MUSCULOSKELETAL

PROBLEMS
SKELETAL SYSTEM
• Framework of body
• Supports vital organs
• Hematopoietic function
• Stores minerals
• Assists in movements
Modalities
• Immobilization
• Casts, traction, internal fixation,
external fixation, splints, braces
• PT
• Hot/cold compress, massage, exercise
CASTS
• Materials • Purpose
• 2-8 inches • Immobilize
• X muscle spasm
• 12-48 hrs
• Reduce fx
• Align bone
• X deformity
Management
• Use palms
• Elevate in room
• May use hair dryer
• Insert 1-2 fingers between skin and cast
• Check for CMS for q2h
Management
• Check for infection
• Nsg. Mgt
• Bivalving/windowing
• Antibiotics
• Asepto-syringe (itchiness)
• Benadryl
TRACTION
• Principles
• Supine
• Q traction = counter-traction
• X friction along line of pool
• Continuous application
Types (Manner/Mode of Application)
• Skin traction • Skeletal traction
• Buck’s • Crutchfield tong
• Russel’s • Vinke tong
• Bryant’s • Manual
Types (Use)
• Intermittent
• Continuous
• Running
• Balance
 OSTEOPOROSIS
• Formation < Resorption • Mgt
• Cause • Fossamax/
• Estrogen Alendromate
• Steroid • Fluid
• Caffeine • Vit. D
• Cigarette • Exercise
• Exercise • Smoking
• Ca
 FRACTURE
• Simple/closed
• Compound/open
• Infection and hemorrhage
• Immobilize fracture
• Bleeding
• s/sx
• Pain, bruising, shortening, limitation, joint swelling, crepitus
• Cx
• Embolism, hemorrhage, infection, compartment syndrome
Compartment Syndrome
• s/sx • Mgt
• Pain • Elevate
• Pallor • Fasciotomy
• Paresthesia • Bone reduction
• Pulselessness • Open
• Paralysis • Closed
AMPUTATION
• Supine with elevated stump
• Prone 20 mins q 4-6 H; flat on bed
• Must @ bedside: tourniquet
Assistive Devices
• Crutch • Cane
• Swing-through • Walker
• Swing-to
• Wheelchair
• 3-point
• 4-point
• 2-point
JOINTS
• SYNARTHROSES • DIARTHROSES
• Immovable • Free
• Skull suture • Ball-&-socket
• AMPHIARTHROSES • Hinge
• Slightly movable • Pivot
• Symphysis pubis • Condyloid
ARTHIRITIS (Inflammatory)
RHEUMATOID ARTHRITIS
• Systemic inflammation of synovial
membrane of diarthroid joint
• Chronic
• s/sx
• Morning stiffnes
• SQ nodules
• Pannus formation
RHEUMATOID ARTHRITIS
• Dx • Mgt
• WBC • Apply compress
• CRP • Warm tub bath then
• ANA exercise
• RF • Drugs
• Hip replacement
ARTHRITIS
(Degenerative)
OSTEOARTHRITIS
• Degeneration/atrophy
• Heberden’s, Bouchard’s, morning stiffness
• Mgt:
• Cold/warm compress
• Tub bath
• Paracetamol, NSAID
ARTHRITIS (Metabolic)
GOUTY ARTHRITIS
• Cause • Mgt
• Purine • Bed cradle
• Tophi • Drugs
• Colchicine
• s/sx • Allopurinol
• Severe pulsating pain • Probenecid
• Linen pain • Fluid