N2261: Total Hip Replacement/ Total Hip Arthroplasty

Terms in this set (28)

4 types (Manual, Skin, Skeletal and External Fixation

Skeletal:
- aligns bones or joints
- used for complex fractures (ex: 3 breaks or more)
- longer term use
- pin or wire is inserted into the bone to align and immobilize fracture
- weights range from 2-20 kg
- increased risk of infection due to pin site and prolonged immobility
- pin sites are a portal of entry of microbes and they require fastidious care to prevent osteomyelitis and other infections
- uses weights and needs to be maintained in a certain position (some surgeons insist that weights not be removed; others allow 20 minutes at a time twice a day for skin care etc.)
- the patient is in bed for 6-8 weeks (risk or pressure sore, muscle wasting, weakness, renal stones, pneumonia, skin irritation and hypotension

Skin:
- short term use (ex: 72 hours prior to surgery)
- maintains alignment, assists in reduction and decreases spasm
- weight is usually 2.3-4.5 kg
- most commonly used for fractured hip
- ex: Buck's Extension is a velcro boot wrapped around effected limb with a weight on the end with the individual acting as counter traction; the patient is constantly being dragged towards the end of the bed and so frequent repositioning is required; if the patient gets too low in bed, there is no counter traction

External Fixation (Hoffman's Apparatus)
- metal pins are inserted into bone and attached to rods to stabilize fracture while it heals
- the device can be adjusted to realign bone
- used to immobilize bone when casts or other methods are innappropriate
- do not use the device to move limbs; limbs must be supported at proximal and distal ends and lifted

Circoelectric Beds:
- used to tilt patients into a near standing position
- engages vasculary system (particularly in lower legs to prevent DVT and avoid hypotension)

Manual:
- simple, closed reduction can be used prior to putting on a cast
- pulling force in applied by hand to provide temporary immobilization, usually accompanied by sedation and anaesthesia to assist with application of immobilizing device
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