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122 Cards in this Set
- Front
- Back
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Comminuted Fracture
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Traction and Surgery main treatment
Sugar-tong splint with collar and cuff sling |
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Grade 1 compound fracture
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Rx - Ancef/Gentamicin and Tetanus
Fracture stabilization Closed intramedullary nail |
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Grade 2-3 compound Fracture
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Rx - Ancef/Gentamicin and Tetanus
Fracture stabilization Intramedullary nail or external fixator |
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Compression Fracture
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Rest, ICE, NSAID
Exercise/PT Surgery for impingement |
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Salter Harris Fracture 1-2
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Cast
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Salter Harris Fracture 3-5
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Soft Cast and refer to Ortho
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Simple (Closed) Fracture - Forarem
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Sugar-tong
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Simple (Closed) Fracture - Femur
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Traction
Skeletal or External Fixatoin Sager Splint |
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Simple (Closed) Fracture - Humerus (Proximal and Shaft)
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Proximal - sling and swathe
Shaft - Sling, Sugar-tong |
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Simple (Closed) Fracture - Distal Elbow
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Long arm sugar-tong
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Simple (Closed) Fracture - Distal Radius
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long or short arm sugar-tong
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Stress Fracture
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Surgical or Conservative
Conservative: NSAID Reduce weight to bone Splint |
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Bursitis
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NSAID, ICE
DO NOT ASPIRATE, drain if becomes chronic |
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Dislocation
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Reduce
Severe shoulder may be stabilized w/ arthroscopic surgery |
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Septic Bursitis
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Antibiotic tx w/Adequate Drainage
ABx = Dicloxacillian (PCN Allergy Clindamycin) Severe = IV vancomycin |
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Benign Solid Bone Cyst
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Aspiration w/ corticosteroid injection
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Ewing Sarcoma
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Radiation Therapy = 5 wks
Multidrug chemotherapy Ortho and Oncology Referal |
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Fibrous Coritcal Defect
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Self limited
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Lipoma
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Only remove if: Painful, Grow quickly, functional problem --> Must remove fibrous capsule
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Multiple Myeloma
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Intralesional Debridement
Chemotherapy - Melphalan Cortisone cemented intramedullary nails/prosthetics Radiation therapy of entire bone |
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Tendon Tears
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Rice, NSAID
Leg cast/immobilize PT Tx w/o surgery is tx of choice |
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ligament tear
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non-surgery or surgery
depends on pt age, mobility, athletic |
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Tendonitis
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Rest, ICE, NSAID
Strength exercise injection of anesthetic and cortisone Surgery for severe case |
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osteoid osteoma
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resolve spontaneously
symptomatic tx NSAID & ASA (No ASA w/ kids) |
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osteosarcoma
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multidrug chemotherapy and surgery - methotrexate or doxorubicin
90 % of surgery is limp sparing procedure |
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Strains and Sprain
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ICE
RICE Surgery for sever case |
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Septic Arthritis
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Antibiotic tx and drain
Abx 6 weeks = start with IV & switch to PO |
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Dry Gangrene
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Refer to Vascular Surgeon
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Wet/Gas Gangrene
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IV antibiotic and surgery debridement (primary tx)
Anticoagulants to prevent clotting IV fluids Pain Relieve Meds |
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Acute Hematogenous Osteomyelitis
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Start Antibiotics Empirically for 6 weeks
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Chronic Osteomyelitis
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Open Drainage
MC = Debridement and Reconstruction Adjunct Tx with Hyperbaric Oxygen |
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Acromioclavicular Joint Separation - Grade I-II
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Sling (2-4 wks)
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Acromioclavicular Joint Separation - Grade III
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Surgical or Non surgical
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Acromioclavicular Joint Separation - Grade III-V
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open reduction
internal fixation reconstruction of CC ligament |
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De Quervian's Tenosynovitis
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Rest, ICE, Analgesics
Thumb spica splint |
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Dupuytren's Tenosynovitis
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Heat/stretching/ultrasound/ splint
Injectable collagenase and triamcinolone Surgery |
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Epicondylitis (medial or lateral)
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NSAID
PT Injection or surgery for extreme case |
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Ganglion Cyst (wrist)
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Immobilize wrist
Aspiration Surgical excision if/when significant |
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Ganglion Cyst (hand/finger)
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Needle Puncture
Surgical management for pain DO NOT ASPIRATE/RUPTURE |
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Radial Head Subluxation
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Reduce
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Rotator Cuff Disorder
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Rest, moist heat
NSAID Steroid Injection |
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Rotator Cuff Tear
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Surgery
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Thoracic Outlet Syndrome
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NSAID
MOST tx with PT Surgery Relief of nerve compression |
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Distal Radius Fracture
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reduce
Sugartong splint |
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Proximal Humerus Fracture
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Reduce
Sling/ Swathe |
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Distal Humerus Fracture
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reduce
sugartong splint |
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Stress Fracture
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managed w/ discontinued activity for 3-6 weeks
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Femur Fracture
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Reduce/Relocate if subluxation
Traction Sager Splint (Or Bucks traction, Skeletal Traction and External Fixation) |
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Tibia/Fibula Fracture
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Evaluate to prevent skin necrosis
Reduce Long Leg non weight bearing cast DO NO USE STIRRUP SPLINT OR SHORT LEG SPLINT |
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Distal Phalanx Fracture
(stable) |
Reduce
Immobilize w/ buddy tape |
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Distal Phalanx Fracture
(unstable) |
Reduce
Immobilize w/ splint/cast radiograph 7-10 days later |
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Proximal/Middle Phalanx Fracture
(stable) |
Immobilization w/ splint
followed by buddy tape |
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Proximal/Middle Phalanx Fracture
(unstable) |
immobilize forearm, wrist, injured digit --> cast/splint
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Bennet Fracture (Thumb Fracture) or Any Carpometacarpal Joint Fracture
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surgical reduction and pinning
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Metacarpal Head Fracture
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open surgery if 20-30% of joint involved = refer
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Metacarpal Neck Fracture
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40 degrees or less = gutter splint 3 weeks
40 degrees or more = closed reduction/surgery |
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Shaft (boxer's) Fracture
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single metacarpal = splint/cast 4-6 weeks
Multiple metacarpal = refer |
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DIP Fracture
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surgery referral if more than 30% of joint damaged and subluxed
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Condylar Fracture
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Emergent referral
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PIP Fracture
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splint 6 weeks in extended position
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Rib Fracture
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Analgesic for pain
Consider Rib belt |
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Rolando Fracture
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open surgical reduction/immobilization by pinning
cast |
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Scaphoid Fracture
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closed reduction
immobilization cast 6-20 weeks |
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Clavicle Fracture
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rest
sling/immobilization 3-4 weeks home PT program |
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Extraarticular Fracture
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open reduction
splint/casting |
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Colle's Fracture
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closed reduction
sugartong splint |
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C-spine
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High resistance neck brace (immobilization)
Emergent Referral |
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Boutonniere Deformity
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Splint
Exercise Protection Surgery if severe |
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Mallet Finger
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Surgery to reattach tendon w/in 10 days of injury
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Swan Neck Deformity
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Mild = finger brace
Severe = surgery (Skin release, ligament reconstruction, joint fusion/replacement) |
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Achilles Tendon Rupture
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MC in young athletes= Surgery
Non-Athlete = non weight bearing and splint 8 weeks PT |
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Aseptic Necrosis
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No weight bearing
Surgery: osteotomy, resurfacing arthroplasty, hemiarthroplasty, total arthroplasty, core decompression |
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Plantar Fasciitis
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NSAID
REST, ICE PT |
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Talipes Equinovarus (Club Foot)
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initial = PT w/ passive manipulation soon after birth
Surgery for severe |
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Pes Planus or Rigid Flat Foot
(flat foot) |
Pes planus = reassurance
Rigid Flat Foot = surgery |
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Hallus Valgus Deformity
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nonoperative = appropriate footwear, pads for bunion/calluses, orthotics/gels
surgical |
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Legg-Calve Perthes Disease
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<5 yro w/ minor involvement w/ and good ROM = NO TX
> 4-5 yro w/ significant collapse, loss of abduction = abduction (Petrie) cast/ ambulatory brace Surgical |
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Developmental Hip Dysplasia
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Newborn: Pavilik harness 1-6 months
6 months - 2 year = femur manipulation then casted |
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Slipped capital femoral epiphysis
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Emergent surgical repair
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Meniscus Injuries
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RICE
Arthroscopic Eval Surgery |
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Osgood-Schlatter
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Self limited
NSAID RICE |
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osteochondritis dissecans
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spontaneous healing
If fragment is free, must be removed = ortho referral |
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Genu Varum (bowleg)
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persist beyond 2 = ortho referral
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Genu Valgum (knock knee)
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Resolve spontaneously
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Tibial Torsion
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resolve spontaneously
may be corrected with night splint |
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Chondromalacia patellae
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rest, ice
NSAID PT |
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patellofemoral arthralgia
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conservative tx = rest, ice NSAID
surgery |
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Transient Synovitis
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Bed rest
NSAID Will resolve in Days |
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Ankylosing spondylitis
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initial = exercise and NSAID
surgery (only in 10 % of PT) |
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Cauda equina syndrome
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prompt surgical decompression
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Cervical Radiculopathy
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1st: NSAID and Cervical Coller
2nd: Surgery (Fusion or decompression) |
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Coccydynia
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Padded Seat
Medication: Steroid Injections &/or Analgesics |
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Costochondritis
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Analgesics
Heat Rest |
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Degenerative Disk Disease
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NSAID and PT
Last resort Surgery |
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Disc Herniation
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Self limited to 6 weeks
NSAIDS Surgery Last resort |
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Low Back Pain
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Self limiting
Conservative tx: analgesic Corticosteroid injections surgery last resort |
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scoliosis
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mild: managed conservatively with brace
Curvature > than 40 degree = surgery |
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Spinal stenosis
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Weight loss, Exercise/PT
Severe/persist = surgery (high cure rate) |
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Spondylolysis
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refrain from movement until symptoms resolve
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Carpal Tunnel Syndrome
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night splint
PT Steroid injection Surgery |
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Isthmic Spondylolisthesis
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Low grade: restrict activities, brace and PT
Greater Slippage: Fusion/decompression |
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Degenerative Spondylolisthesis
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Decompression and Fusion
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Kyphosis
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severe case: bracing or surgery
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Lordosis
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MC = PT
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Duchenne's Muscular Dystrophy
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No treatment available
(Prednisone may help temporarily) |
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Fibromyalgia
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DO NOT TX with NARCOTIC
NSAID, Behavioral therapy PT No treatment/ drug is best |
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Giant Cell Artertitis
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High oral prednisone
TX urgent to prevent blindness |
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Gout
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1st: NSAIDs
Colchicine to prevent flare up Allopurinol Corticosteroids (for NSAID intolerance) ASA should be avoided |
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pseudogout
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Acute attack: Immobilization, elevation, NSAID
Meds: NSAID, Colchicine, corticosteroid injection Joint aspiration |
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Inflammatory Arthritis
(Rheumatoid Arthritis) |
1st line = DMARDS: Methotrexate, Hydroxycholroquine
NSAIDS, Corticosteroids Biological Agents |
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Juvenile Rheumatoid Arthritis
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1st: NSAID
2nd: DMARD (methotrexate/sulfasalazine) immunosuppresants, corticosteroids, anti-TNF drug |
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Non-inflammatory Arthritis
(osteoarthritis) |
NSAID - Acetaminophen
PT/exercise |
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osteogenesis imperfecta
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supportive/protective equipment
Manage fractures Gene therapy = future tx |
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Polyarteritis nodosa
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High dose corticosteroid
antiviral therapy, and plasma pheresis Immunosuppressant: cyclophosphamide |
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polymyalgia rheumatica
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Low dose prednisone
(taper after 2-3 weeks of asymptomatic) |
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Raynaud phenomenon
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1st line: Calcium channel blocker
Wear gloves/mittens (protect hands) |
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Reiter's Syndrome
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Rest & Joint Immobilization
NSAIDs, steroid injections, immunosuppressants IV penicillin, tetracycline |
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Scleroderma
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Refer: Rheumatologist
NSAID, corticosteroid, DMARD |
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Systemic Lupus Erythematous
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corticosteroid - Prednisone
DMARD - azathioprine |
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osteoporosis
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Vitamin D and Calcium supplement
Bisphosphonate Sex hormone |
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Sjogren's syndrome
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EYES/ MOUTH = Artificial Tears, fluids for dental care
ARTHRITIS = NSAID, DMARD (hydroxychlorquine) |
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polymyositis
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Prednisone
DMARD PT |
