II Lecture Chapter 21 Short Answer: Open Reduction Internal Fixation (ORIF) pp 464

When using PMMA bone cement, what is the importance of using a closed mixing system?

A closed mixing system that is attached to suction to exhaust the fumes created during the process of mixing the cement. The fumes are irritating to the mucus membranes and possibly toxic to the liver.

What is the recommended time that tourniquet pressure may be applied to an upper extremity.

Continuous pressure should not be applied for more than one hour on an upper extremity.

What is meant by the term exsanguination? How does this apply to extremity surgery with the use of a tourniquet?

Exsanguination provides a bloodless surgical site which aids in visualization. A popular tourniquet is the double-cuffed pneumatic tourniquet. Continuous pressure should not be applied for more than one hour on an upper extremity or more than 1 and 1/2 hour on the thigh.

If you are using a fracture table, what precautions must be taken? What additional precautions are taken when the use of a C-arm is anticipated?

Fracture tables have several moving parts and can cause injury to the patient and OR personnel if not correctly handled. The unaffected leg is placed in a boot that is abducted to allow for the C-arm fluoroscope to be positioned over the injured site or may be placed in a leg-well holder.

When closing the periosteum, use ___ suture such as ___ and ___ and for bone use ___ suture such as ___ .

Polyglactin; Vicryl; surgical steel;

Review the advantages of using the continuous passive motion (CPM) machine, and select the two that you feel are the most important reasons.

Surgeons may order the use of a continuous passive range-of-motion machine (CPM) for the patient after major knee, elbow, shoulder, and femoral surgical procedures. The CPM provides the following advantages: 1) Aids in decreasing pain and swelling at the operative site 2) Reduces joint stiffness resulting from the patient being bedridden 3) Inhibits the formation of adhesions 4) Provides early mobilization 5) Decreases the effects of immobilization, such as muscle wasting

What types of alloys are used in the manufacturing process?

The most frequently used alloys include titanium, stainless steel, and cobalt-chromium.

Describe the direction of the blade motion for a reciprocating saw and an oscillating saw.

reciprocating saw: the saw blade moves back and forth oscillating saw: the blade moves from side to side

What information is required regarding implant documentation?

Number of implants used Type of implants Size of implants Manufacturers serial numbers

Describe what can happen if implants are scratched or reused, or if implants with differing alloys are used from different manufacturers (e.g. a plate from one set made of titanium is used with stainless steel screws from two different companies).

If implants composed of different alloys are placed in a patient, they will corrode, causing a breakdown of the implant. This will delay healing and possibly cause an infection. Implants should never be reused. Scratches that can occur on the surface of an implant can cause complications if the implant is reused. These complications may include corrosion of the implant, irritation, and infection of the bone due to the imperfections "digging" into the bone. If an implant, particularly a total joint implant is dropped, it should not be used because it may have become marred or scratched.