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General Principles and
Spesific Methods ofMusculoskeletal
Treatment
Debora Lusiana Herman
11 2014 02
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General Principles of Treatment
!ooperate "ith the la"s of nature
#e realistic and practical in $our treatment
Select treatment for $our patient as an
indi%idual
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&orm of Treatment
Ps$cholo'ical consideration
Therapeutic dru's
(rthopaedic apparatus and appliances
Ph$sical and occupational therap$
Sur'ical manipulation
Sur'ical repair and reconstruction
)lectrical stimulation
!ontinuous passsi%e motion
*adiation therap$
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Therapeutic Dru's
+nal'esics ,S+-D!hemotherapeutic
+'ent
!orticosteroid .itamin Specific Dru's
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(rthopaedic +pparatus and +ppliances
*est
Support forMuscle
"eakness and/oint -nstabilit$
Pre%ention and!orrection of
Deformit$
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*est
Disuse atroph$ of muscle "ith resultant 'eneralied "eakness
Disuse atroph$ of bone -ncreased calcium ecretion Deep %ein thrombosis "ith the threat of pulmonar$ embolism Decubitus ulcers
Prolon'ed andcontinuous bed
rest
Slin' 3pper limb !rutches lo"er limb*elati%e rest
To Stretch 'raduall$ soft tissue that ha%e become shortened secondar$ to alon' standin' 5oint deformit$ or dislocation
To relie%e painful muscle spasm associated "ith 5oint inflammation or in5ur$ To maintain len'th of the limb and ali'nment of fracture fra'ments in
unstable fractures of the shaft of lon' bones
!ontinuousTraction
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Support for Muscle
&unctionalbraces
Spinalbraces
+dhesi%etape
strappin'
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Ph$sical and (ccupational Theraph$
/oint Motion Muscle stren'th-mpro%ement ofmusculoskeletal
&unction
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Sur'ical Manipulation
To correct deformit$ and to re'ain motion
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Sur'ical (peration
General methods of operation 6
*epair
*elease
*esection
*econstruction
*eplacement
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(peration on Muscles7 Tendons and
Li'ament
!ompartment s$ndrome
+ cut tendon is repaired b$ suture
Tendon tethered b$ adhesions
Shortened muscle that "ants to belen'thened
&asciotom$
Tenorrhaph$
Tenol$sis
Tenotom$ or Tendon len'thenin'
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(peration on ,er%es
+ cut ner%e
-f the 'ap is too lar'e
Spinal ner%e root 'et continuedpressure fro a protruded
inter%ertebral disc ,er%e suture
,er%e 'raft
Laminectom$
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(peration on /oints
+n opened 5oint +rthrotom$ and
eplored a remo%e a loose bod$
The elon'ated fibrous capsule of
the 5oint is ti'htened and repaired
!apsulorraph$
+lterin' or replacin' one or both
5oint surfaces +rthroplast$ *eplacement of one or both 5oint
surfaces Prosthetic 5oint
replacement
&used of bone or unite to each
other +rthrodesis
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(peration on #ones
Se8uestrectom$
(steotom$
Transplantation of bone or bone'raftin'
*emo%ed a piece of infected dead bone
to !orrect either an an'ular or rotational deformit$ in a bone
*emo%al of bone from one location to other location
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)lectrical Stimulation of &racture
Healin'
+s an alternati%e to bone 'raftin' to stimulate osteo'enesis in the treatmentof established non union of fractures9
: electrical s$stems6
!onstant direct current throu'h percutaneous "ire cathodes semi in%asi%e
#ri'hton
!onstant direct current throu'h implanted electrodes and po"er pack in%asi%e
D"$er and also Paterson -nducti%e !ouplin' throu'h electroma'netic coils non in%asi%e #assett and also
de Haas
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!ontinuous Passi%e Motion
-ndications
+rthrotom$7 !apsulotom$7 debridement7 arthol$sis of 5oints "ith painful restriction of motions
secondar$ to post; traumatic arthritis
(pen reduction of intra articular fractures as "ll as metaph$seal and diaph$seal fractures
Patellectom$
*epair of li'ament in5uries
S$no%ectom$ for rheumatoid arthritis and hemophilic arthropat$
+rthrotom$ and drain'e for acute septic arthritis
#iolo'ical resurfacin' for a ma5or defect in a 5oint surface
Sur'ical repair of a complete laceration of a tendon
*i'id internal fiation of a metaph$seal osteotom$
Total prosthetic 5oint replacement
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