5. What are the fractures that delay or prevent bone healing/callus formation?

 Edema
 Diabetes
 Infection
 Poor nutrition
 Insufficient immobilization
 Callus formation easily broken down
8. How would you position the patient:

a. Post-hip surgery
 Patient is usually positioned supine in bed.
 The affected extremity is held in slight abduction by either abduction splint or pillow or Buck’s
extension traction to prevent dislocation of the prosthesis.
 Avoid acute flexion of the hip.
 The patient must not adduct or flex the operated hip – may lead to subluxation or dislocation
of hip.

b. Post knee surgery

 A towel roll should be placed at the ankle to promote knee extension when patients are
supine in bed.
 Nothing should be placed behind the operative knee, to promote maximal knee extension and
prevent knee flexion contracture.
 Encourage active flexion of the foot every hour.

c. Spinal fracture
 Prone position
 Supine position with head traction in anterior approach to cervical spine
 Sitting or decubitus position: occasionally

9. What is Congenital clubfoor and congenital hip dislocation? Its management.

Congenital clubfoot – is a deformity in which an infant’s foot is turned inward, often so severely that the
bottom of the foot faces sideways or even upward.

Management:
Most cases of clubfoot are successfully treated with non-surgical methods that may include a
combination of stretching, casting and bracing. Treatment usually begins shortly after birth.
Congenital hip dislocation-occurs when child is born with unstable hip.it is caused by abnormal formation of
the hip joint during their early stages of fetal development. Another name for this condition is
“developmental dysplasia of the hip”. This instability worsens as the child grows.

Management:

 Pavlik Harness –this harness presses their hip joints into the sockets. The harness abducts the
hip by securing their legs in a frog like position. The baby may wear the harness for 6-12 weeks
depending on their age and the severity of the condition. Child needs surgery if the treatment
with Pavlik harness is unsuccessful or the baby is too big for the harness. Surgery occurs with
general anesthesia and may include maneuvering their hip into the socket which is called close
reduction or the surgeon will lengthen the baby’s tendons and remove the obstacles before
positioning the hip this is called open reduction. After the baby’s hip is placed into position their
hips and legs will be cast for atleast 12 weeks.