Professional Documents
Culture Documents
A fracture, caused by
repeated , prolonged
or abnormal stress
A pulling away of a
fragment of bone by a
ligament or tendon and
its attachment.
• Cylindrical Leg
cast; for
Fractured patella
TYPES OF CAST, MOLDS
AND INDICATIONS
• Quadrilateral
(Ischial Weight
Bearing) Cast: for
fractured shaft of
the femur with
callus formation
TYPES OF CAST, MOLDS
AND INDICATIONS
• Cast Brace: for
fracture of the
femur (distal
curve) with
flexion and
extension.
TYPES OF CAST, MOLDS
AND INDICATIONS
• Short Leg
Circular Cast:
ankle and foot
fracture
TYPES OF CAST, MOLDS
AND INDICATIONS
• PTB (Patellar
Tendon Bearing)
Cast: for
fractured tibia-
fibula with callus
formation
TYPES OF CAST, MOLDS
AND INDICATIONS
• Delvet/Delbit
Cast: fracture of
tibia or fibula
TYPES OF CAST, MOLDS
AND INDICATIONS
• Short Leg
Posterior Mold:
ankle and foot
with compound
affectation
TYPES OF CAST, MOLDS
AND INDICATIONS
• Internal Rotator
Splint: for post
hip operation
TYPES OF CAST, MOLDS
AND INDICATIONS
• Cocked-Up Splint
for wrist drop
TYPES OF CAST, MOLDS
AND INDICATIONS
• Night Splint:
for post
polio
TYPES OF CAST, MOLDS
AND INDICATIONS
• For fracture of
humerus
BOOT LEG TRACTION
• Pelvic Girdle
– For lumbo-sacral
affection and
Herniated Nucleus
Pulposus
BRYANT’S SKIN TRACTION
• for femoral
fracture, hip
injuries among
kids below 3 years
old
HALO FEMORAL
• For severe
scoliosis
HALO PELVIC
• For Scoliosis
90 DEGREE
• For fracture of
femur
STOVE IN CHEST
• For
supracondylar
fracture of the
humerus
HAMMOCK SUSPENSION
KRUTCHEDFIELD TONGS
VINKE’S CALIPER
TOWERS
TYPES OF BRACES,
SPLINTS AND INDICATIONS
1. Banjo Splint: for peripheral nerve injury.
2. Bilateral Leg Brace: for polio
3. Chair Back Brace: lumbo-sacral affectation
4. Cock up splint: for wrist drop
5. Dennis Brown Splint: Clubfoot or Talipes
6. Finger Splint: for fractured digits
7. Forester Brace; lower thoracic and upper lumbar affectation
8. Jewett Brace: for scoliosis T9 and above
9. Milwaukee Brace: lower thoracic and upper lumbar
affectation
10. Shantz Collar: cervical affectation
12. Unilateral leg Brace: polio unilateral affectation
13. Yamamoto Brace: severe scoliosis T9 and below.
MILWAUKEE BRACE
• For Scoliosis
FORESTER BRACE
• Cervico-Thoraco
Lumbar Affection
Spine
YAMAMOTO
• For Scoliosis
TAYLOR BRACE
• For Lumbo-sacral
fracture
CERVICAL COLLAR/ SHUNTZ
COLLAR
• For cervical
affection
PHILADELPHIA
• For Cervical
affection
BANJO SPLINT
• For Peripheral
Nerve Injury
LIVELY FINGER SPLINT
• For fracture of
finger
DENIS BROWNE SPLINT
• For Clubfoot or
talipes
equinovarus
UNILATERAL LEG BRACE
• For Polio
(bilateral leg)
Roger Anderson External
Fixator
MOBILITY
Use of Braces and Splints:
B. Purposes:
Support and protect weakened muscles
Prevent and correct anatomic deformities
Aid ain controlling voluntary muscle movements
Immobilized & protect a diseased or injured joint
Provide for improvement of function
B. Nursing Care:
9. Keep equipment in good repair (oil joints, replace straps when worn,
wash with saddle soap)
10. Provide adequate shoes( keep in good repair, heels low and wide, high
top to hold the heel in the shoe).
11. Examine the skin daily for evidence of breakdown at pressure points.
12. Check alignment of braces( leg braces: joint should coincide with body
joint; back brace: upright bars in center of the back, brace should grip
the pelvis and trochanter firmly, lacing should begin from the bottom).
13. Evaluate client’s response to procedure.
MOBILITY
Use of Cane:
A. Purposes:
improve stability of the client with lower limb disability.
Maintain balance
Prevent further injury
Provide security while developing confidence in
ambulating.
Relieve pressure on weight bearing joint
Assist in increasing speed of ambulation with less fatigue
Provide for greater mobility and independence
MOBILITY
B. Nursing Care:
1. Ascertain that the client is able to bear weight bearing on the affected extremity
2. Ensure that the client is able to use the upper extremity opposite the affected lower
extremity
3. Measure to determine the length of cane required
a. Highest point should be approximately level with the greater trochanter
b. Handpiece should allow 30 degrees of flexion at the elbow with the wrist held in extension.
4. Explain the proper technique in using cane.
a. Hold in the hand opposite the affected extremity
b. Advance the cane and the unsaffected extremity simultaneously and then the affected leg.
c. Keep cane close to the body
d. When climbing, step up with the unaffected extremity and then place the cane and the affected
lower extremity on the step; when descending, reverse the procedure.
5. Observe for incorrect use of cane
a. Leaning the body over the cane
b. Shortening the stride on the affected side
c. Inability to develop a normal walking pattern
d. Persistence of the abnormal gait pattern after the cane is no longer needed.
6. Observe client’s response to procedure
MOBILITY
Crutch Walking:
A. Purposes:
Support body weight, assist weak muscles, and provide joint stability.
Relieve pain.
Prevent further injury and provide for improvement of function.
Allow for greater independence.
Nursing Care:
1. Ensure proper fit of crutches by measuring the distance from the anterior
fold of the axilla to a point 15 cm (6 inches) out from the heel.
i. Axillary bars must be 5 cm (2 inches) belaw the axillae and should be
padded.
j. Hand bars should allow almost complete extension of the arm with the
elbow flexed about 30 degrees when the client places weight on the
hands.
k. Rubber crutch tips should be in good condition, about 5.1 to 7.6 cm ( 3-
MOBILITY
2. Assist in use of proper technique, depending on ability to bear weight and to take steps
with either one or both of the lower extremities.
a. Four point alternate crutch gait
Right crutch, left foot, left crutch right foot
Equal but partial weight bearing on each limb
Slow but stable gait; there are always three points of support on the floor
The client must be able to manipulate both extremities and get one foot ahead of the
other (e.g. persons with polio, arthritis, cerebral palsy)
b. Two point alternate crutch gait
Right crutch and left foot simultaneously
There are always two points of support on the floor
This is a more rapid version of the four point gait and requires more balance and strength
(e.g., a bilateral amputee)
c. Three-point gait
Advance both crutches and the weaker lower extremity simultaneously, then the stronger
lower extremity
Fairly rapid gait, but requires more balance and strength in the arms and good lower
extremity
Used when one leg can support the whole body weight and the other cannot take full
weight bearing (e.g a client with a fractured hip)
MOBILITY
d. Swing crutch gait
d.1 Swing-to-gait
Place both crutches forward, lift and swing the body up to
the crutches, then place crutches in front of the body and
continue
There are always two points of support on the floor
This technique is indicated for anyone with adequate
power in the upper arms.
d.2 Swing-through-gait
Place both crutches forward, lift and swing the body
through the crutches. Then place crutches in front of the
body and continue.
Very difficult gait, because as the client swings through the
crutches it necessitates rolling the pelvis forward and
arching the back to get the center of gravity in front of the
hips.
Indicated for the client who has power in the trunk and
upper extremities, excellent balance, self confidence, and
a dash of daring (e.g., bilateral amputee, paraplegic with
MOBILITY
e. Tripod crutch gait
e.1 Tripod alternate gait
Right crutch, left crutch, drag the body and legs forward
The client constantly maintains a tripod position: both crutches are held
fairly widespread out front while both feet are held together in the back
Necessary for the individual who cannot place one extremity ahead of
the other ( e.g. persons with flaccid paralysis from poliomyelitis, one
with spinal cord injury.
e.2 Tripod simultaneous gait
Place both crutches forward, drag the body and legs forward
Because the tripod must have a large base, the client’s body must be
inclined forward sufficiently to keep the center of gravity in front of the
hips.
MOBILITY
3. Observe for incorrect use of crutches
b. Using the body in poor mechanical fashion
c. Hiking hips with abduction gait( common in amputees)
d. Lifting crutches while still bearing down on them
e. Walking on ball of foot with foot turned outward and
flexion at hip or knee level
f. Hunching shoulders (crutches usually too long) or
stooping with shoulders ( crutches usually too short).
g. Looking downward while ambulating
h. Bearing weight underarms; should be avoided to prevent
injury to the nerves in the brachial plexus; damage to
these nerves can cause paralysis (crutch palsy).
4. Evaluate client’s response to the procedure.
MOBILITY
Use of walker
B. Purposes:
Maintain balance
Provide additional support because of wide area of contact with the floor
Allow for some ambulatory independence
Nursing Care:
7. Assist in selecting a walker
Device should not be used unless the client will never be able to ambulate with
a cane or crutches
Measure for a walker are the same as for cane
The client must have a strong elbow extensor and shoulder depressor and
partial strength in the hands and wrist muscles.
The client needs maximum support to ensure security and enhance confidence.
Device is ordinarily limited to the home because it cannot be used on steps
2. Assist in ambulating with the walker
Lift the device off the floor and place forward a short distance, then advance
between the walker
Two wheeled walkers: raise back legs of the device off the floor, roll walker
forward, then advance to it.
Four wheeled walkers: push device forward on the floor and then walk to it.
MOBILITY
3. Observe for incorrect use of walker
Keeping arms rigid and swinging through to
counterbalance the position of the lower
extremities
Tending to lean forward with abnormal
flexion at the hips.
Tending to step forward with the unaffected
leg and shuffle the affected leg up to the
bar.
4. Evaluate client’s response.
RELATED TERMS IN ORTHOPAEDIC,
DIAGNOSTIC, PROCEDURES AND
SURGERY
• Ventriculography: x-ray examination of the ventricular system brain
after replacing some of the cerebrospinal fluid with air.
• Angiography: x-ray of the cerebrovascular tree following the injection
of a radio-opaque medium into the spinal arachnoid space.
• Craniotomy: an incision to the soft and underlying tissues and removal
of the part of the skull in order to gain access to brain to reduce a
depressed fracture of the skull.
• Myelography: x-ray examination of the spinal cord after the injection of
a radio-opaque medium into the spinal arachnoid.
• Cranioplasty: repair of the skull either with metal plates or a bone
graft.
• Lumbar Sypathectomy: surgical removal of a portion of a symphatetic
nerve ganglion.
• Open Reduction: the correction through surgical method of fracture in
a dislocation by the use of nails, screws, wires, or rods with or without
plates.
RELATED TERMS IN ORTHOPAEDIC,
DIAGNOSTIC, PROCEDURES AND
SURGERY
• Screwing: is used for fixation of bone fragment that are
partially threaded.
• Wiring: internal fixation of fracture by means of wire cup.
• Bone Graft:
a. Autogenous bone graft: graft taken from the patient
himself, usually taken from either the tibia, fibula or
ilium.
b. Femogenous bone graft: graft taken from another
human donor, are obtained from non-infected
amputated limbs and are strored in deep freeze.
• Aspiration: removal of fluid on a joint by suction using a
syringe and hallow needle under local anesthesia
• Arthrectomy: removal of loose bodies (knees), removal
of a test semi lunar cartilage or removal of loose bodies
which are usually osteocartilageous in nature.
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DIAGNOSTIC, PROCEDURES AND
SURGERY
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