ONP-C key terms

A limb-threatening rise in pressure within a closed fascial compartment that compromises capillary perfusion, producing pain out of proportion, pain on passive stretch, paresthesia, and pallor; measured pressure guides emergent fasciotomy.

Discomfort elicited when a clinician gently stretches the muscles within a suspected compartment; it is among the earliest and most reliable clinical indicators of compartment syndrome, appearing before late findings such as pulselessness.

Absence or weakening of a distal arterial pulse. In extremity trauma it is a late and unreliable sign of compartment syndrome, so its absence should never be used to rule out elevated compartment pressure.

Surgical division of fascia and skin over a compartment to restore perfusion. It is the definitive treatment for compartment syndrome and is usually left open with dressing changes until swelling resolves, then closed or grafted.

A sealed dressing connected to suction that removes exudate and promotes granulation in open or complex wounds, commonly used after fasciotomy or over grafts and flaps; it requires monitoring for bleeding and infection.

A structured check of circulation and nerve function distal to an injury or cast, covering color, temperature, capillary refill, pulses, sensation, and motor function, documented serially so subtle deterioration is detected early.

Handheld audible or duplex ultrasound used to detect arterial and venous flow, assess pulses that are difficult to palpate, and evaluate suspected deep vein thrombosis or impaired perfusion after fracture or surgery.

Measures that prevent clot formation in immobilized orthopaedic patients, including early mobilization, mechanical compression, and anticoagulant agents; risk rises with hip fracture, major joint replacement, and prolonged bed rest.

Temporary use of a short-acting parenteral anticoagulant while a long-term oral agent is interrupted around surgery, balancing bleeding risk against thrombotic risk; timing is individualized by procedure and renal function.

Combining analgesics with different mechanisms, such as acetaminophen, NSAIDs, local anesthetics, and opioids at reduced doses, to improve pain relief while limiting opioid adverse effects and dependence risk.

A reduced response to opioid analgesia after repeated exposure, requiring higher doses for the same effect. It differs from physical dependence and addiction and complicates postoperative pain plans in chronic opioid users.

Slowed or shallow breathing caused by opioid action on brainstem respiratory centers, signaled by low respiratory rate, sedation, and falling oxygen saturation; it is the most dangerous adverse effect of postoperative opioids.

Injection of local anesthetic near a nerve or plexus to numb a region for surgery or postoperative pain, such as an adductor canal or interscalene block; requires monitoring for motor weakness and local anesthetic toxicity.

A rare but life-threatening reaction to local anesthetic absorbed into the circulation, producing tinnitus, metallic taste, seizures, and cardiovascular collapse; treatment includes airway support and intravenous lipid emulsion.

A fracture with a wound connecting bone to the outside environment, graded by soft-tissue injury. Management prioritizes antibiotics, tetanus status, debridement, and stabilization to prevent deep infection and nonunion.

A system grading open fractures from type I, a small clean wound, through type IIIC, an open fracture with arterial injury needing repair; higher grades carry greater infection risk and guide antibiotic and surgical urgency.

Removal of devitalized tissue, foreign material, and contamination from a wound or open fracture to reduce infection risk and support healing; severe open injuries often require serial debridement in the operating room.

Infection arising within 30 days of surgery, or within a year if hardware is implanted, marked by wound drainage, redness, fever, or loosening; orthopaedic implants may require irrigation, debridement, or removal.

Infection involving a joint replacement and surrounding tissue, causing pain, swelling, and implant loosening; diagnosis uses joint aspiration and inflammatory markers, and treatment ranges from debridement to two-stage exchange.

An acute-phase protein that rises with inflammation and infection. Serial levels help track response to treatment and, alongside erythrocyte sedimentation rate, support evaluation of periprosthetic joint infection.

A nonspecific blood test reflecting inflammation, often elevated in infection, inflammatory arthritis, and giant cell arteritis; trends over time are more useful than a single value in orthopaedic evaluation.

Bone infection from hematogenous spread, direct inoculation, or contiguous soft-tissue infection; it causes localized pain, fever, and bone destruction, and often needs prolonged antibiotics plus surgical debridement.

Low bone mass and microarchitectural deterioration that raise fracture risk, especially at the hip, spine, and wrist. Diagnosis uses bone mineral density and prior fragility fracture, and treatment combines calcium, vitamin D, and antiresorptive drugs.

A fracture caused by a fall from standing height or less, signaling underlying bone weakness. It warrants evaluation for osteoporosis and treatment to reduce the risk of a subsequent fracture.

A validated calculator estimating ten-year probability of major osteoporotic and hip fracture from age, sex, bone density, and clinical risk factors; it helps decide who should start pharmacologic osteoporosis treatment.

A five-type system describing fractures through the growth plate in children, from type I through the physis alone to type V crush injury; higher types carry greater risk of growth disturbance and deformity.

Damage to the cartilaginous growth plate that can cause premature closure, limb shortening, or angular deformity; it requires careful reduction and follow-up because growth disturbance may appear months later.

The capacity of growing bone to reshape and correct angulation after fracture, greatest in young children and near the ends of long bones; it allows some pediatric fractures to be treated without perfect reduction.

Injury inflicted by a caregiver, suspected when fracture patterns, timing, or explanations do not fit the child's development; clinicians must document findings and report to protective services per law.

A legal duty of clinicians to notify designated authorities about suspected abuse, neglect, or certain communicable and injury conditions, even without proof and sometimes without patient consent.

A patient's voluntary agreement to a procedure after receiving understandable information about its nature, risks, benefits, and alternatives, confirmed by the clinician performing it and documented in the record.

A written statement of a patient's future healthcare wishes, such as a living will or durable power of attorney for healthcare, used when the patient cannot decide during serious illness or surgery.

An acute fluctuating disturbance of attention and awareness common in older orthopaedic patients, often triggered by pain, surgery, infection, or medications; it requires prompt search for the underlying cause.

Use of multiple medications, often five or more, raising risks of interactions, falls, and confusion in older adults; orthopaedic care should include medication reconciliation and deprescribing where appropriate.

A degenerative joint disease with cartilage loss, pain, stiffness, and reduced motion, managed through activity, weight control, physical therapy, injections, and joint replacement when symptoms become disabling.

Replacement of a damaged joint surface with prosthetic components to relieve pain and restore function; postoperative care emphasizes mobilization, thromboprophylaxis, and precautions against dislocation or infection.

Movement restrictions after hip replacement, such as avoiding deep hip flexion beyond ninety degrees, internal rotation, and crossing the legs, intended to prevent prosthetic dislocation during early healing.

A prescribed allowance for loading an operated or injured limb, from non-weight-bearing through partial, touch-down, and full weight-bearing; it must be communicated clearly and followed with the correct assistive device.

The arc through which a joint moves, measured actively or passively and expressed in degrees. Serial measurement documents rehabilitation progress and detects stiffness or contracture after injury and surgery.

A machine that moves a joint slowly through a set arc for extended periods after surgery, used to maintain motion and reduce stiffness; evidence supports early motion but not routine prolonged use.

Injection of hyaluronic acid derivatives into a joint, most often the knee, to supplement synovial fluid and ease osteoarthritis pain; benefit is modest and duration is limited.