0 penilaian0% menganggap dokumen ini bermanfaat (0 suara)
17 tayangan2 halaman
A fracture is considered stable if only the anterior column is involved. When the anterior and middle columns are involved, the fracture may be more unstable. Non operative treatment remains the standard for compression fx.
A fracture is considered stable if only the anterior column is involved. When the anterior and middle columns are involved, the fracture may be more unstable. Non operative treatment remains the standard for compression fx.
A fracture is considered stable if only the anterior column is involved. When the anterior and middle columns are involved, the fracture may be more unstable. Non operative treatment remains the standard for compression fx.
Generally, a fracture is considered stable if only the anterior column is involved, as in the case of most wedge fractures. When the anterior and middle columns are involved, the fracture may be considered more unstable. When all three columns are involved, the fracture is by definition considered unstable, because of the loss of the integrity of the posterior stabilizing ligaments. The table below shows the types of fractures, the part or parts of the spine involved, and whether or not it is a stable or unstable injury. Type of Fracture
Column Affected
Stable vs Unstable
Wedge fractures
Anterior Only
Stable
Burst fractures
Anterior and middle
Unstable
Fracture/dislocation injuries
Anterior, middle, posterior
Unstable
Seat belt fractures
Anterior, middle, posterior
Unstable
- Classification: (stable or unstable)
- stable frx: - neurologically intact; - posterior arch remains intact: pedicle widening implies post arch disruption w/ instability; - less than 50% anterior body height collapse: - compression fractures: - unstable frx: - neurologic deficit; - loss of 50% of vertebral body height; - fracture dislocation: - thoracolumbar burst frx: - angulation of the thoracolumbar junction > 20 deg - canal comprimise > 30 percent
- Non Operative Treatment:
- non operative treatment remains the standard for compression fx; - most pts can be treated symptomatically w/ short period of bed rest until pain is diminished; - in some cases an NG tube is required for severe ileus; - if bowel sounds and flatus are not present then patient should be made NPO, and should receive IV Fluid; - early ambulation is encouranged in a hyperextion orthosis; - avoidance of compression overloads for a period of 12 weeks; - depending on degree of compression, pt may be treated effectively by hyperextension exercises & avoidance of compression overloads for period of approximately 12 weeks. - early ambulation is encouraged in a hyperextension orthosis. -Observation for 3 month. --for 3 months.