Term
| Acetabular Labral Tears (ALT): MOI |
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Definition
trauma
sporting activities
torsional movements |
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Term
| Acetabular Labral Tears (ALT): MOI in younger pt's |
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Definition
| ER force with hip in hyperextension |
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Term
| Acetabular Labral Tears (ALT): MOI in older pt's |
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Definition
| repeated pivoting or twisting |
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Term
| Acetabular Labral Tears (ALT): found to represent 20% of what type of pain in athletes |
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Definition
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Term
| Acetabular Labral Tears (ALT): locations |
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Definition
anterior
posterior
superior (lateral)
anterosuperior |
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Term
| Acetabular Labral Tears (ALT): most common locatino of tear |
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Definition
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Term
| Acetabular Labral Tears (ALT): why is anterior/anterosuperior msot common |
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Definition
| d/t increased force or stress during wb |
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Term
| Acetabular Labral Tears (ALT): type of injury |
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Definition
| degenerative or idiopathic |
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Term
| Acetabular Labral Tears (ALT): degenerative tears may be associated with what |
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Definition
| inflammatory arthropathies |
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Term
| Acetabular Labral Tears (ALT): Type I |
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Definition
| labrum detached from articular cartilage surface |
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Term
| Acetabular Labral Tears (ALT): where does a Type I occur |
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Definition
at area between fibrocartilaginous labrum and articular hyaline cartilage
may extend into the subchondral bone |
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Term
| Acetabular Labral Tears (ALT): type II |
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Definition
| cleave plane tear within the substance of the labrum |
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Term
| Acetabular Labral Tears (ALT): both types are associated with what |
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Definition
| proliferation of chondrocytes, hyalinzation of labral fibrocartilge and increased microvascularity within substance of labrum |
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Term
| Acetabular Labral Tears (ALT): what may form within labral tears? |
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Definition
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Term
| Acetabular Labral Tears (ALT): common complaints |
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Definition
pain
clicking
locking
catching
instability
giving way
stiffness |
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Term
| Acetabular Labral Tears (ALT): % of cases with anterior groin pain |
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Definition
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Term
| Acetabular Labral Tears (ALT): % that report hip locking |
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Definition
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Term
| Acetabular Labral Tears (ALT): predisposing factor and % |
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Definition
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Term
| Acetabular Labral Tears (ALT): c/o clcking in the hip |
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Definition
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Term
| Acetabular Labral Tears (ALT): hx: c/o (4) |
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Definition
buckling
locking
twinges
instability |
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Term
| Acetabular Labral Tears (ALT): hx: painful clicking SN/SP |
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Definition
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Term
| Acetabular Labral Tears (ALT): hx: pain locaiotn (7) |
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Definition
anteiror groin
thigh
medial knee
tronchanteric
buttock
low back
C sign |
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Term
| Acetabular Labral Tears (ALT): hx: onset |
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Definition
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Term
| Acetabular Labral Tears (ALT): hx: Physical Exam findings: ROM |
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Definition
| may be full with pain at extremes of ranges |
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Term
| Acetabular Labral Tears (ALT): hx: Physical Exam findings: (2 tests) |
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Definition
FADIR (Flex, ADD, IR)
FABER |
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Term
| Acetabular Labral Tears (ALT): hx: Physical Exam findings: FADIR test good for ID'ing what tears |
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Definition
anterior superior ters
anterior tears
iliopsoas tendinitis |
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Term
| Acetabular Labral Tears (ALT): hx: Physical Exam findings: FABER test good for id'ng what tears |
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Definition
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: ROM |
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Definition
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: radiographs |
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Definition
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: longstanding c/o (2) |
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Definition
anterior hip/groin pain
clicking |
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: (+) tests/signs/evaluations (4) |
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Definition
(+) thomas test from flexion to extension for popping/clicking (McCarthy sign)
C sign
(+) FADIR test
Pain with active/resisted SLR (loads labrum) |
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: confirm with what (2) |
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Definition
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: conservative mgmt: the obvious |
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Definition
rest c/s traction and protected WB
NSAIDS, corticosteroid injection, viscosupplementation, platelet rich protein injection |
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: conservative mgmt: Manual therapy (3) |
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Definition
soft tissue manip to Psoas, ITB
Long axis traction thrust/non thrust
mob with movement (mulligan) |
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: conservative mgmt: correct biomechanical faults and abnormal movement patterns (3) |
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Definition
foot biomechanics (orthotics)
strengthen hib abd, glut max, iliopsoas, deep ext rot
proper loading strategies |
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Term
| Acetabular Labral Tears (ALT): hx: test clustering: conservative mgmt: pt education (3) |
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Definition
avoid sitting with hips lower than knees or legs crossed, prolonged sitting
sit with pressure through ischial tuberosity
avoid passive or excessive hip extension during gait |
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Term
| Acetabular Labral Tears (ALT): surgical mgmt: |
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Definition
debridement, repair, or reconstruction
correction of cam/pincer bony deformities |
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Term
| Acetabular Labral Tears (ALT): surgical mgmt: more favorable outcomes with what |
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Definition
| absence of degenerative changes |
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Term
| Acetabular Labral Tears (ALT): surgical mgmt: complications |
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Definition
sciatic or pudendal nn injury
typically neuropraxic in nature |
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Term
| most common cause of mechanical symptoms in kene |
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Definition
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Term
| Meniscal Injury: how may it occur |
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Definition
| in isolation or in combo with other knee pathology |
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Term
| Meniscal Injury: pain and the meniscus |
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Definition
meniscus are not innervated with nociceptive fibers
pain production likely d/t tearing and bleeding in peripheral attachments as well as traction to the capsule |
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Term
| Meniscal Injury: aging changes |
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Definition
| meniscus degerates and can delaminate making it more suscpetible to shear stress and horizontal cleavage tears |
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Term
| Meniscal Injury: common mechanisms |
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Definition
turning, twisting, or change direction when wb
may also occur with a blow/contact to the lateral/medial knee |
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Term
| Meniscal Injury: dx fingings |
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Definition
| asymptomatic meniscal tears ID'd in 16% of pop. increasing to 46% of pt's over the age of 45 |
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Term
| Meniscal Injury: gold standard to ID |
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Definition
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Term
| Meniscal Injury: MRI SN/SP |
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Definition
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Term
| Meniscal Injury: clinical dx: problem with tests |
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Definition
| no stand alone clinical exam procedure/finding that demo's high dx value |
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Term
| Meniscal Injury: clinical dx: purpose of testing |
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Definition
| cllustering increases likelihood of accurate dx |
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Term
| Meniscal Injury: clinical dx: symptoms (5) |
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Definition
locking
jt line tenderness
pain with flexion
pain with hyperextension
pain with squatting |
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Term
| Meniscal Injury: clinical dx: signs/(+) tests (4) |
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Definition
swelling
McMurrays
Apleys
Thessaly's |
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Term
| Meniscal Injury: mgmt considerations: how many can be managed conservatively |
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Definition
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Term
| Meniscal Injury: mgmt considerations: which can be managed conservatively |
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Definition
degenerative/horizontal cleavage tears
periphery (red zone), stable, and acute |
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Term
| Meniscal Injury: mgmt considerations: conservative tx focus |
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Definition
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Term
| Meniscal Injury: mgmt considerations: surgery indications |
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Definition
tears inavascular zone (white zone, middle and inner 3rd)
knee is locked (bucket handle)
displaced unstable fragment |
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Term
| Meniscal Injury: mgmt considerations: types of surgery |
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Definition
meniscectomy (usually inner 1/3)
repairs (in periphery)
allograft (meniscus translpation to well vascularized areas) |
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Term
| Meniscal Injury: meniscal repair: choice of intervention based on (3) |
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Definition
pt age
size and location of tear
collateral tissue injuries |
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Term
| Meniscal Injury: meniscal repair: post op mgmt considerations |
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Definition
other procedures performed (ACL/MCL)
flexion typically limtited to 90 for 4-6 wks
wb may be limited
bracing in extension/slight flexio indiciated for up to 4 weeks |
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Term
| Meniscal Injury: meniscal repair: cons |
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Definition
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Term
| Achilles Tendon Injury and Repair: etiology |
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Definition
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Term
| Achilles Tendon Injury and Repair: common population |
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Definition
| middle age indivuals (weekend warriors) |
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Term
| Achilles Tendon Injury and Repair: /area of injury/predisposing factors |
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Definition
hypovascular zone
microtrauma
pharmacologic contribution (corticosteriods, fluroquinolones (antibiotics)) |
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Term
| Achilles Tendon Injury and Repair: MOI |
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Definition
pushing off of forefoot while extending the knee
sudden DF with full WB (slip or fall)
aggressive eccentric DF that occurs when landing from a jump/fall on a PF foot |
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Term
| Achilles Tendon Injury and Repair: dx (6) |
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Definition
sudden pain associated with an audible pop
inability to step or WB
calf swelling
palpable defect in tendon (hatchet strike)
ecchymosis around malleoli
(+) thompshon test |
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Term
| Achilles Tendon Injury: Mgmt considerations: conservative: immombilization |
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Definition
| short or long cast immobilization in 10-20 degrees of PF |
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Term
| Achilles Tendon Injury: Mgmt considerations: conservative: re-rupture |
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Definition
10-30% higher incidence of re-rupture
decrease in maximal function |
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Term
| Achilles Tendon Injury: Mgmt considerations: conservative: length tension relationship |
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Definition
| difficult to restore relationship to achilles |
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Term
| Achilles Tendon Injury: Mgmt considerations: conservative: better conservative outcomes with what |
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Definition
| occuring with use of fixed or hinged boots and earlier mobilization |
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Term
| Achilles Tendon Injury: Mgmt considerations: conservative: incorporation of what type of injection |
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Definition
| plate rich plasma injections |
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Term
| Achilles Tendon Injury: Mgmt considerations: conservative: high complications with what |
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Definition
| high complication rates with surgical mgmt (up to 15.7%) |
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Term
| Achilles Tendon Injury: Mgmt considerations: surgical mgmt: surgical candidates |
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Definition
younger, active indiviuals
returning to more explosive type sports
high level athletes
those on restricted time schedules for return to activity |
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Term
| Achilles Tendon Injury: Mgmt considerations: surgical mgmt: risks |
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Definition
infection
scar formation
re-rupture (<5%) |
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Term
| Achilles Tendon Injury: Mgmt considerations: surgical mgmt: post op considerations |
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Definition
| early mgmt after injury very important |
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Term
| Achilles Tendon Injury: Mgmt considerations: post op considerations: |
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Definition
| full vs PWB and early vs delayed mobilization |
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Term
| Achilles Tendon Injury: Mgmt considerations: post op considerations: FWB vs PWB and Early vs delayed mobilization. Who wins? |
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Definition
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Term
| Achilles Tendon Injury: Mgmt considerations: post op considerations: FWB vs PWB and Early vs delayed mobilization. Who wins? |
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Definition
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Term
| Achilles Tendon Injury: Mgmt considerations: post op considerations: FWB vs PWB and Early vs delayed mobilization. re-rupture rate comparison |
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Definition
| no increased re rupture for FWB and early |
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Term
| Achilles Tendon Injury: Mgmt considerations: post op considerations: benefits of FWB and early mobilization |
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Definition
higher pt satisfaction
less use of rehab resources
earlier return to preinjury activities
increase calf mm strrength
reduced atrophy and tendon elongation |
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