Musculoskeletal Disorders -wadding sheet (cotton) is needed before casting

- There are 632 muscles Fiber Glass- expensive one

- Mother cell of the platelets
How do you when the cast is already dried
megakaryocytes (located at bone marrow)
up? 24 hours
**Failure of bone marrow APLASTIC ANEMIA
1. It is white
-chloramphenicol: cause of failure 2. Resonant (pagkinatok may sound HAHA
3. Can no longer create indentation (Pisil)
Four stages of healing:
How do you hold the cast when drying up?
 Hematoma formation/blood clot
 Formation of tissue/ or soft collagen  Hold it using the palm.
 Bony cartilage  Insert one finger to make sure that the
 Remodeling cast is not too tight

Common complication of tight cast:

Closed reduction  Compartment syndrome

 Check toes
- no communication between the bone and  Instruct the client to move
ouside environment (walang punit sa skin, the toes
hindi lumabas buto)
- With the help of radiographic report, and ADDITIONAL
manually they fix it  Prevent the cast getting wet and bump
Open reduction  DO NOT put anything inside.
 3 months healing process.
- may punit sa skin and may communicate ang buto
sa outside or environment Traction

- there is an incision to get thru the bone and correct - Act of pulling and counter pulling.
it
Purpose:
Simple- crack only
 To prevent pain
Complex  To promote alignment

- there is development of two or more **Traction should be continuous

fragments of the bone
Open reduction with internal fixation/ Open
reduction with external fixation
- perform in cases that is complicated
fracture such as comminuted fracture
Compact fracture/ Impacted fracture
- bone to bone
- Provide traction (para hilain)
**The weights should be hanging freely
---overhead trapeze
**Avoid wear and tear of the used lines (tali)
**Pulleys should be effective and functional, because
dito dumaan ang tali.
**It is temporary.
**Last thing you’ll do is internal/external fixation.

Signs of Fracture: Skeletal Balance Traction

 Shortening of the limb - Mas matibay

 Pain - Usually,
 Immobility
Skin Traction
 Can see hematoma but not always
- Max. weight is 8 pounds.
Management:
- Bandage and wadding sheet is used.
 Immobility  esp. when the case if fall,
vehicular accident (possible for spine
fracture) **BEST COUNTERTRACTION- BODY
WEIGHT!!!!!
Ventral- motor
Fixators (5 years only)
Dorsal- sensory
 Wires
Plaster of paris
 Screws
- white (looks like gauze with powder)  Pins

-lukewarm water is needed Gaits

-only the doctor will cast  Palm ang pwersa if crutch

  Distance of upper portion to axilla. 3
fingers/ 1 ½ inch.
 Distance of side of the feet 4-6 inches and
crutch. Hindi diretso.
Two point gait
- There are two points that touches the
ground. When you move the right crutch
make sure to move your left. When you
move the left crutch, you will move right.
Three point gait
- Three points are on the ground.
- Used only when one foot isn’t effective.
(Hindi mailakad)
- When you move the two crutches, and then
lift body with affected leg.
- Used w/ external fixator. In case of
comminuted fracture.
Four point gait
- Move right crutch then right foot, move left
crutch then left foot. Alternate.
Rheumatoid Arthritis
-inflammation and autoimmune.
-starts very early.
Gouty Arthritis
- Involving the abn. metabolism such as
protein and the by product is purine 
resulting uric acid
- 3.4-7 mg/dL men, 2.4-6 mg/dL women
NORMAL VALUES!!!!
- Factor: Age and Sex
- Avoid foods high in purine: beans, internal
organs, sardines, nuts, fresh strawberries
- Dietary modification: LOW PURINE
DIET
- S/x: Pain (especially the Big Toe)
- Mgmt: Colchicine (incase of acute attack)
 Drug would prevent the production of
uric acid/ formation: Colchicine
- Zyloprim (Allopurinol) DRUG OF
CHOICE!!!! 
- Probenecid (Benemid) 

Swing-to Major Complications:

- Move two crutches then swing pero aligned - Stone formation in the kidney called uric
sa crutch. acid stone (with pt. with hyperuricemia,
result is 10 mg/dL and above)
Swing through
Mgmt: Increase the fluid intake. 10 glasses
- two crutches move forward and lalagpasan
mo yung crutches. a day.

TOPHI- if severe! Crystal in the joints

Osteoporosis

- decreased in the mass in the bone. (Lack of calcium

and phosphorus)

- affected hormones such as estrogen in women.

-occurring because of dietary requirement, genetics.

Most common complication:

 Pathological Fracture- the bone is not

healthy, lacks integrity.
Mgmt: Fix the deficiency but it will take
some time.

Osteomalasia-
Osteomyelitis
- happens when there is infection before
getting this.
- there is an infection called stapph. It then
will be brought to the bone.
- Infection will cause death to the bone.
-
Osteoarthritis

- related with age because of degeneration.

- commonly affected joints are weight bearing such

as knees, hips, spine.

- no inflammatory process. It is just that bones and

joints practically done through some process of
degeneration.

- pain is dull.