Podcast
Questions and Answers
Which of the following is a common cause of bone fractures?
Which of the following is a common cause of bone fractures?
- High force impact (correct)
- Prolonged rest
- Regular exercise
- High-fiber diet
What is a characteristic of an open (compound) fracture?
What is a characteristic of an open (compound) fracture?
- The bones remain aligned
- The fracture is barely out of place
- The fracture is not exposed to the outside
- The fracture is exposed to the outside through a wound (correct)
What is a primary characteristic of a stable fracture?
What is a primary characteristic of a stable fracture?
- The broken ends of the bones are basically aligned (correct)
- The bones are exposed through a wound
- The bone is shattered into many pieces
- The broken ends of the bones are significantly displaced
Which type of fracture has a horizontal fracture line?
Which type of fracture has a horizontal fracture line?
What force typically causes a spiral fracture?
What force typically causes a spiral fracture?
What distinguishes a comminuted fracture from other types of fractures?
What distinguishes a comminuted fracture from other types of fractures?
At what location does an avulsion fracture typically occur?
At what location does an avulsion fracture typically occur?
Which of the following is an immediate effect of a fracture?
Which of the following is an immediate effect of a fracture?
What is one of the primary aims in the treatment of a fracture?
What is one of the primary aims in the treatment of a fracture?
Which of the following occurs during the inflammatory phase of fracture healing?
Which of the following occurs during the inflammatory phase of fracture healing?
What is the role of soft cartilaginous callus formation in fracture healing?
What is the role of soft cartilaginous callus formation in fracture healing?
What characterizes 'delayed union' in fracture healing?
What characterizes 'delayed union' in fracture healing?
What term describes a fracture that heals in an abnormal position?
What term describes a fracture that heals in an abnormal position?
Which of the following is a basic step in fracture treatment?
Which of the following is a basic step in fracture treatment?
What does 'reduction' refer to in the context of fracture treatment?
What does 'reduction' refer to in the context of fracture treatment?
What is the primary concern with open fractures compared to closed fractures?
What is the primary concern with open fractures compared to closed fractures?
What is debridement in the treatment of open fractures?
What is debridement in the treatment of open fractures?
What is the purpose of external fixation in fracture treatment?
What is the purpose of external fixation in fracture treatment?
Why is rehabilitation important after fracture treatment?
Why is rehabilitation important after fracture treatment?
Which factor is MOST likely to determine whether a fracture is classified as stable versus unstable?
Which factor is MOST likely to determine whether a fracture is classified as stable versus unstable?
Which of the following is a primary goal of using a functional fracture brace?
Which of the following is a primary goal of using a functional fracture brace?
According to the soft tissue hydraulic theory, how does a cast support fracture healing?
According to the soft tissue hydraulic theory, how does a cast support fracture healing?
What role does the interosseous membrane play in fractures of the leg or forearm?
What role does the interosseous membrane play in fractures of the leg or forearm?
Why is a moderate level of micromovement considered beneficial at a fracture site?
Why is a moderate level of micromovement considered beneficial at a fracture site?
How does using a functional fracture brace (FFB) improve blood supply at the fracture site?
How does using a functional fracture brace (FFB) improve blood supply at the fracture site?
What is one advantage of orthotic management of tibial fractures?
What is one advantage of orthotic management of tibial fractures?
In orthotic management for tibial fractures, what is an important consideration for the wound area?
In orthotic management for tibial fractures, what is an important consideration for the wound area?
What is the definition of a spinal cord injury (SCI)?
What is the definition of a spinal cord injury (SCI)?
Which of the following mechanisms can cause a spinal cord injury?
Which of the following mechanisms can cause a spinal cord injury?
How many pairs of spinal nerves are there?
How many pairs of spinal nerves are there?
What regions are the 31 pairs of spinal nerves divided into?
What regions are the 31 pairs of spinal nerves divided into?
How many bones are in the spine (vertebrae)?
How many bones are in the spine (vertebrae)?
What is a dermatome?
What is a dermatome?
What is a myotome?
What is a myotome?
In spinal cord injury, what does quadriplegia (tetraplegia) refer to?
In spinal cord injury, what does quadriplegia (tetraplegia) refer to?
In spinal cord injury, what does paraplegia refer to?
In spinal cord injury, what does paraplegia refer to?
What is the difference between a complete and incomplete spinal cord injury?
What is the difference between a complete and incomplete spinal cord injury?
What is spinal shock following a spinal cord injury?
What is spinal shock following a spinal cord injury?
Which secondary complications do individuals with spinal cord injuries experience?
Which secondary complications do individuals with spinal cord injuries experience?
What level of SCI is a patient at if they are candidates for orthotic intervention for walking?
What level of SCI is a patient at if they are candidates for orthotic intervention for walking?
What is a key function of AFOs (Ankle-Foot Orthoses) in SCI management?
What is a key function of AFOs (Ankle-Foot Orthoses) in SCI management?
What is a main purpose of KAFOs (Knee-Ankle-Foot Orthoses) in SCI management?
What is a main purpose of KAFOs (Knee-Ankle-Foot Orthoses) in SCI management?
What is a reason a patient may require orthotic hip joints?
What is a reason a patient may require orthotic hip joints?
What is the primary purpose of RGOs (Reciprocal Gait Orthoses)?
What is the primary purpose of RGOs (Reciprocal Gait Orthoses)?
Which of the following is the MOST accurate definition of a bone fracture?
Which of the following is the MOST accurate definition of a bone fracture?
A patient has a bone fracture due to a low-impact injury, possibly caused by a pre-existing condition. Which of the following conditions is MOST likely the cause?
A patient has a bone fracture due to a low-impact injury, possibly caused by a pre-existing condition. Which of the following conditions is MOST likely the cause?
In which type of fracture is the bone exposed through the skin?
In which type of fracture is the bone exposed through the skin?
What primary characteristic defines a displaced fracture?
What primary characteristic defines a displaced fracture?
When both the tibia and fibula are fractured transversely, what does MOST often result?
When both the tibia and fibula are fractured transversely, what does MOST often result?
What is a KEY characteristic of an oblique fracture that influences its management?
What is a KEY characteristic of an oblique fracture that influences its management?
In a comminuted fracture, how many fragments does the bone typically shatter into?
In a comminuted fracture, how many fragments does the bone typically shatter into?
Why are open fractures considered more serious than closed fractures?
Why are open fractures considered more serious than closed fractures?
Which of the following is the MOST immediate effect of a bone fracture?
Which of the following is the MOST immediate effect of a bone fracture?
What is a crucial step in the initial treatment of an open fracture to reduce the risk of infection?
What is a crucial step in the initial treatment of an open fracture to reduce the risk of infection?
During fracture healing, what is the PRIMARY role of the soft cartilaginous callus?
During fracture healing, what is the PRIMARY role of the soft cartilaginous callus?
What is the PRIMARY goal of 'reduction' in the treatment of fractures?
What is the PRIMARY goal of 'reduction' in the treatment of fractures?
Which of the following BEST describes the rationale behind using external fixation for treating fractures?
Which of the following BEST describes the rationale behind using external fixation for treating fractures?
Why is mobilizing the healthy parts of the anatomy important during rehabilitation after a fracture?
Why is mobilizing the healthy parts of the anatomy important during rehabilitation after a fracture?
Which of the following BEST explains the 'soft tissue hydraulic theory' in the context of fracture bracing?
Which of the following BEST explains the 'soft tissue hydraulic theory' in the context of fracture bracing?
Which of the following is the MOST significant role of the interosseous membrane in the context of tibial or forearm fractures?
Which of the following is the MOST significant role of the interosseous membrane in the context of tibial or forearm fractures?
Why is some level of micromovement now considered beneficial during fracture healing when using functional braces?
Why is some level of micromovement now considered beneficial during fracture healing when using functional braces?
What is one of the primary advantages of using orthotic management for tibial fractures compared to traditional casting?
What is one of the primary advantages of using orthotic management for tibial fractures compared to traditional casting?
In designing an orthosis for a tibial fracture with a wound, what is the MOST important modification that an orthotist should consider?
In designing an orthosis for a tibial fracture with a wound, what is the MOST important modification that an orthotist should consider?
A surgeon insists on using a weight-relieving caliper brace based solely on the theory that fractures must be completely off-loaded, and dismisses concerns by the orthotist about potential disuse atrophy. Which of the following arguments BEST challenges the surgeon's rigid adherence to the weight-relieving caliper theory in light of modern fracture management principles, assuming the fracture is stable enough to tolerate some load?
A surgeon insists on using a weight-relieving caliper brace based solely on the theory that fractures must be completely off-loaded, and dismisses concerns by the orthotist about potential disuse atrophy. Which of the following arguments BEST challenges the surgeon's rigid adherence to the weight-relieving caliper theory in light of modern fracture management principles, assuming the fracture is stable enough to tolerate some load?
A bone fracture is defined as a disruption in the bone's continuity.
A bone fracture is defined as a disruption in the bone's continuity.
Osteogenesis imperfecta, also known as 'strong bone disease', is a genetic condition leading to fragile bones.
Osteogenesis imperfecta, also known as 'strong bone disease', is a genetic condition leading to fragile bones.
A closed fracture involves the bone protruding through the skin.
A closed fracture involves the bone protruding through the skin.
In a stable fracture, the broken bone ends are significantly displaced and misaligned.
In a stable fracture, the broken bone ends are significantly displaced and misaligned.
A transverse fracture runs vertically along the bone shaft.
A transverse fracture runs vertically along the bone shaft.
Oblique fractures are generally considered stable and rarely shift out of place.
Oblique fractures are generally considered stable and rarely shift out of place.
Spiral fractures are commonly caused by compression forces acting on the bone.
Spiral fractures are commonly caused by compression forces acting on the bone.
Comminuted fractures involve the bone shattering into multiple pieces.
Comminuted fractures involve the bone shattering into multiple pieces.
An avulsion fracture occurs when a ligament pulls away a piece of bone at the point of attachment.
An avulsion fracture occurs when a ligament pulls away a piece of bone at the point of attachment.
Deformity is not a common effect of fractures.
Deformity is not a common effect of fractures.
A primary aim of treating fractures is to exacerbate complications.
A primary aim of treating fractures is to exacerbate complications.
The first phase of bone healing involves the formation of a hard, bony callus.
The first phase of bone healing involves the formation of a hard, bony callus.
In delayed union, the fracture heals faster than expected.
In delayed union, the fracture heals faster than expected.
Non-union describes a fracture that fails to heal.
Non-union describes a fracture that fails to heal.
Reduction involves realigning bone fragments to their normal position.
Reduction involves realigning bone fragments to their normal position.
Open reduction involves aligning the bone fragments without surgical exposure.
Open reduction involves aligning the bone fragments without surgical exposure.
Open fractures typically have a lower risk of infection compared to closed fractures.
Open fractures typically have a lower risk of infection compared to closed fractures.
Debridement, used in treating open fractures, involves removing dead tissues.
Debridement, used in treating open fractures, involves removing dead tissues.
External fixation is exclusively a conservative (non-surgical) method of immobilization.
External fixation is exclusively a conservative (non-surgical) method of immobilization.
Plaster of Paris casts are an example of an internal fixation method.
Plaster of Paris casts are an example of an internal fixation method.
Rehabilitation after a fracture should only begin once the fracture is fully healed.
Rehabilitation after a fracture should only begin once the fracture is fully healed.
The weight-relieving caliper theory suggests weight-bearing should be entirely avoided above the fracture site.
The weight-relieving caliper theory suggests weight-bearing should be entirely avoided above the fracture site.
According to the Soft Tissue Hydraulic Theory, the soft tissues surrounding a fracture do not absorb stresses.
According to the Soft Tissue Hydraulic Theory, the soft tissues surrounding a fracture do not absorb stresses.
The gradual fracture load bearing theory states that a fracture site should never bear any load during healing.
The gradual fracture load bearing theory states that a fracture site should never bear any load during healing.
If the interosseous membrane in the leg or forearm remains intact during a fracture, maintaining bone fragment alignment becomes more challenging.
If the interosseous membrane in the leg or forearm remains intact during a fracture, maintaining bone fragment alignment becomes more challenging.
Complete rigidity is essential for optimal fracture healing.
Complete rigidity is essential for optimal fracture healing.
Improved blood supply at a fracture site reduces callus formation.
Improved blood supply at a fracture site reduces callus formation.
According to the source, having soft tissue compressed within an orthosis surrounding long bones has the effect of the surrounding soft tissues behaving as an incompressible mass.
According to the source, having soft tissue compressed within an orthosis surrounding long bones has the effect of the surrounding soft tissues behaving as an incompressible mass.
Orthotic management of tibial fractures offers no benefit in facilitating wound inspection.
Orthotic management of tibial fractures offers no benefit in facilitating wound inspection.
When using orthotic considerations for tibial fracture, gentle compression should be avoided when covering the limb with a stocking.
When using orthotic considerations for tibial fracture, gentle compression should be avoided when covering the limb with a stocking.
Spinal cord injury (SCI) always results in permanent loss of motor and sensory function.
Spinal cord injury (SCI) always results in permanent loss of motor and sensory function.
Direct trauma is the only mechanism by which a spinal cord injury can occur.
Direct trauma is the only mechanism by which a spinal cord injury can occur.
There are 33 pairs of spinal nerves.
There are 33 pairs of spinal nerves.
A dermatome relates to an area of skin.
A dermatome relates to an area of skin.
Myotomes relate to muscles.
Myotomes relate to muscles.
A C6 spinal injury would cause finger abduction.
A C6 spinal injury would cause finger abduction.
Quadriplegia results from damage to the thoracic spinal cord.
Quadriplegia results from damage to the thoracic spinal cord.
Incomplete spinal cord injuries never have any presence of function below the point of injury.
Incomplete spinal cord injuries never have any presence of function below the point of injury.
Patients with injury level of L1 or lower are not candidates for orthotic intervention for walking.
Patients with injury level of L1 or lower are not candidates for orthotic intervention for walking.
Bone fractures are characterized by a compromise in the bone's physical continuity.
Bone fractures are characterized by a compromise in the bone's physical continuity.
Minimum trauma injuries are typical in individuals with healthy bone density.
Minimum trauma injuries are typical in individuals with healthy bone density.
In a closed fracture, the bone fragments penetrate the skin, leading to an increased risk of infection.
In a closed fracture, the bone fragments penetrate the skin, leading to an increased risk of infection.
An oblique fracture is characterized by a fracture line that runs perpendicular to the bone's axis.
An oblique fracture is characterized by a fracture line that runs perpendicular to the bone's axis.
A stable fracture is significantly displaced and requires immediate surgical intervention to realign the bone.
A stable fracture is significantly displaced and requires immediate surgical intervention to realign the bone.
Avulsion fractures commonly occur due to compressive forces directly impacting the bone shaft.
Avulsion fractures commonly occur due to compressive forces directly impacting the bone shaft.
Comminuted fractures characteristically involve the bone shattering into multiple (3 or more) fragments.
Comminuted fractures characteristically involve the bone shattering into multiple (3 or more) fragments.
Deformity is a typical sign of a fracture.
Deformity is a typical sign of a fracture.
A primary aim in fracture treatment is to exacerbate any existing complications.
A primary aim in fracture treatment is to exacerbate any existing complications.
During fracture healing, a hard callus, composed of cartilage, forms initially to provide stability.
During fracture healing, a hard callus, composed of cartilage, forms initially to provide stability.
In fracture treatment, reduction refers to the process of introducing infectious agents to stimulate bone repair.
In fracture treatment, reduction refers to the process of introducing infectious agents to stimulate bone repair.
Open fractures typically have fewer complications and faster healing times compared to closed fractures due to direct vascular access.
Open fractures typically have fewer complications and faster healing times compared to closed fractures due to direct vascular access.
The advantage of using a Plaster of Paris (POP) cast is that it allows for dynamic movement and weight-bearing during the initial healing phase.
The advantage of using a Plaster of Paris (POP) cast is that it allows for dynamic movement and weight-bearing during the initial healing phase.
Micromovement at the fracture site is detrimental and should be completely eliminated to ensure proper bone union.
Micromovement at the fracture site is detrimental and should be completely eliminated to ensure proper bone union.
Functional fracture braces are designed to encourage some degree of activity, potentially enhancing the healing environment.
Functional fracture braces are designed to encourage some degree of activity, potentially enhancing the healing environment.
In spinal cord injuries (SCI), damage to the spinal cord always results in permanent loss of motor and sensory function below the level of injury.
In spinal cord injuries (SCI), damage to the spinal cord always results in permanent loss of motor and sensory function below the level of injury.
Spinal cord injuries primarily result from chronic diseases like osteoporosis rather than traumatic events.
Spinal cord injuries primarily result from chronic diseases like osteoporosis rather than traumatic events.
The presence of some retained function below the injury site in spinal cord injuries suggests a complete injury with an unfavorable prognosis.
The presence of some retained function below the injury site in spinal cord injuries suggests a complete injury with an unfavorable prognosis.
In SCI, orthotic intervention is only considered for patients with complete injuries as they provide the most benefit in terms of mobility and function.
In SCI, orthotic intervention is only considered for patients with complete injuries as they provide the most benefit in terms of mobility and function.
Individuals with spinal cord injuries above the T9 level are typically strong candidates for AFOs.
Individuals with spinal cord injuries above the T9 level are typically strong candidates for AFOs.
List three potential causes of bone fractures beyond direct trauma.
List three potential causes of bone fractures beyond direct trauma.
Differentiate between a closed and an open fracture.
Differentiate between a closed and an open fracture.
What is a comminuted fracture?
What is a comminuted fracture?
Describe what is meant by "reduction" in the context of fracture treatment?
Describe what is meant by "reduction" in the context of fracture treatment?
What are the three basic steps for fracture treatment?
What are the three basic steps for fracture treatment?
Explain the primary risk associated with open fractures compared to closed fractures.
Explain the primary risk associated with open fractures compared to closed fractures.
List two methods of immobilization used in fracture treatment.
List two methods of immobilization used in fracture treatment.
What is the main goal of rehabilitation in the context of fracture management?
What is the main goal of rehabilitation in the context of fracture management?
Describe how functional bracing improves fracture healing compared to casting.
Describe how functional bracing improves fracture healing compared to casting.
What is the difference between delayed union and non-union in fracture healing?
What is the difference between delayed union and non-union in fracture healing?
What is the primary function of the interosseous membrane in the context of lower leg fractures?
What is the primary function of the interosseous membrane in the context of lower leg fractures?
Explain the soft tissue hydraulic theory in the context of fracture bracing.
Explain the soft tissue hydraulic theory in the context of fracture bracing.
What are the signs of fracture?
What are the signs of fracture?
What is the primary aim of fracture treatment?
What is the primary aim of fracture treatment?
Explain the first two steps of fracture healing.
Explain the first two steps of fracture healing.
Name 3 possible negative effects of a fracture?
Name 3 possible negative effects of a fracture?
What is an avulsion fracture?
What is an avulsion fracture?
What is meant by closed reduction?
What is meant by closed reduction?
When is external fixation indicated?
When is external fixation indicated?
Give on example of an external appliance used for immobilization.
Give on example of an external appliance used for immobilization.
Where is an intramedullary nail placed?
Where is an intramedullary nail placed?
Describe what differentiates a spinal cord injury from a typical bone fracture, highlighting the primary concern in SCI.
Describe what differentiates a spinal cord injury from a typical bone fracture, highlighting the primary concern in SCI.
Name two mechanisms that can lead to spinal cord injury?
Name two mechanisms that can lead to spinal cord injury?
Name the number of spinal nerve pairs for each section of the spine.
Name the number of spinal nerve pairs for each section of the spine.
What is the difference between quadriplegia and paraplegia?
What is the difference between quadriplegia and paraplegia?
What is meant by incomplete spinal cord injury?
What is meant by incomplete spinal cord injury?
List 2 possible medical complications that can occur after a spinal cord injury?
List 2 possible medical complications that can occur after a spinal cord injury?
For orthotic intervention for walking, which level injury should the patients have?
For orthotic intervention for walking, which level injury should the patients have?
What two orthoses are mentioned?
What two orthoses are mentioned?
When are KAFOs prescribed?
When are KAFOs prescribed?
Name on purpose of KAFOs.
Name on purpose of KAFOs.
What is the purpose of HKAFOs?
What is the purpose of HKAFOs?
Name the key element in functional fracture bracing theory that promotes healing by counteracting the negative effects of complete immobilization?
Name the key element in functional fracture bracing theory that promotes healing by counteracting the negative effects of complete immobilization?
Describe how a functional fracture brace (FFB) leverages the 'soft tissue hydraulic theory' to provide support and stability to a tibial fracture.
Describe how a functional fracture brace (FFB) leverages the 'soft tissue hydraulic theory' to provide support and stability to a tibial fracture.
Explain the clinical significance of dermatomes in assessing spinal cord injuries, and provide an example of how this knowledge is applied.
Explain the clinical significance of dermatomes in assessing spinal cord injuries, and provide an example of how this knowledge is applied.
Explain why 'Early Ambulation' is considered an advantage of Orthotic Management of Tibial Fractures, detailing its physiological benefits.
Explain why 'Early Ambulation' is considered an advantage of Orthotic Management of Tibial Fractures, detailing its physiological benefits.
A patient presents with a spiral fracture of the tibia and a fracture of the fibula due to a skiing accident. Explain the biomechanical rationale for choosing a functional fracture brace over a traditional cast in this scenario, considering the typical instability of transverse fractures.
A patient presents with a spiral fracture of the tibia and a fracture of the fibula due to a skiing accident. Explain the biomechanical rationale for choosing a functional fracture brace over a traditional cast in this scenario, considering the typical instability of transverse fractures.
Imagine a scenario where a patient with a T10 spinal cord injury is being considered for orthotic intervention. Elaborate on the factors that would influence your decision between prescribing AFOs versus KAFOs, specifically addressing the expected level of trunk control, potential for knee instability, and the long-term impact on energy expenditure during ambulation.
Imagine a scenario where a patient with a T10 spinal cord injury is being considered for orthotic intervention. Elaborate on the factors that would influence your decision between prescribing AFOs versus KAFOs, specifically addressing the expected level of trunk control, potential for knee instability, and the long-term impact on energy expenditure during ambulation.
If an individual damages their C7 myotome, what motion will be limited?
If an individual damages their C7 myotome, what motion will be limited?
What is the medical term for a bone fracture, abbreviated?
What is the medical term for a bone fracture, abbreviated?
What are the two main categories of bone fractures based on skin penetration?
What are the two main categories of bone fractures based on skin penetration?
What is the primary difference between a stable and a displaced fracture?
What is the primary difference between a stable and a displaced fracture?
Name one of the main aims of fracture treatment.
Name one of the main aims of fracture treatment.
Describe a transverse fracture.
Describe a transverse fracture.
What is the primary cause of a spiral fracture?
What is the primary cause of a spiral fracture?
Define a comminuted fracture.
Define a comminuted fracture.
What is the term for the restoration of normal bone alignment?
What is the term for the restoration of normal bone alignment?
Which type of fracture is exposed to the outside environment and carries a higher risk of infection?
Which type of fracture is exposed to the outside environment and carries a higher risk of infection?
In fracture healing, what is the role of the soft cartilaginous callus?
In fracture healing, what is the role of the soft cartilaginous callus?
What are the two methods of reduction?
What are the two methods of reduction?
What are the aims of treatment in fracture management?
What are the aims of treatment in fracture management?
What is the potential consequence of delayed union or non-union in fracture healing?
What is the potential consequence of delayed union or non-union in fracture healing?
Explain the significance of the interosseous membrane in fractures of the leg or forearm.
Explain the significance of the interosseous membrane in fractures of the leg or forearm.
What are the 3 main theories for Functional Fracture Braces?
What are the 3 main theories for Functional Fracture Braces?
Describe the Soft Tissue Hydraulic Theory.
Describe the Soft Tissue Hydraulic Theory.
What is the main advantage of using orthotic management for tibial fractures compared to traditional casting methods?
What is the main advantage of using orthotic management for tibial fractures compared to traditional casting methods?
Explain the trade-offs between complete immobilization and controlled micromovement at a fracture site, and how functional bracing addresses this.
Explain the trade-offs between complete immobilization and controlled micromovement at a fracture site, and how functional bracing addresses this.
Integrating your knowledge of fracture types, biomechanics, and healing principles, propose a novel functional brace design that optimizes healing for oblique fractures of the tibia, considering factors like stability, weight-bearing, and prevention of rotational forces.
Integrating your knowledge of fracture types, biomechanics, and healing principles, propose a novel functional brace design that optimizes healing for oblique fractures of the tibia, considering factors like stability, weight-bearing, and prevention of rotational forces.
Flashcards
Bone Fracture
Bone Fracture
A medical condition in which there is a break in the continuity of the bone.
Closed (Simple) Fracture
Closed (Simple) Fracture
The fracture is not exposed to the outside; there is no open wound.
Open (Compound) Fracture
Open (Compound) Fracture
The fracture is exposed to the outside through a break in the skin.
Stable Fracture
Stable Fracture
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Displaced Fracture
Displaced Fracture
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Transverse Fracture
Transverse Fracture
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Oblique Fracture
Oblique Fracture
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Spiral Fracture
Spiral Fracture
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Comminuted Fracture
Comminuted Fracture
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Avulsion Fracture
Avulsion Fracture
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Internal Bleeding (Fracture)
Internal Bleeding (Fracture)
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Neurovascular Injury (Fracture)
Neurovascular Injury (Fracture)
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Swelling (Fracture)
Swelling (Fracture)
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Fracture Pain
Fracture Pain
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Fracture Deformity
Fracture Deformity
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Loss of Function (Fracture)
Loss of Function (Fracture)
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Abnormal Motion (Fracture)
Abnormal Motion (Fracture)
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Fracture Healing Process
Fracture Healing Process
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Delayed Union
Delayed Union
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Non-union
Non-union
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Mal-union
Mal-union
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Reduction (Fracture)
Reduction (Fracture)
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Closed Manipulation
Closed Manipulation
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Open Reduction
Open Reduction
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Traction (Fracture)
Traction (Fracture)
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Immobilization (Fracture)
Immobilization (Fracture)
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External Appliances (Fracture)
External Appliances (Fracture)
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Plaster of Paris (POP) Cast:
Plaster of Paris (POP) Cast:
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Internal Fixation (Fracture)
Internal Fixation (Fracture)
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Functional Fracture Braces
Functional Fracture Braces
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Cleansing (Open Fracture)
Cleansing (Open Fracture)
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Debridement
Debridement
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External Fixation (Fracture)
External Fixation (Fracture)
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Antibiotics
Antibiotics
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Rehabilitation (Fracture)
Rehabilitation (Fracture)
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Spinal Cord Injury (SCI)
Spinal Cord Injury (SCI)
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SCI Mechanism
SCI Mechanism
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Quadriplegia (Tetraplegia)
Quadriplegia (Tetraplegia)
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Paraplegia
Paraplegia
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Incomplete SCI
Incomplete SCI
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Complete SCI
Complete SCI
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Spinal Shock
Spinal Shock
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SCI - Orthoses Considerations
SCI - Orthoses Considerations
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Orthotic intervention for walking
Orthotic intervention for walking
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SCI-AFOs
SCI-AFOs
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SCI-KAFOs
SCI-KAFOs
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Bone Fracture Causes
Bone Fracture Causes
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Transverse Fracture Characteristics
Transverse Fracture Characteristics
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Oblique Fracture Characteristics
Oblique Fracture Characteristics
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Blood Clots (Fractures)
Blood Clots (Fractures)
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Soft Tissue Hydraulic Theory Contribution
Soft Tissue Hydraulic Theory Contribution
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Gradual Fracture Load Bearing Theory focus
Gradual Fracture Load Bearing Theory focus
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Interosseous Membrane Benefit
Interosseous Membrane Benefit
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Micromovement at Fracture Site
Micromovement at Fracture Site
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Soft Tissue Action with Orthosis
Soft Tissue Action with Orthosis
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Orthotic Management Advantages
Orthotic Management Advantages
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Orthotic Considerations for Tibial Fractures
Orthotic Considerations for Tibial Fractures
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Other SCI Causes
Other SCI Causes
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Dermatome Definition
Dermatome Definition
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Myotome Definition
Myotome Definition
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Dermatomes Use
Dermatomes Use
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Myotomes Use
Myotomes Use
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KAFOs Purpose
KAFOs Purpose
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When are HKAFOs/RGOs required?
When are HKAFOs/RGOs required?
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HKAFOs/RGOs locked hip meaning
HKAFOs/RGOs locked hip meaning
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HKAFOs/RGOs unlocked hip meaning
HKAFOs/RGOs unlocked hip meaning
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Stable Fracture Definition
Stable Fracture Definition
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Displaced Fracture Definition
Displaced Fracture Definition
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Bone Fracture Results From
Bone Fracture Results From
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Bone Loss (Open Fractures)
Bone Loss (Open Fractures)
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Tissue Damage (Open Fractures)
Tissue Damage (Open Fractures)
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Delayed Union Cause
Delayed Union Cause
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Tibial Shell Use
Tibial Shell Use
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SCI Improve
SCI Improve
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HKAFOs/RGOs unlocked hip action
HKAFOs/RGOs unlocked hip action
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Study Notes
- Functional fracture braces aid in bone fracture management.
Bone Fracture
- Bone fracture (FRX, Fx, Fx, or #)is a medical condition where there is a break in the continuity of the bone.
- Results from high force impacts or stress exceeding the bone's bending ability, often from falls, sports injuries, or vehicle accidents.
- Can result from minimal trauma in certain medical conditions that weaken bones like osteoporosis, bone cancer, or osteogenesis imperfecta (brittle bone disease), a genetic condition with soft, easily broken bones.
Classification of Fractures
- Closed (Simple) Fracture: Fracture is not exposed to the outside, no wound present.
- Open (Compound) Fracture: Fracture exposed to the outside through a wound.
- The larger the wound, the greater the risk of infection.
Stable vs Displaced Fracture
- Stable Fracture: Fracture is barely out of place.
- The broken ends of the bones are aligned correctly.
- The bones usually stay in place during healing.
- Displaced Fracture: When a bone breaks and is displaced, the broken ends are separated.
- These fractures often require surgery to put the pieces back together.
Types of Fractures
- Transverse Fracture: Horizontal fracture line.
- Unstable, especially if the fibula is also broken in addition to the tibia.
- Oblique Fracture: Angled pattern.
- Typically unstable, even if initially stable, becoming more displaced over time.
- Spiral Fracture: Caused by twisting force.
- Spiral-shaped fracture line about the bone.
- Can be either stable or displaced, depending on the force causing the fracture.
- Comminuted Fracture: Bone shatters into 3 or 4 pieces.
- Very unstable.
- Avulsion Fracture: A bony fragment is pulled away from the main body of the bone.
- Occurs at the point of tendon attachment.
Effects of Fractures
- Internal bleeding
- Injury to major blood vessels and/or nerves
- Swelling
- Pain
- Deformity
- Loss of function
- Abnormal motion
Aims of Treatment
- Healing of fracture
- Minimize complications
- Restoration of functions
Fracture Healing Process
- Inflammatory Phase: Blood coagulates, and a hematoma forms.
- Formation of Soft Cartilaginous Callus: Provides stability to the bone.
- Capillaries connect to the callus.
- Soft Callus is reabsorbed and replaced by hard bony callus.
- Hard bony cell is reabsorbed and remodeled into normal strong bone.
Problems in Fracture Healing
- Delayed Union: Healing takes longer than expected.
- Non-union: Fracture does not heal.
- Mal-union: Fracture unites in an abnormal position.
Basic Steps for Treatment
- Reduction: Restoration of normal alignment of the bones.
- Immobilization: Stabilizing the fracture.
- Rehabilitation: Restoring function
Reduction
- Restoration of the normal alignment of the bones.
- Closed manipulation (without surgical exposure)
- Open reduction (through a wound or surgical exposure)
- Traction with skin or skeletal implementations
Open Fractures
- Tissue damage is usually more extensive compared to closed fractures.
- Leads to poor blood supply.
- Poor defense to infection and wound contamination.
- Bone loss may occur as small fragments need removal, leading to slow, complicated healing.
Treatment of Open Fractures
- Cleansing
- Removal of dead tissues (Debridement)
- External fixation of fracture
- Use of antibiotics
Anatomical Treatment
- Traction
- External appliances (Conservative)
- Plaster of Paris (POP) Cast
- Orthosis
- External fixation (Surgical)
- Internal fixation (Surgical)
- Intramedullary nails
- Pins
- Screws and Plate
Theories
- Weight-relieving Caliper Theory (Earlier theory): Weight-bearing through ischial tuberosity, off-loaded above fracture site.
- Soft Tissue Hydraulic Theory
- The cast converts the limb into a semi-rigid hydraulic tube, which supports the fracture
- Soft tissue thus absorbs stresses by behaving as fluids.
- Encased in a rigid container (the cast)prevents outward expansion.
- Pressure of the soft tissue against the cast equalize the collapsing forces
- Gradual Fracture Load Bearing Theory: The fracture site itself bears the load during healing.
- Patients use crutches to provide progressive loads on the fracture bone.
- Brace acts as an anti-buckling tube to prevent bending rather than for weight-bearing.
- Role of Interosseous Membrane: Fractures of the leg or forearm if the interosseous membrane remains intact, the alignment of bone fragments will be easier to be maintained.
- Micromovement: No perfect rigidity inside a brace.
- Immobility is neither helpful nor necessary to healing, a moderate level of movement (physiological) could aid healing.
- Blood clots form at the fracture site.
- These clots supply nutrients and promote fibroblasts action in callus formation (fibroblast: cell that contributes to the formation of connective tissue).
- Microvascular invasion is reduced When the fracture site is immobilize
- Functional fracture brace (FFB) use, activity can be maintained and the environment for healing improves.
Orthotic Management of Tibial Fracture
- Soft tissue surrounding the long bones behaving as an incompressible mass while contained within the orthosis
- The soft tissues will hold the bone fragments in appropriate alignment and ensure the length of the bony fragments is maintained.
Advantages of Orthotic Management of Tibial Fracture
- Early ambulation
- Promotes bone healing
- Lighter
- Facilitate would inspection & healing
- Adjustable
- Cosmetic
- Economic (total cost concept)
Orthotic Considerations for Tibial Fracture
- Wound should be suitably dressed
- Cover limb with stocking, applying gentle pressure.
- Tibial shell should encompass entire lower limb from knee to ankle.
- Proximal & Posterior shell should be similar to PTB prosthetic socket.
- It should allow knee flexion and incorporate mechanical ankle joints.
Spinal Cord Injury (SCI)
- Insult to spinal cord resulting in a change in the normal motor, sensory or autonomic function.
- This can be either temporary or permanent.
Mechanisms
- Direct trauma, compression by bone fragments or hematoma, disc material.
- Ischemia from damage or impingement on the spinal arteries.
Other Causes
- Vascular disorders
- Tumors
- Infectious conditions
- Spondylosis via the degeneration of column
- Vertebral fractures secondary to osteoporosis.
- Development disorders.
Spine (Spinal Cord)
- 31 pairs of spinal nerves are present
- 8 Cervical
- 12 thoracic
- 5 lumber
- 5 sacral
- 1 coccygeal
Spine (Vertebrae)
- 33 bones
- C7
- T12
- L5
- S5
- Coccyx 4 (fused)
Dermatomes
- Area of skin innervated by sensory axons within a particular segmental nerve root. Knowledge is essential in determining the level of injury.
- Useful in assessing improvement or deterioration.
Myotomes
- Segmental nerve root innervating a muscle.
- Important in determining level of injury
Upper Limb
- C5: Shoulder abduction
- C6: Wrist extension
- C7: Elbow extension
- C8 : Finger flexion
- T1 : Finger abduction
Lower Limbs
- L2: Hip flexion
- L3,4 : Knee extension
- L4, L5, S1 : Knee flexion
- L5: Ankle dorsiflexion
- S1: Ankle plantar flexion
Spinal Cord Injury Classification
- Quadriplegia (Tetraplegia)
- Injury is in the cervical region.
- All 4 extremities are affected.
- Paraplegia
- Injury is in thoracic, lumbar, or sacral segments.
- 2 extremities are affected.
- Incomplete injury: Some functions are present below site of injury and has a more favorable prognosis overall.
- Complete Injury: Loss of voluntary movements of the parts, innervated by segment, which is irreversible.
- Loss of sensation.
- Spinal shock: Temporary loss of muscle tone and spinal reflexes below the level of injury.
Considerations for Orthoses
- Spinal cord injury is one of the most traumatic and disabling orthopedic conditions.
- Most patients diagnosed with a significant spinal cord injury are confined to a wheelchair for the most part of their lives.
- Aside from a significant loss of sensory/motor functions below the lesion, paraplegic subjects may also experience medical complications. Spasticity. Joint contractures. Pressure sores. Osteoporosis. Urinary tract infections
- 95% of patients usually suffer from at least one secondary complication
- 58% have 3 or more complications
- Standing and walking in some way helps improve patients physiological and psychological well being
- Physiologically, standing and walking helps with joint contractures, urinary and bowel function, spasticity, incidence of pressure sores.
- Likewise, patients can improve psychologically.
Orthotic Intervention
- Candidates for orthotic intervention for walking are patients with injury level of L1 or lower, and who have incomplete injuries
- They usually have functional trunk muscular strength to use
- AFOS
- KAFOS
- Candidates include Patients with incomplete SCI and Lesion level between L4 and S2
- AFOs support weaken muscles around the ankle joint and address excessive plantarflexion
- KAFOs are prescribed when AFOs cannot provide sufficient control of knee stability due to knee extensor weakness or laxity and prescribed to patients with incomplete SCI between L1 to T9 injury levels
- Purpose
- Manage involuntary movements such as spasticity and hypertonicity
- Support ankle and knee
- Control joint movement to prevent painful and undesired position
HKAFOS & RGOS
- Patients may require orthotic hip joints because of the following reasons Hip flexion, knee flexion or ankle plantarflexion contractures, Poor balance, Reduced motor control
- Orthotic hip joint can provide stability.
- If orthotic hip joint is locked patients use Swing-to or swing-through gait
- If orthotic hip joint can be unlocked patients use RGO, or walking with reciprocal gait patterns
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