Physical Medicine Rehabilitation

Handbook of physical medicine and rehabilitation : the by Susan J. Garrison MD

By Susan J. Garrison MD

Revised and up to date for its moment variation, this well known guide is a concise but entire fast reference for the overview and remedy of actual disabilities. specialists from top associations current very sensible, problem-oriented guidance in 23 subject parts. themes are indexed alphabetically via common prognosis and chapters have a constant, easy-to-follow association.

This edition's brand-new bankruptcy on handbook medication covers evaluate and prognosis; formula of the actual remedy prescription; follow-up; stretch vs. power vs. obstacle of actions; and time frames for every step of the remedy plan. different new chapters hide pediatric rehabilitation, geriatric rehabilitation, and prosthetics and orthotics.

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Extra info for Handbook of physical medicine and rehabilitation : the basics

Sample text

It also provides protection for the residual limb from trauma (such as hitting it against the side rail). Although the plaster cast can be windowed or temporarily removed to enable close examination of the limb, it must be closed promptly (within 30 to 45 minutes) to avoid accumulation of edema. The rigid dressing is generally left in place for 7 to 1091-03 CH03 03/19/03 15:14 Page 37 3. Amputations 37 14 days and then replaced with another rigid dressing or with a preparatory prosthetic socket with a pylon that allows partial weight bearing on the residual limb.

The primary difference lies in using the preparatory socket to assist in the maturation (primarily shrinkage) of the residual limb, which usually occurs over 3 to 4 months. During this interval, decreasing residual limb size (because of edema absorption and pressure atrophy of soft tissue) is accommodated to maintain proper socket fit, by using one or more prosthetic socks of varying thickness (measured as one ply, three ply, or five ply). Once the residual limb has stabilized in size, depending on the patient’s functional level, a definitive prosthesis (also referred to as the permanent prosthesis) can be prescribed.

After the patient reaches a stable state with the prosthesis, he or she must be seen by the physiatrist only if and when complications arise. The prosthetist generally continues to follow the patient regularly for minor adjustments and is the first level of intervention when problems occur. If this is unsuccessful in resolving the problem, the patient should be seen for a more comprehensive team evaluation, because any major change or replacement of the prosthesis requires a prosthetic prescription from the physician.

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