COMPRESSION FRACTURE
What is a COMPRESSION FRACTURE (or the type of fracture that we will be tested on)?
Compression Fractures occur when a VERTEBRA (bone in the spine) COLLAPSES (C for COLLAPSE)
1. HERNIATED LUMBAR DISC: occurs when the SOFT CENTER PART OF THE SPINAL DISC PUSHES THROUGH THE TOUGH EXTERIOR CASING
What are the 4 types of Musculoskeletal Complications?
1. DELAYED UNION
2. NONUNION
3. MALUNION
4. OSTEOMYELITIS
What is OSTEOMYELITIS and describe how it can occur.
INFECTION OF THE BONE:
OSTEOMYELITIS can occur through:
- a soft tissue infection (diabetes)
- a direct bone CONTAMINATION
- BLOOD BORNE SPREAD FROM OTHER INFECTED SITES (tonsils, boils, or teeth)
What type of manifestations will we be noticing in patients suffering from a HERNIATED LUMBAR DISC ( a type of compression fracture)?
1. PAIN (straight leg raise in a supine position)
2. NUMBNESS/WEAKNESS
3. DIFFICULTY URINATING/PASSING STOOL (d/t changes in sensation and inability to move the leg)
Describe DELAYED UNION
When the BONE DOES NOT HEAL AT A NORMAL RATE
What is the patho behind OSTEOMYELITIS?
1. ABSCESS CAVITY (POCKET OF DEAD BONE TISSUE) FAILS TO DRAIN
2. CAUSING BONE GROWTH and SCAR TISSUE
3. LEADING TO A COMPROMISED BLOOD SUPPLY
What are the SURGICAL OPTIONS FOR patients suffering from a HERNIATED LUMBAR DISC (a type of compression fracture)?
"OTOMY" "ECTOMY"
1. LAMINOTOMY: removes a SMALL PART of the LAMINA
2. LAMINECTOMY: removes the ENTIRE LAMINA
3. DISKECTOMY: removal of PART/ALL of the INTERVERTEBRAL DISC
4. FUSION: remove the damaged discs and then fuse the vertebrae together with w bone graft or metal implant
Describe NONUNION
BONE FAILS TO FULLY HEAL (distance between the fracture site (bones))
BONES DID NOT CONNECT PROPERLY
What MANIFESTATIONS will we be observing in patients suffering from OSTEOMYELITIS?
THINK INFLAMMATION/INFECTION s/s:
1. SWELLING
2. TENDERNESS
3. WARMTH
4. CONSTANT PULSATING PAIN
5. DRAINAGE (trapped within the wound)
6. FEVER
What are complications of the following surgical options for patients suffering from a HERNIATED LUMBAR DISC (a type of compression fracture)?
- Laminotomy
- Laminectomy
- Diskectomy
- Fusion
1. DVT
2. PERONEAL NERVE PALSY (weakness or payalysis in the muscles)
3. Infection
4. Atelectasis
5. LIMITED ROM
Describe MALUNION
BONE IS HEALED, BUT IN A DEFORMED POSITION (bent).
How can we prevent the development of OSTEOMYELITIS?
1. REMOVE DRAINS ASAP
2. PROVIDING ASEPTIC WOUND CARE
3. ADMINISTERING PROPHYLACTIC ANTIBIOTICS
4. IMMOBILZATION
5. HYDRATION
6. HIGH PROTEIN DIET
7. PAIN CONTROL: as tolerated (NOT PAIN FREE)
What patient education is indicated for patients who have just had a:
- Laminotomy
- Laminectomy
- Diskectomy
- Fusion
1. Plan MOBILITY
2. NO BENDING OR TWISTING
3. FALL PREVENTION (use of assistive devices at home; make sure to assess the home situation)
Describe OSTEOMYELITIS
Bone marrow infection (bacteria or fungi), typically caused by Staph. Aureus
How do we treat patients suffering from OSTEOMYELITIS?
1. ANTIBIOTICS
2. WOUND CARE
3. INTERNAL FIXATION (surgical stabilization through plates, screws and rods)
4. BONE GRAFTS (surgical procedure that uses bone tissue to repair bone defects or fractures, or to stimulate bone growth)