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OT Process III Hip fracture and LE joint replacement
Terms in this set (34)
Specific risk factors for hip fractures
presence of osteoporosis, OA, RA
when does a fracture occur?
when the bone's ability to absorb tension, compression, or shearing force is exceeded.
causes of hip fracture are:
falling is most common
reduction of a fracture refers to __
restoring bone fragments to normal alignment
What are the two ways to perform reduction?
manipulation or surgery
A open procedure or surgery is one way to perform the reduction and is held in place by ___
internal fixation (pins, screws, a plate, nails, or a rod)
A closed procedure is done via manipulation and is held in place by __
cast, brace, traction, or skeletal fixation
indicates no weight at all can be placed on the extremity involved
toe-touch weight bearing; 90% of the weight is on the unaffected leg and only the toe may touch the ground for balance purposes
partial weight bearing; indicates only 50% of the person's body weight can be placed on the affected leg.
weight bearing at tolerance; indicates that clients are allowed to judge how much weight to place on the affected leg
full weight bearing; clients should be able to place 100% of their weight on the affected leg without causing damage to the fracture site.
A fracture that occurs just below the femoral head is called __
A fracture that occurs just below the femoral neck is ___
A client has sustained a hip fracture and received hip pinning which is typical with minimal displacement and in tact blood supply. What will this client typically be able to do?
begin out of bed activities in 1-3 days after surgery
weight bearing restrictions will apply and use of crutches or walker depending on union of healing
hemiarthroplasty (hemipolar arthroplasty)
replacement of the femoral head with synthetic one (endoprosthesis)
open reduction internal fixation
intertrochanteric fractures are most treated via __
posterolateral hip precautions (traditional or minimally invasive)
no hip flexion greater than 90 degrees
no internal rotation
no adduction (crossing legs or feet)
anterolateral precautions (traditional or minimally invasive)
no external rotation
hip abduction may be prohibited
minimally invasive technique
minimizes risk of postoperative limp and hip dislocation
small vertical incision made on anterior surface of hip joint
When a client is transferring from one surface to another, what is the general procedure to follow to ensure safety and protection of the involved side?
safety and protection of the involved side is maintained by
With knee or hip replacement done that uses cement weight bearing is typically __
no avoided post op
emphasis of rehab is __
maintain or increase joint motion
slowly increase the strength of the surrounding musculature
increase independence of client
OT will focus intervention on __
education about adaptive techniques in order to complete ADLs/IADL with limited mobility while maintaining joint precautions
list the most common types of adaptive equipment used during rehab of hip fractures and LE joint replacements
sequential compression devices
client controlled administration IV
continuous passive motion machine
describe how the case coordinator and occupational therapist can work together to ensure a safe discharge for the client
access to community resources for equipment and living accommodations, access to ongoing therapy after discharge from acute hospitalization
list two specific suggestions for performing sexual activities for someone with a hip fracture
refrain from sexual activity for 6 weeks
side-lying on the non-operates side -maintain abduction precautions with pillows
what information should be obtained during occupational profile
client's occupational history, prior functioning level of ADL/IADL, description of performance context (home, pool, work), and clients goals.
height of bed
home set up
psychosocial issues related to surgery
physical evaluation baseline (perf skills, client factors, UE ROM, strength, endurance, sensation, coordination
Then functional evaluation of ADL/IADL
two factors that affect fracture healing
age and health of the client
site and configuration of the fracture
blood supply and fragments
identify 2 ways an OT can address psychosocial adjustment to LE joint replacement and hip fracture ie: anxiety and fear
removal from familiar environment, emotional lability
make sure the client understands the intervention and procedures she is receiving as well as the prognosis associated with them
decorating the clients room with familiar objects and photos; use a calendar
why are weight bearing precautions observed with ORIF?
to protect from excessive forces
benefits of of conducting client education preoperative classes for persons who are at risk for falls or who are planning a joint replacement?
prepares the client for the process and prognosis
gives a sequence of events
opportunity answer questions
plan for postop expectations in clinic and at home
how will bilateral joint replacement impact rehab program?
slower progress because client cannot use a nonoperated leg
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