Hip and Pelvis

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Author:
hgienau
ID:
117335
Filename:
Hip and Pelvis
Updated:
2011-11-16 18:30:28
Tags:
Ortho 2011
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hg
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  1. When is a plevic fracture to be non-weightbearing
    If the fracture disrupts the pelvic ring
  2. Clinical Presentation of a pelvic fracture
    • significant pain and discomfort
    • transitional movements are difficuld and painful to perform
    • will want to remain in bed, reluctant to move - can lead to respirtatory and circulatory compromise
  3. Clincial management for pelvic fracture for a stable fracture
    • acute care
    • out of bed asap
    • 1st week- pain med before Rx, amubation with walker, funcation activites, gente strengthening , isometrics, closed chain
  4. Important Rehab considerations for Pelvic Fractures
    • Strengthening - stable avoid SLR Empasis on abducation
    • Unstable - no open chain exericses
  5. Clinical managment for a unstable pelvic fracture
    • limited weight bearing for 3 monts
    • isometric exercises
    • wheelchair management / gait training
    • Functional activties
    • week 12 increase aggressiveness of strengtheing
    • may need to go skilled
  6. Intracapsular hip fracture
    • femoral head
    • 47% of all fractures
    • usual caused by trauma
    • can be displaced or non displaced
    • risk of avascular nercosis - leads in THA
  7. Extracapsular Hip Fracture
    • Trochanteric or intertrochanteric
    • usual cause is trauma
    • 49% of fractures
    • stable or unstable
    • very little risk of avascular necrosis
    • .4%
  8. Clinical Presentation with a hip fracture
    • most likely surgically reduced and fixated
    • will have dressing and staples
    • may have drain
    • may have ted hose
    • may have compression pumps
  9. Acute managemnet for hip fractures
    • isometric exercise
    • ankle pumps
    • AAROM
    • bed mobility training
    • begin gait skills from side of bed following weight bearing precautions
    • transfers
    • standing balance activities
    • establish discharge parameters
  10. Subacute management for hip fractures
    • increase gait independence
    • advance asst device
    • increase standing balance ex
    • standing exercises -flex, abduction, toe raises, partial squats, extension, knee flexion
  11. Typical discharge parameters for hip fractures
    • independent in all bed mobility
    • Able to amb 100ft
    • independtent transfers or family trained
    • able to do stairs and curbs
  12. Reasons for total hip replacement
    • frature
    • OA
    • RA
    • bone cancer
  13. THA pre-op planning
    • class
    • PT consult
    • home assessment
    • blood donations
  14. Anterior THA
    • TFL, Glut Med
    • Precautions - hip ext, ER
  15. Lateral THA
    • Glut Med, Greater Trochanter
    • Precautions - IR, ADD, FLEX
  16. Posteriorlateral THA
    • most common
    • TFL, GLUT med, ER
    • IR, ADD, FLEX

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