requirements)

management for fractures

- can be surgical or non-surgical

- closed reduction

- open reduction internal fixation

- external fixation

what is the difference between closed reduction and open reduction internal fixation for fracture management?

- closed reduction = manual traction or manipulation

- open reduction internal fixation = surgery and hardware

how many weight bearing limbs are required to ambulate with an assistive device?

3