ONC key terms

A quick check for carpal tunnel syndrome in which the patient holds both wrists bent fully forward with the backs of the hands together for about a minute. Numbness or tingling in the thumb, index, and middle fingers is a positive result.

A test in which the examiner lightly taps over a nerve, such as at the wrist or elbow. A positive response is tingling or an electric shock sensation felt farther down in the area that nerve supplies.

The measurement of a joint's range of motion using a goniometer, a device with a stationary arm, a moving arm, and a protractor. The examiner records the starting and ending angles in degrees.

Insertion of a needle into a joint space to withdraw synovial fluid. The fluid is analyzed for cells, crystals, bacteria, and blood to distinguish inflammatory, infectious, and crystal-caused arthritis.

A low-radiation scan that measures bone mineral density, usually at the hip and spine. Results are reported as a T-score, which compares the patient's bone density with that of a healthy young adult.

The strip of skin supplied by a single spinal nerve root. Knowing the dermatome map lets the examiner link a numb or painful area to a specific nerve level, such as C6 or L5.

A fracture in which the broken bone communicates with the outside environment through a skin wound. It carries a high risk of infection and requires prompt antibiotics, wound coverage, and surgical cleansing.

Failure of a fracture to heal within the expected time, with no further signs of healing on x-ray and movement at the fracture site. It often requires bone grafting or revision surgery.

A device in which pins or wires are placed into bone above and below a fracture and connected to a rigid bar outside the skin. It stabilizes the bone while allowing access for wound care.

A degenerative joint disease in which cartilage gradually wears away, causing pain, stiffness, and bony enlargement. Symptoms typically worsen with activity and ease with rest, and weight-bearing joints are most often affected.

A chronic autoimmune disease that inflames the synovial lining of joints, usually symmetrically in the small joints of the hands and feet. Morning stiffness lasting more than an hour is typical, and organs can also be affected.

A condition of low bone mass and weakened bone structure that raises the risk of fracture, especially of the hip, vertebra, and wrist. It is often silent until a fracture occurs.

An inflammatory arthritis caused by uric acid crystals depositing in joints, classically the big toe. Attacks are sudden and extremely painful, red, and swollen, and treatment both treats inflammation and lowers uric acid.

An infection of bone, often from bacteria that reach bone through the bloodstream, an open wound, or surgery. Signs include fever plus localized pain, redness, and swelling; treatment needs prolonged antibiotics and sometimes surgery.

Death of bone tissue caused by loss of its blood supply. Common sites are the femoral head, scaphoid, and talus, and risk factors include fractures, corticosteroid use, and heavy alcohol use.

A focused check of circulation and nerve function in a limb, compared with the opposite side. It includes pulses, color, warmth, capillary refill, sensation, movement, swelling, and pain that is out of proportion to the injury.

A surgical emergency caused by compression of the nerve roots below the end of the spinal cord. Warning signs are severe back pain, saddle-area numbness, bladder or bowel dysfunction, and rapidly worsening leg weakness.

A life-threatening reaction in patients with spinal cord injury above about T6, triggered by a painful or irritating stimulus such as a full bladder. It causes severe hypertension, pounding headache, flushing, and sweating.

A technique for turning a patient while keeping the spine aligned, used after spinal surgery or injury. Several staff members move the patient as one unit, supporting the head, trunk, and legs together.

Symptoms caused by compression or irritation of a spinal nerve root, producing pain, numbness, tingling, or weakness along that nerve's distribution, such as shooting pain down the leg in sciatica.

A five-part classification of fractures that involve the growth plate in children. Types are numbered I through V according to how much of the physis and nearby bone is involved, with higher types carrying greater risk to growth.

The growth plate, a layer of cartilage near the end of a child's long bone where new bone forms. Injury or infection at this site can slow or distort growth, so it is a key concern in pediatric fractures.

A spectrum of infant hip problems in which the socket is shallow and the femoral head is unstable, partly dislocated, or fully dislocated. Early detection allows treatment with a harness rather than surgery.

A childhood condition in which the blood supply to the femoral head is interrupted, so the bone dies and later reshapes. It usually affects boys aged about 4 to 8 years and causes a limp with hip or knee pain.

Displacement of the femoral head through the growth plate at the hip, usually in older children and teens, often those with obesity. It causes hip, thigh, or knee pain and a limp and requires surgery to prevent further slipping.

Traction applied through a pin or wire placed in bone and connected to weights and pulleys. It allows a heavier pull than skin traction and requires careful pin site care and neurovascular monitoring.

A form of skin traction applied with a boot and weights to rest a limb or relieve muscle spasm, often before hip surgery. The weight used is limited, and the skin must be checked for breakdown.

A ring fixed to the skull with pins and attached to a rigid vest, used to immobilize the cervical spine after injury or surgery. Pin sites are checked daily for loosening, drainage, and signs of infection.

A soft strap device that holds an infant's hips in flexion and abduction to treat developmental dysplasia of the hip. It is worn nearly full time and requires frequent fit checks and skin assessment.

Increased pressure inside a closed muscle compartment that cuts off blood flow and can cause permanent nerve and muscle damage. The hallmark is severe pain, especially with passive stretch, that opioids do not relieve.

A complication, usually after long bone fractures, in which fat droplets enter the bloodstream and cause respiratory distress, confusion, and a petechial rash. Symptoms typically appear 24 to 72 hours after the injury.

Measures to prevent blood clots in the legs and lungs of patients who are immobilized or recovering from orthopaedic surgery. It includes anticoagulant drugs, compression devices, early ambulation, and adequate hydration.

A chronic pain condition that may follow injury or surgery, causing severe burning pain, swelling, skin color and temperature changes, and extreme sensitivity in a limb that is out of proportion to the original injury.

Using two or more pain treatments with different mechanisms together, such as acetaminophen, an NSAID, a nerve block, and an opioid. Each can then be given at a lower dose, improving relief and reducing side effects.

A machine that slowly and repeatedly moves a joint through a set range of motion, often after joint surgery. It helps maintain motion and reduce stiffness while the patient rests.

A teaching method in which the patient explains or demonstrates what was taught in their own words. It confirms understanding and shows the nurse which points need to be explained again.

Techniques that reduce stress on painful or damaged joints, such as using larger joints for lifting, pacing activities, and using assistive devices. The goal is to preserve function and limit fatigue and pain.

A crutch-walking pattern in which both crutches and the affected leg move forward together, then the unaffected leg steps through. It is used when one leg is not allowed to bear weight.