Term
| what potential systemic problems can masquerade as a hip dx |
|
Definition
| cancer (spinal metastasis, tumors), arterial insufficiency, urologic/renal, psoas abscess, appendicitis, diverticulitis, PID, ankylosing spondylitis, osteoporosis, TB, sickle cell, hemophilia |
|
|
Term
| Describe Gilmore's groin tear |
|
Definition
| adductor tear at their attachment to pubic ramus |
|
|
Term
| does overuse or overstress cause acute strain |
|
Definition
|
|
Term
| does overuse or overstress cause chronic strain |
|
Definition
|
|
Term
| describe grade 1 muscle strain |
|
Definition
| mild. Muscle has been stressed. Won't be painful/irritated until after the activity |
|
|
Term
| describe grade 2 muscle strain |
|
Definition
| moderate. The person usually feels the strain during the activity |
|
|
Term
| describe grade 3 muscle strain |
|
Definition
| severe. Muscle torn 75-100% |
|
|
Term
| where do most muscle strains/tears occur |
|
Definition
| musculotendinous junction |
|
|
Term
| does deleceration or acceleration cause more muscles strains? |
|
Definition
|
|
Term
| what are causes of muscle strains |
|
Definition
| deceleration, acceleration, imbalance in strength, flexibility imbalance, weakness |
|
|
Term
| what are some commonly strained muscles |
|
Definition
| hamstrings, adductor longus, iliopsoas, rectus femoris |
|
|
Term
| what is the rehab time for mild muscle strains |
|
Definition
|
|
Term
| what is the rehab time for severe muscle strains |
|
Definition
|
|
Term
| what is the good thing about muscle injuries |
|
Definition
| there is a lot of blood to help heal. |
|
|
Term
| how to treat muscle strains |
|
Definition
| need to reduce swelling and get scar tissue down. As soon as pt can tolerate movement through the range, get them on a bike so they can elongate the muscle but control it. Rhythmic, repetitive motion to align scar tissue in the direction you want. |
|
|
Term
| what are signs/symptoms of muscle strains |
|
Definition
| ecchymosis, hemorrhage, pain with resistance, decreased PROM, TTP at lesion, swelling, defect |
|
|
Term
| when would the lesion not be TTP for muscle strain |
|
Definition
| if the muscle is not intact and there are no intact nerve endings |
|
|
Term
| Intervention for chronic muscle strain? |
|
Definition
| focus on prevention. Progress activities so muscle-tendon unit can with stand heavier workload. Maybe compression. Late stage rehab for active person: closed kinetic chain exercises, eccentrics |
|
|
Term
| Intervention for acute/subacute muscle strain? |
|
Definition
| RICE, deep friction massage to promote organized alignment of new fibers, myofasical release, gentle stretching, anti-inflammatory modalities, gradually resume activity, protect |
|
|
Term
| how long after acute muscle strain is there increased vulnerability for re-injury |
|
Definition
|
|
Term
| does iliopectineal bursitis or trochanteric bursitis occur less frequently? |
|
Definition
|
|
Term
| where is pain with iliopectineal bursitis |
|
Definition
|
|
Term
| when does someone with iliopectineal bursitis feel pain |
|
Definition
| resisted hip flexion, passive hip extension |
|
|
Term
| what causes a hip pointer |
|
Definition
|
|
Term
| when does someone with hip pointer feel pain |
|
Definition
| abdominal contraction, abduction |
|
|
Term
| interventions for hip pointer |
|
Definition
| rest, compression, ice, anti-inflammatory meds, anti-inflammatory modalities, refer for imaging, protect |
|
|
Term
| where do avulsions/apophyseal injuries occur |
|
Definition
| AIIS, ASIS, GT, LT, ischial tuberosity, iliac crest, symphysis pubis |
|
|
Term
| what causes extra-articularsnapping hip |
|
Definition
| ITB passes over GT OR iliopsoas snaps over front of hip |
|
|
Term
| what are the causes of intra-articular snapping hip |
|
Definition
| labrum: tear in labrum gets caught between acetabulum and femoral head. Loose body: loose body gets caught and makes a click. |
|
|
Term
|
Definition
| loss of articular cartilage and reactive bone formation leading to pain, defromity, disability |
|
|
Term
| what is the most common hip problem |
|
Definition
|
|
Term
| what is the path of locatino of hip OA pain |
|
Definition
| pain first felt in groin, then in anterior thigh and knee. Sometimes only complaint is knee pain |
|
|
Term
| what will you see in observation in patient with OA |
|
Definition
| difficulty rising from chair, antalgic gait, maybe assistive device, difficulty dressing (esp putting shoes and socks on) |
|
|
Term
| what will you see in inspection in patient with OA |
|
Definition
| atrophy of glutes and abductors, joint tightness, compensatory postural changes, asymmetry in bony landmarks |
|
|
Term
| what things to test for OA |
|
Definition
| PROM, capsular pattern, joint play, strength, functional activities, neuro screens, palpation, special tests |
|
|
Term
| how will PROM be in someone with OA |
|
Definition
| limited by pain/spasm if acute; limited by soft tissue restriction/discomfort if chronic |
|
|
Term
| what is the capsular pattern for the hip |
|
Definition
| flexion, abduction, IR but order can vary |
|
|
Term
| what to look for in joint play testing that indicates OA |
|
Definition
| restrictions in all ROM, hard end feel |
|
|
Term
| what determines strength in someone with OA |
|
Definition
|
|
Term
| what are functional activities that cause pain in someone with OA |
|
Definition
| squatting, stair climbing, sitting, bending |
|
|
Term
| what are functional concerns for hip OA patients |
|
Definition
|
|
Term
| are neuro screens typically issues for OA patients |
|
Definition
|
|
Term
| how to palpate for hip OA |
|
Definition
| typically unable to locate one tender area with palpation |
|
|
Term
| what are special tests for hip OA |
|
Definition
| trendelenburg, scour, FABER |
|
|
Term
| describe trendelenburg test |
|
Definition
| in SLS, a drop of the iliac crest opposite stance leg = + indicating glute weakness of stance side |
|
|
Term
|
Definition
| flex knee, give axial pressure, run femur around superior rim of acetabulum from Add/IR to ABD/ER |
|
|
Term
|
Definition
| put leg in flexion, abduction, ER (figure 4) |
|
|
Term
| what is the onset of trochanteric bursitis |
|
Definition
|
|
Term
| what sometimes goes along with trochanteric bursitis |
|
Definition
|
|
Term
| what is the site of pain for trochanteric bursitis |
|
Definition
| lateral hip, radiates distally to lateral thigh and knee. Occasionally in lumbosacral region |
|
|
Term
| what is the nature of pain in trochanteric bursitis |
|
Definition
|
|
Term
| what functional activities cause pain with trochanteric bursitis |
|
Definition
| ascending stairs, rolling on involved side, other activities that press ITB into bursa |
|
|
Term
| will you see swellin, redness with trochanteric bursitis |
|
Definition
|
|
Term
| describe PROM with trochanteric bursitis |
|
Definition
| pain at very end range Abduction. Pain with flexion, adduction, IR |
|
|
Term
| what resisted motion causes pain with trochanteric bursitis |
|
Definition
|
|
Term
| what special test is positive with trochanteric bursitis |
|
Definition
| Ober's: Positive because they won't relax because relaxing hurts |
|
|
Term
| what is joint play like with trochanteric bursitis |
|
Definition
| normal mobility, painless |
|
|
Term
| will a neuromuscular exam show anything with trochanteric bursitis |
|
Definition
|
|
Term
| what will palpation show with trochanteric bursitis |
|
Definition
| tenderness over posterolateral GT. Occasional lateral thigh referred tenderness |
|
|
Term
| what determines gait change in someone with trochanteric bursitis |
|
Definition
|
|
Term
| what causes acute labral tears |
|
Definition
| twisting with axial loading as in golf |
|
|
Term
| what causes chronic labral tears |
|
Definition
| low grade loading over time OR hip dysplasia |
|
|
Term
| what are the 2 types of femoral acetabular impingement? |
|
Definition
|
|
Term
| what is the cam type femoral acetabular impingement |
|
Definition
| enlargement of femoral neck on anterior portion, causes pain with flexion and IR when the enlargement hits the acetabulum |
|
|
Term
| what is pincer femoral acetabular impingement |
|
Definition
| enlargement of acetabulum will put a pressure dent into the femoral neck when with IR and flexion. Gets irritated over time. |
|
|
Term
| in what population is femoral acetabular impingement most common? |
|
Definition
|
|
Term
| what is the onset of femoral acetabular impingement like? |
|
Definition
|
|
Term
| when does pain increase in someone who has femoral acetabular impingement |
|
Definition
| increases with high demand activities and sitting |
|
|
Term
| what are clinical indications of femoral acetabular impingement |
|
Definition
| ROM limitations of ADD and IR esp with hip flexed to 90; scour, labral tests |
|
|
Term
| what labral tests are positive with femoral acetabular impingement |
|
Definition
| F-AB-ER into E-AD-IR and F-AD-IR into E-AB-ER |
|
|
Term
| what does positive trendelenburg indicate |
|
Definition
|
|
Term
| what does positive scour indicate |
|
Definition
|
|
Term
| what does positive FABER indicate |
|
Definition
| OA, iliopsoas problem, SI problem |
|
|
Term
| what does positive OBER's indicate |
|
Definition
| tight IT band, trochanteric bursitis |
|
|
Term
| what does positive F-AB-ER into E-AD-IR indicate |
|
Definition
| femoral acetabular impingement, labral tear/impingement |
|
|
Term
| what does F-AD-IR into E-AB-ER indicate |
|
Definition
| femoral acetabular impingement, labral tear/impingement |
|
|
Term
| define greenstick fracture |
|
Definition
| one side of the bone is broken, the other is bent |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| define transverse fracture |
|
Definition
| fracture straight across the bone |
|
|
Term
|
Definition
| fracture occuring at angle across the bone |
|
|
Term
|
Definition
| fracture twisting around bone shaft |
|
|
Term
| define comminuted fracture |
|
Definition
| fracture in which bone splintered into fragments |
|
|
Term
| define depressed fracture |
|
Definition
| fracture in which fragments are driven |
|
|
Term
| define compressed fracture |
|
Definition
| bone compressed on one side (think vertebral) |
|
|
Term
| define pathologic fracture |
|
Definition
| occurs through area of diseased bone |
|
|
Term
|
Definition
| pulling away a fragment of bone by ligament or tendon |
|
|
Term
| define epiphysis fracture |
|
Definition
| fracture through epiphysis |
|
|
Term
| what are the 4 possible fracture sites |
|
Definition
| diaphysis, metaphysis, epiphysis, intra-articular |
|
|
Term
|
Definition
| the part of the long bone adjacent to epiphyseal plate that grows during childhood |
|
|
Term
| what is a complete fracture |
|
Definition
| bone fragments separate completely |
|
|
Term
| what is an incomplete fracture |
|
Definition
| bone fragments are still partially joined |
|
|
Term
| what are the 4 configurations of fractures |
|
Definition
| transverse, oblique, comminuted, spiral |
|
|
Term
| how do we describe the relationship of the fragments in a fracture |
|
Definition
|
|
Term
| how do we describe displacement of one fracture compared to another |
|
Definition
| describe it as the placement of the distal segment compared to the proximal segment |
|
|
Term
| what are the 2 relationships to the environment of a fracture |
|
Definition
|
|
Term
|
Definition
| fracture or object penetrated the skin |
|
|
Term
| if a fracture has varus angulation, what does that mean |
|
Definition
| distal segment is angulated toward midline |
|
|
Term
| what do we call it when a fractured bone is now shorter than it should be |
|
Definition
|
|
Term
| are bones weaker in tension or in compression |
|
Definition
|
|
Term
| describe a butterfly fracture |
|
Definition
| bone fails on tension side first, which puts even more force on the part of the bone that is still connected. However, the other part of the bone is still strong in compression, so the fracture goes above or below the compressed part of the bone |
|
|
Term
| what is the purpose of ottowa ankle rules |
|
Definition
| decision aid for excluding fractures of ankle and midfoot to help ppl avoid unnecessary xrays |
|
|
Term
| what are the Ottowa Ankle Rules |
|
Definition
| if you are between ages 2-55 and have any of the following, you need an xray: 1. tender over posterior 6cm or tip of med/lat malleoli; tender base of 5th metatarsal; tender navicular; inability to bear weight 4 steps BOTH immediately AND in ER (limping ok) |
|
|
Term
| what is the purpose of ottowa knee rules |
|
Definition
| decision aid for excluding fractures of the knee and help ppl avoid unnecessary xrays |
|
|
Term
| what are the Ottowa Knee Rules |
|
Definition
| Age 55 or older; Isolated tenderness over patella; Tender fibular head; Unable to flex knee past 90; Unable to bear weight immediately OR in ER for 4 steps |
|
|
Term
| what does Salter Harris classify |
|
Definition
|
|
Term
| what is a Salter Harris Type I |
|
Definition
| Separation of epiphysis from metaphysis. Rarely manipulated; requires immobilization |
|
|
Term
| what is a Salter Harris Type II |
|
Definition
| Epiphysis and growth plate partially separated from cracked metaphysis |
|
|
Term
| what is a Salter Harris Type III |
|
Definition
| fracture goes completely through epiphysis and separates part of the epiphysis and growth plate from the metaphysis |
|
|
Term
| what is the most common Salter Harris fracture |
|
Definition
| Type II: epiphysis and growth plate partially separated from cracked metaphysis |
|
|
Term
| how is a Type II salter harris treated |
|
Definition
| manipulated and immobilized |
|
|
Term
| is a type III salter harris fracture common |
|
Definition
|
|
Term
| how is a type III salter harris treated |
|
Definition
|
|
Term
| what is a type IV salter harris |
|
Definition
| fracture runs through epiphysis, across growth plate, into metaphysis |
|
|
Term
| how is type IV salter harris treated |
|
Definition
|
|
Term
| what is a type V salter harris |
|
Definition
| occurs when the end of the bone is crushed and the growth plate is compressed |
|
|
Term
| is a type V salter harris fracture common |
|
Definition
|
|
Term
| what is the prognosis for a type V salter harris fracture |
|
Definition
|
|
Term
| what is the SALTR mnemonic |
|
Definition
| Straight across, Above (in metaphysis), Lower (in epiphysis), through (metatphysis, growth plate, epiphysis), Rammed |
|
|
Term
| what are the 3 types of acetabular fractures |
|
Definition
| posterior, anterior, central |
|
|
Term
| what is the most common type of acetabular fracture |
|
Definition
|
|
Term
| what is the MOI of a posterior acetabular fracture |
|
Definition
|
|
Term
| what is a complication of posterior acetabular fracture |
|
Definition
|
|
Term
| what precautions must be used with posterior acetabular fracture |
|
Definition
| hip dislocation precautions |
|
|
Term
| is an anterior acetabular fracture rare |
|
Definition
|
|
Term
| what is an MOI of central acetabular fracture |
|
Definition
| force of femoral head into acetabulum |
|
|
Term
| what are the 4 types of femoral neck fractures |
|
Definition
| subcapital, transcervical, basilar, intertrochanteric |
|
|
Term
| which femoral neck fracture types are intracapsular |
|
Definition
| subcapital, transcervical, basilar |
|
|
Term
| where is a subcapital fracture |
|
Definition
|
|
Term
| where is a transcervical fracture |
|
Definition
| through the middle of the neck |
|
|
Term
| where is a basilar fracture |
|
Definition
| at the junction of the neck and shaft |
|
|
Term
| where is an intertrochanteric fracture |
|
Definition
| extracapsular: from GT to LT |
|
|
Term
| what is important in an intertrochanteric fracture |
|
Definition
|
|
Term
| what must be avoided in an intertrochanteric fracture |
|
Definition
|
|
Term
| what are the 4 types of femur fractures |
|
Definition
| subtrochanteric, mid-shaft, supracondylar, condylar |
|
|
Term
| are subtrochanteric fractures complex? |
|
Definition
|
|
Term
| what is the WB for subtrochanteric fractures |
|
Definition
|
|
Term
| what must usually be done to fix a mid-shaft femur fracture |
|
Definition
| skeletal traction to align bone and reduce swelling before surgery |
|
|
Term
| what type of hardware is put into mid-shaft fracture |
|
Definition
|
|
Term
| where is a supracondylar femur fracture |
|
Definition
|
|
Term
| how is a supracondylar femur fracture repaired |
|
Definition
|
|
Term
| what is an MOI for condylar fracture |
|
Definition
|
|
Term
| what to do in healing condylar fracture |
|
Definition
|
|
Term
| what is a complication of condylar fracture |
|
Definition
|
|
Term
| what are 4 types of tibial fractures |
|
Definition
| tibial plateau, midshaft, bimalleolar, trimalleolar |
|
|
Term
| what other bone is usualy involved in tibia mid-shaft fracture |
|
Definition
|
|
Term
| what is the main surgical management for tibial mid-shaft fracture |
|
Definition
|
|
Term
| what is a distal trimalleolar tibial fracture |
|
Definition
| medial malleolus, lateral malleolus, part of the tibia |
|
|
Term
| what are the basic PT interventions for fractures |
|
Definition
| initial assessment, ambulation training, weightbearing precautions, AAROM, discharge planning |
|
|
Term
| what walking distance shows that a patient is safe to go home |
|
Definition
|
|
Term
| what are the basics of fracture treatment per dr. dirschl |
|
Definition
| Managing trauma means more than making pretty x-rays; fracture reduction is not always required; closed reduction is preferred whenever possible |
|
|
Term
| what are the 2 main requirements for fracture healing |
|
Definition
| sufficient mechanical stability and healthy biology |
|
|
Term
| what are the 2 types of mechanical stability |
|
Definition
| primary bone healing, secondary bone healing |
|
|
Term
| what is primary bone healing |
|
Definition
| no motion whatsoever between fracture fragments. Osteoclasts go right across the segment and osteoblasts follow and heal. |
|
|
Term
| is primary bone healing fast or slow |
|
Definition
|
|
Term
| what will hold to parts of bone together in primary bone healing |
|
Definition
|
|
Term
| what are risks of primary bone healing |
|
Definition
| if there is too much stability, soft tissues/periosteum is stretched so tight that the cortex under the bone becomes necrotic. |
|
|
Term
| in what types of bones are we more likely to take the risk of necrosis with primary bone healing |
|
Definition
| in an area with good bloodflow where bone can heal |
|
|
Term
| what is secondary fracture healing |
|
Definition
| when there is a little bit of wiggle that turns the body on to heal faster than if there is no wiggle at all. |
|
|
Term
| why does secondary bone healing heal faster |
|
Definition
| periosteum that lines the bones gets involved. Hematoma in fracture site turns to clot, to callous, to cartilage, to bone |
|
|
Term
| what is another term for the healing that occurs in secondary bone healing |
|
Definition
| healing with callous = endochondral ossification |
|
|
Term
| what are the necessary parts of healthy biology for fracture healing |
|
Definition
| no infection, adequate nutrition, control diabetes if present |
|
|
Term
| what are the 2 goals of fracture care |
|
Definition
| relieve pain, restore function |
|
|
Term
| in what ways is pain relieved following fracture |
|
Definition
| reduction, stabilization, analgesia |
|
|
Term
| in what ways is function restored following fracture |
|
Definition
| reduction, stabilization, rehabilitation |
|
|
Term
| what are the 4 R's of fracture treatment |
|
Definition
| recognition of the fracture, reduction if needed, retention of reduction, rehabilitiation |
|
|
Term
| what are the 4 ways to retain fracture reduction |
|
Definition
| traction, casts/braces, external fixation, internal fixation |
|
|
Term
| what are the principles of fracture reduction |
|
Definition
| reduction is not always required. Closed reduction is preferred whenever possible |
|
|
Term
| what is the principle of closed reduction |
|
Definition
| 3 point contact and stabilization is necessary to maintain most closed reductions |
|
|
Term
| when are open reductions indicated |
|
Definition
| when closed reduction cannot be obtained or maintained, when precise reduction is required |
|
|
Term
| when is precise reduction required necessitating open reduction |
|
Definition
| intraarticular fracture when open reduction is needed to restore articular congruity and stability; when surgery is required for function such as a femur fracture |
|
|
Term
| what are the advantages of internal fixation |
|
Definition
| rigid fixation, you may be able to visualize the reduction |
|
|
Term
| what are the advantages of external fixation |
|
Definition
| maintain biology, early patient mobilization, adjustable |
|
|
Term
| what is the rationale for doing a total joint replacement |
|
Definition
| correct alignment, release contractures: need to be sure that the benefits outweigh the risks |
|
|
Term
| what are potential TJR complications |
|
Definition
| infections, blood clots, heart attack, stroke |
|
|
Term
| are blood clots common after TJR |
|
Definition
| calf clots occur in 50% of knee replacements, but these are not as clinically significant as proximal clots, which are rare but more dangerous |
|
|
Term
| why are heart attacks and strokes potential TJR complications |
|
Definition
| because of hypotension of surgery and occasionally because of bone cement |
|
|
Term
| what are the general PT interventions/considerations of TJR |
|
Definition
| functional mobility, ADLs, therapeutic exercise, education about precautions, ROM |
|
|
Term
| what are the posterior approach THA precautions |
|
Definition
| no flexion > 90, no adduction past neutral, no IR past neutral |
|
|
Term
| should you transfer to injured or uninjured side following posterior approach THA |
|
Definition
| transfer to uninjured side |
|
|
Term
| what are the precautions for anterior approach THA |
|
Definition
| no flexion > 90, no extension past neutral, no adduction past neutral, no ER past neutral, no combined flexion/abduction/ER |
|
|
Term
| if glute med was incised or a trochanteric osteotomy was done in anterior THA, what are additional precautions |
|
Definition
| no active antigravity hip ABD for 6-8 weeks |
|
|
Term
| should you do step to or step through gait after anterior approach THA |
|
Definition
| step to the operated hip to avoid hyperextension |
|
|
Term
| what is the onset of developmental hip dysplasia |
|
Definition
| present at birth or early in life |
|
|
Term
| what are risk factors of developmental dysplasia |
|
Definition
| family history, breech position, female |
|
|
Term
| what are signs/symptoms of early diagnosis of DDH |
|
Definition
| asymmetric skin increases, Ortolani, Barlow |
|
|
Term
| what does ortolani test for |
|
Definition
|
|
Term
|
Definition
| leg is adducted and flexed, then lifted into abducted frog legged position. Feel for click/clunk as femoral head pops back into place |
|
|
Term
| what does Barlow test for |
|
Definition
|
|
Term
|
Definition
| leg is adducted and flexed. Push axially to try to dislocate the hip |
|
|
Term
| what are signs/symptoms of DDH with late diagnosis (1yr) |
|
Definition
| asymmetric skin creases, apparent shortening, limited abduction, limp, xrays |
|
|
Term
| what is early treatment of DDH |
|
Definition
| maintain reduction with harness that flexes, abducts the hip |
|
|
Term
| what are treatments for someone with DDH who is less than 2-3 years |
|
Definition
| obtain and maintain reduction, manipulation, traction, surgical reduction |
|
|
Term
| what are treatments for someone with DDH who is more than 2-3 years |
|
Definition
| reduction and reconstruction |
|
|
Term
| what is an acetabular osteotomy |
|
Definition
| need to open up acetabulum, put the head in it, but then we also need to reconstruct the acetabulum so that it will face the right direction. Have to put a piece of the ilium in it to keep it in place |
|
|
Term
| what are the reductions/reconstructions for DDH in someone >2-3 years |
|
Definition
| femoral osteotomy, acetabular osteotomy |
|
|
Term
| what is the age of onset of Legg-Calve-Perthes |
|
Definition
|
|
Term
|
Definition
| bone necrosis of femoral epiphysis |
|
|
Term
| what are the signs/symptoms of LCP |
|
Definition
| limp; loss of ABD; loss of IR; atrophy; mild activity-related pain (maybe in knee) |
|
|
Term
| what are prognostic factors for LCP |
|
Definition
| age of onset, extent of involvement, range of motion, sphericity |
|
|
Term
| what is the most important prognostic factor that we can do something about in LCP |
|
Definition
| sphericity of femoral head |
|
|
Term
| what is the best way to promote sphericity of femoral head |
|
Definition
|
|
Term
| what is the age of onset of slipped capital femoral epiphysis |
|
Definition
| boys 10-16 years; girls 9-14 years |
|
|
Term
| what are the characteristics of a kid who is most likley to have slipped capital femoral epiphysis |
|
Definition
| more common in boys and obese children |
|
|
Term
| what are the signs/symptoms of slipped capital femoral epiphysis |
|
Definition
| same as legg calve perthese disease but in an older child: limp, pain with activity (could be in knee), limited IR, limited ABD, atrophy |
|
|
Term
| what are the intervnetions of slipped capital femoral epiphysis |
|
Definition
| stop progression: put in a screw to keep epiphysis from slipping further; correct alignment if needed to prevent AVN |
|
|
Term
| what is the functional range of motion of elbow F/E |
|
Definition
|
|
Term
| what is the functional range of motion of elbow sup/pron |
|
Definition
|
|
Term
| what is the natural range of elbow motion sup/pron |
|
Definition
|
|
Term
| what type of person is most likely to get lateral epicondylitis |
|
Definition
| most commonly seen in males 35-50 yo in dominant arm |
|
|
Term
| what is the tendon that is injured in lateral epicondylitis |
|
Definition
| extensor carpi radialis brevis |
|
|
Term
| how is lateral epicondylitis diagnosed |
|
Definition
| pain/tenderness at lateral epicondyle, +Cozen's test, + Mill's test, + Chair lift test, normal x-rays |
|
|
Term
|
Definition
| pain with resisted wrist extension and supination |
|
|
Term
|
Definition
| pain with passive wrist flexion with elbow extended |
|
|
Term
| what is a positive chair lift test |
|
Definition
| pain with lifting back of chair with 3 finger pinch and extended elbow |
|
|
Term
| what are differential diagnoses of lateral epicondylitis |
|
Definition
| cervical pathology, shoulder, DJD of radial head/olecranon, fracture, radial nerve |
|
|
Term
| how to determine that cervical pathology C5 C6 is not causing lateral epicondylitis symptoms |
|
Definition
| if you put your hand on your head and that relieves pain, it is taking strain off the nerve implicating cervical tissues |
|
|
Term
| how to rule out shoulder problems that look like lateral epicondylitis |
|
Definition
|
|
Term
| what are potential mechanisms of lateral epicondylitis |
|
Definition
|
|
Term
| why is lateral epicondylitis such a bugger |
|
Definition
| poor blood supply to tendon, insufficient healing. Cyclical symptoms: sub-clinical and back |
|
|
Term
| what are non-operative interventions for lateral epicondylitis |
|
Definition
| rest, ice, NSAIDs, wrist brace, modalities, corticosteroid injections, PT |
|
|
Term
| do most patients do well with non-operative treatment of lateral epicondylitis |
|
Definition
|
|
Term
| what are the 3 types of operative treatments of lateral epicondylitis |
|
Definition
| open, percutaneous, arthroscopic |
|
|
Term
| what is an open operation to repair lateral epicondylitis |
|
Definition
| excise ECRB, decorticate ECRB attachment area, pin it back down |
|
|
Term
| what is a percutaneous operation for lateral epicondylitis |
|
Definition
| release ECRB without pinning it back down |
|
|
Term
| what tendons are involved in medial epicondylitis |
|
Definition
| pronator teres, flexor carpi radialis |
|
|
Term
| how is medial epicondylitis diagnosed |
|
Definition
| Reverse Cozen's, Reverse Mill's |
|
|
Term
| what is reverse cozen's test |
|
Definition
| pain with resisted wrist flexion and pronation |
|
|
Term
| what is reverse mill's test |
|
Definition
| pain with passive wrist extension and elbow extended |
|
|
Term
| what are MOIs of medial epicondylitis |
|
Definition
| faulty mechanics, work station/athletic equpiment |
|
|
Term
| what are treatments for medial epicondylitis |
|
Definition
| cross friction massage, controlled exercise progressed based on pain, ice |
|
|
Term
| what types of exercises are good for medial epicondylitis |
|
Definition
| eccentric, controlled. Use theraba. 3 x 15 twice a day for 6-12 weeks. Gradually increase frequency, intensity, duration |
|
|
Term
| what nerve is impinged with cubital tunnel syndrome |
|
Definition
|
|
Term
| how is cubital tunnel syndrome/ulnar nerve impingement diagnosed? |
|
Definition
| pain in ulnar nerve distribution, symptoms increase with activity, weakness and atrophy of hypothenar eminence and thumb adductor, + Tinel's sign, + Upper Limb Tension Test, pain with hyperflexion |
|
|
Term
| what are MOIs of ulnar nerve impingement |
|
Definition
| direct trauma, traction, compression, recurrent subluxation, degenerative changes of surrounding bone |
|
|
Term
| where would compression of ulnar nerve occur |
|
Definition
| in cubital tunnel, at arcade of struthers, at arcade of osborne |
|
|
Term
| what are interventions of ulnar nerve impingement |
|
Definition
| rest, NSAIDs, education and protection, strengthen surrounding muscles, maintain ROM and nerve mobility, surgery |
|
|
Term
| how long after ulnar nerve surgery can athletes return to play |
|
Definition
|
|
Term
| what usually impinges the median nerve with pronator teres syndrome |
|
Definition
| pronator teres, ligament of struthers, bicipital aponeurosis, flexor digitorum superficialis |
|
|
Term
| how is median nerve impingement with pronator teres syndrome diagnosed |
|
Definition
| pain along median nerve distribution, median nerve sensory disturbance, weakness to the motor distribution (pronator teres may be spared) |
|
|
Term
| what are MOIs for median nerve impingement with pronator teres syndrome |
|
Definition
| repeated forceful pronation and finger flexion, trauma, compression, hypertrophy from repetitive gripping |
|
|
Term
| interventions for median nerve ontator teres syndrome |
|
Definition
| protection, rest, decreased activity |
|
|
Term
| what is most likely entrapping the median nerve with anterior interosseous syndrome |
|
Definition
| pronator teres, FDS, FDP/FDL interface |
|
|
Term
| how is anterior interosseous syndrome diagnosed |
|
Definition
| deep forearm pain, no sensory disturbance (pure motor), weakness to FPL/lateral FDP/quadratus, + pinch grip test |
|
|
Term
| what is a positive pinch grip test |
|
Definition
| can't make ok signor can't keep fingertip to fingertip with resistance |
|
|
Term
| potential mechanisms for median nerve impingement anterior interosseous syndrome |
|
Definition
| repeated forceful finger flexion, trauma, compression, hypertrophy |
|
|
Term
| what are interventions for anterior interosseous syndrome |
|
Definition
| protection, rest, decreased activity |
|
|
Term
| what is another term for radial nerve impingement |
|
Definition
| posterior interosseous syndrome |
|
|
Term
| how is radial nerve impingement diagnosed |
|
Definition
| weakness, but pain is not at lateral epicondyle. Deep forearm pain. maudsley's test |
|
|
Term
|
Definition
| resist 3rd finger extension. Pain at lateral epicondyle = lateral epicondylitis. Pain in forearm = posterior interosseous syndrome |
|
|
Term
| what is a differential diagnosis for radial nerve impingement |
|
Definition
|
|
Term
| what are mechanisms for radial nerve impingement |
|
Definition
| entrapment of supinators in Arcade of Froshe caused by grip with supination, wrist or finger extension, throwing |
|
|
Term
| if there is weakness with no pain, and there is no sensory loss, where is the radial nerve impingement |
|
Definition
| in or below the Arcade of Froshe |
|
|
Term
| if there is weakness with no pain, and there is sensory loss, where is the radial nerve impingement |
|
Definition
| proximal to Arcade of Froshe |
|
|
Term
| what are mechanisms for radial nerve impingement that has weakness and pain |
|
Definition
| trauma: radial fracture/dislocation or subluxation that puts pressure on radial nerve |
|
|
Term
| what type of injury is little league elbow |
|
Definition
|
|
Term
| what else is going on with little league elbow |
|
Definition
| separation/stress of growth plate at medial epicondyle, may have associated radial shearing |
|
|
Term
| diagnosis of little league elbow |
|
Definition
| TTP, + Tinel's sign of ulnar nerve, 0 deg extension valgus stress test |
|
|
Term
| what are potential mechanisms of little league elbow |
|
Definition
| traumatic or repetitive valgus stress |
|
|
Term
| interventions for little league elbow |
|
Definition
| rest, NSAIDS, assess biomechanics that caused injury, strengthen flexor carpi ulnaris and FDS, surgery |
|
|
Term
| what type of surgery is done on little leaguer |
|
Definition
| Tommy John Procedure: use plamaris longus or extensor hallucis tendon to repair UCL. |
|
|
Term
| when can little leaguer play again after tommy john procedur |
|
Definition
|
|
Term
| how long must little leaguer be in splint without ROM after Tommy John procedur |
|
Definition
|
|
Term
| describe ligament injury trace |
|
Definition
| normal joint play. 1-2mm movement |
|
|
Term
| describe grade I ligament injury |
|
Definition
| integrity maintained, 0-25% injury, up to 5 mm movement, pain, solid end feel |
|
|
Term
| describe grade II ligament injury |
|
Definition
| partial integrity loss, moderate injury, 25-75% injury, 6-10mm movement, pain, solid-mushy end feel |
|
|
Term
| describe grade III ligament injury |
|
Definition
| 75-100% injury, severe, >10mm movement, possibly no pain because of complete rupture |
|
|
Term
| what are some complications of post surgical elbow rehab |
|
Definition
|
|
Term
| when does capsular tightness occur following elbow surgery |
|
Definition
|
|
Term
|
Definition
| heterotopic ossification: extra bone growth in an area where it shouldn't be |
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