- List factors that influence the rate of bone loss.
a. Hormonal status, nutrition, smoking, alcohol use, and activity level
- Which population has the greatest vulnerability to bone fracture?
a. Both young children as well as postsurgical children and adults
- For which conditions are hip orthoses indicated?
a. Inadequate or ineffective development of the acetabulum and head of the femur in infancy.
b. Avascular necrosis of the femoral head associated with inadequate blood supply during childhood.
c. loss of cartilage and abnormal bone deposition associated with OA.
d. Loss of bone strength and density in osteoporosis.
- List 2 important functions of the hip joint.
a. Support the top half of the body during functional activities.
b. Translate motion to the lower half of the body.
- How long does clinical union of a fracture take in the repair phase post injury and what is recommended during this timeframe?
a. Can last up to 3 months.
b. Immobilization.
- How long does the process of callus maturation last, particularly with complex fractures?
a. Can last a year or more.
- What are intertrochanteric fractures?
a. Fractures of the femoral metaphysis; they may require ORIF or hip replacement.
- How are fractures of the pelvis classified?
a. They are classified as either stable or unstable on the basis of the extent of damage that disrupts the circumferential integrity of the pelvis.
- What are persons with unstable fractures of the pelvis at risk for?
a. At risk for life threatening hemorrhage, residual genitourinary or neurological complications because of the vessels, nerves, muscles, and organs that are housed within the pelvis
- What is a pathological fracture?
a. Fractures due to underlying pathologies that compromise bone density or metabolism.
- What factors/issues does the orthopedist consider when choosing an appropriate immobilization strategy?
a. Stability of the fracture site and how well a device will be able to maintain fracture reduction and achieve desired result.
b. The condition of the skin and the soft tissue
c. Limb volume over time, i.e., edema.
d. Patient’s ability to comply with instructions.
- What are 2 reasons a bent knee cast is chosen for immobilization?
a. NWB must be ensured.
b. Aid in controlling tibial rotation.
- What are custom-fabricated/fit fracture orthoses designed to do?
a. Designed to maintain a body part in optimal anatomical position, limit joint motion, and unload weight bearing forces.
- What is the major advantage of fracture orthoses vs cast brace?
a. Can be removed for wound care.
- What might be added to an AFO fracture orthosis to compensate for limited heel, ankle, and toe rocker motion during gait?
a. A cushion heel and rocker sole.
- What structures of the distal LE require adequate clearance of the trimlines of an AFO fracture orthosis?
a. Proximally the trim line is at the tibial tubercle for the head of the fibula and the peroneal nerve
- What does a PTB fracture orthosis do for the tibia during weight bearing activities?
a. Protection form bending and rotary torque for the tibia during weight bearing activities
- What is the purpose of a knee/ankle/foot fracture orthosis?
a. To provide long term protection for fractures of the distal to middle femur or for fractures about the knee.
- If axial unloading is desired (loading of the femur, tibia, foot) what must be used to achieve this during ambulation with a fracture orthosis?
a. Crutches or walker must be used.
- What type of device is used when the fracture disrupts pelvic stability?
a. External fixation devices.
- In what period of time after a fracture or dislocation must the blood supply and nutrition to the distal muscle and bone be restored before significant tissue death occurs?
a. 6-8 hours.
- Name one of the most important considerations for LE fractures regarding mobility.
a. Weight bearing status.
