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2010-03-28 16:18:23
General Orthopedics OP

OP study cards
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  1. Definition + Etiology
    • Medial Tibial Periostitis (MTSS, MTTP): Overuse, overtraining, hard surface, poor shoe choice, bad warmup, bad biomechanics, Pes planus, tight posterior leg MMs (Soleus eccentrically resists pronation, overpronation = traction on attachments)
    • CECS: Changes in mechanical properties of fascia
    • Age: + children, - seniors
  2. CIs + Precautions
    MTP (MTSS, MTTP): ?????????????????????

    CECS: Acute = medical emergeancy
  3. S&S
    MTP (MTSS, MTTP): Tenderness 5cm diffuse area at post-med margin of middle-distal 1/3rd of tibia. Pain on RRoM plantarflexion, passive soleus stretch or unilateral hopping. Pain decreases with warmup, returns after activity. Localized swelling possible. + women.

    • CECS: Achy and tight in compartment
    • No pain at rest. Pain gruadually builds during activity (10-15 mins), decreases at rest
    • Swelling can comprimize blood supply, cause NN or MM damage
    • MM weaknesss and parestesia possible
    • MM herniation?
  4. H
    • Nature/behavior of pain
    • Change in exercise, shoe, repetitive ADLs.
    • Health, diet
  5. O
    • Local swelling, erythema, biomechanics of foot (pes planus, rigid cavus etc), lower leg, knee,
    • Gait
  6. P
    • Diffuse tenderness over 5cm area
    • SH
    • Pain in vertical orientation
  7. M
    Soleus PRoM and RRoM pain
  8. N
    Probably not.
  9. R
  10. S
    Unilateral hopping
  11. Tx Goals
    • Decr inflammation
    • Adress underlying cause
    • Rest from activity/modification
    • pt Edu - retrain posture/gait
    • Decr scar tissue formation, adhesions
    • Balance MM/retrain proprioception
  12. Tx
    • MFR, Soleus/FDL TrP/MFR + passive ankle movements
    • Swedish
    • jt mobes
    • MLD, fine vibes, light strokes for inflammation
    • Frictions in sub-acute
    • Stimulate hypotonic MM
    • Contract/Relax, PRoM
  13. Hydro
    • Cool/cold for swelling
    • DMH prior to Tx for chronic
  14. RemEx
    • Proper warm, gruadual return to activity (start slow, go slow)
    • Pain-free cross-training, MM balancing
    • Gait re-education
    • Change training surface
    • Footwear change (every 300 miles)
    • Pediatrist