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List the function of bones
- Rigid support for the body
- protection of viscera, SC and Brain
- Storage of calcium and phosphate
- Production of blood cells
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Skeletal Muscle Function
- movement
- maintain position
- stabilize
- body temperature
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Function of the Ligaments
- Attach bone to bone
- static stabilizers
- non contractile
- propioceptors
- little blood supply slow healing
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Effects of Anabolic Steroids
- synthetic hormones that muscle strength and mass
- Serious side effect: liver damage, CV disease, personality changes, emotional lability and sterility
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Function of Tendons
- attach muscle to bone
- dynamic stabilizers
- contractile
- little blood supply, slow healing
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Stages of Healing
- Hematoma
- Granulation tissue
- Procallus (fibrocartiliage) -PWB, fragile
- Bony callus - stronger
- Remolding: osteoclast remove fracture pieces remodel bone, WB usually allowed
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Complications from Fractures
- Damage to adjacent tissue/ structures
- Pain ms. spasm
- Ischemia
- if open risk for infection
- nerve damage
- failure to heal
- compartment syndrome (swelling with in the fasicle compartemnt can lead to nerve and circulatory sompression pain can lead to ampulation)
- Fat emboli - from blood marrow
- In near joint can lead to deformities
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Factors that affect healing time.
- Age of Pt
- Site and confiuration of fracture
- Intial displacement of frature
- blood supply
- UE 6-12 wks
- LE 12-24wks
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Rehab Treatment Goals
- Presserve function during immob.
- kunut ns atropy maintain circulation minimize contracture return to previous functiona level
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Rehab Complications
- Early: poor healing due to infection, poor circulation
- non union or mal unions
- skin
- vascular
- Late:
- Persistent osteomyelitis - bone infection
- Joint Adhesions
- RSD
- Post Traumatic osteoporosis
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Management of Dislocations
- reduction and immobilization
- Gradual Return to mobility
- ROM: avoid the motions of dislocation
- gradual strenthening program
- function activites
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Define Subluxation
partial displacement, partial contact of bone surfaces
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Define Dislocation
complete loss of joint interrity with loss of joint anatomical relationship
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Define a sprain
an injury to a ligament where the ligament sustains a load or force sufficient to produce a mechanical disruption of structural fibers
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Grade of sprains
- Grade 1: microscpoic tear, no joint laxity, present with mild edema and pain with activity
- Grade II: tearing of some fibers: moderate laxity moderate pain limits activity movement and palaption are painful, Treat non-surgically: PRICE
- Grade III: near complete or complete rupture, prfound laxity and unstable may be treated surgically will be immobilized follow facility and doctors protocols
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Define Strains
Injury to a musculo-tendon unit, results from over stretching or excessive contraction orces (often in awkard positions) that exceed the physiological limit of the tissue
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Grades of Strains
- Grade I: less than 50% damage
- Grade II: more than 50% damage
- Grade III: complete tear
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Sprains Common Sites, Treatment and Prevention
- Common Sites: AC joint, Latera ankle, hand and finger
- Treatment: Acute: PRICE
- Rehab: early WB and control inflammation
- Prevention: braces, tape, strength, flexability, warm-up
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Strains S&S, Treatment, and Prevention
- S&S: pain wiht AROM, tender to palpation. May feel a knot may see brusing or swelling
- Grade III: marked pain during activity which subsides. absolute loss of function. Ruptured tissue will be felt as a ball that has migrated toward the intact insertion point of bone
- Treatment: price
- Prevention: warm up, dont move in awkward posistions
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Signs and Sym of Meniscal Injuries
- May cuase knee to lock in flexed position
- Pain at time of injury then subsides to mild edema
- Sensation of joint crepitue of licking
- Specific test to confirm dx, best test is arthroscope
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