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ESSENTIALS of
ORTHOPEDIC NURSING
James Malce Alo, RN, MAN, MAP, Ph.D

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ESSENTIALS of ORTHOPEDIC NURSING
1ST Edition
2009
BY: JAMES M. ALO, RN, MAN, MAP, Ph.D
A & C Printers
200- A N Domingo St. San Juan City
Tel. # 986-33-23/998-2507
E-mail Add: ac_printer@yahoo.com.ph

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ESSENTIALS of ORTHOPEDIC NURSING
Philippine Copyright, 2009 by
James M. Alo
1ST Edition
ISBN 978-971-94484-0-2
ALL RIGHTS RESERVED
No part of this book may be reproduced in any form or by any means
without the written permission from the author.
Published and exclusively distributed
By: HanjazZ Publishing
Blk 2 Lt 13-C Grasshopper St. Saint Mary Village, Las Pinas City
Tel #: (02) 846-1450
Mobile #:09187309403
Web site: http://www.james2gloves.com
A & C Printers
200- A N Domingo St. San Juan City
Tel. # 986-33-23/998-2507
E-mail Add: ac_printer@yahoo.com.ph

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PREFACE
Fundamental concepts, principles, and methods of orthopedic nursing
designed to provide the students with basic knowledge on the clinical
procedures on how to manage and care orthopedic patient.
This book will aid the student to demonstrate the knowledge and skills
related to the management of care to patients with fracture and musculoskeletal
disorders.
This book consists of four parts. The first part deals with the history of
orthopedic nursing, today’s’ orthopedic nurse, orthopedic nursing in the
Philippines, perspectives on orthopedic nurses, the environment of care, the
health care team, nurses key role in promoting environment of care and using a
model for orthopedic nursing.
The second part deals with the anatomy and physiology of the
musculoskeletal system. The third part is on basic care and comfort; principles of
basic body mechanics, transfer techniques, ambulation and it’s assistive devices,
joint movement, therapeutic exercises, complication of immobility and specific
therapeutic positions. The fourth part deals with the musculoskeletal disorders
with it’s definition, causes, signs and symptoms, anatomy and pathophysiology,
diagnostic procedures, medical management and nursing management.
This book is especially good to be possessed by teachers and students
who will be exposing in orthopedic nursing and is guide of them. Care has been
taken to confirm the accuracy of the information presented and to describe
generally accepted nursing practices. Thus, it is hard to ensure that all the
information presented is entirely exact for all circumstances. The author make
no warranty, express or implied, with respect to this work, and disclaim any
liability, loss or damage as a result, directly or indirectly of the application of any
of the contents of this endeavor.
The author also acknowledges his owe of gratitude to all those who, in
one way or another, helped in the publication of this book.
James M. Alo

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To my wife, jazzy and hannah who are my joy
and inspiration,
To my family and friends,
gives support and strength.
To my students, past and tomorrow,
who are the hope for nursing’s future.
To AdU and UPHSD, who give me the opportunity to enhanced
my skills in orthopedic nursing. in Philippines Orthopedic Center under
DOH.
To Dr. Teodoro R. Castro- POC Director, Agnes G. Sarabia- Chief
Nurse, Dr. Judy C. Franco- Nurse IV, Eva T. Cruza- Nurse III, Sheirna
B. Campita- Nurse III, Elizabeth M. Raymundo- Nurse III and POC
Clinical Instructors with the marvelous learning experienced.

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TABLE OF CONTENTS
Page
Preface iii
Acknowledgment iv
PART 1
Introduction 1
History of Orthopedic Nursing 2
Today’s Orthopedic Nurse 2
Orthopedic Nursing in the Philippines 3
Perspectives on Orthopedic Nurses 6
Perspectives on Orthopedic Nursing 7
The Environment of Care 8
The Health Care Team 9
Nurses Key Role in Promoting Environment of 10
Care
Using a Model for Orthopedic Nursing 11
PART 2
Musculoskeletal System 12
List of Major Human Organ System 12
Structures in Humans 14
1.1. Skeletal 14
1.2. Muscular 39
1.3. Joints 43
1.4. Tendons 44
1.5. Ligaments 45
1.6. bursa 46
PART 3
Basic Care and Comfort 47
Basic Body Mechanics 47
Principles of Body Mechanics 48
Transfer Techniques 48
Ambulation and it’s Assistive Devices 49
Joint Movements 51
Therapeutic Exercises 51
Complications of immobility 52

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Specific Therapeutic Positions 54
PART 4 vi
Musculoskeletal Disorders 55
Osteoporosis 56
Paget’s Disease 61
Bone Tumors 63
Osteoarthritis 67
Disorders of Joints and Connective Tissues 71
a. Rheumatoid Arthritis 73
b. Psoriatic Arthritis 80
c. Discoid Lupus Erythematosus 82
d. Systemic Lupus Erythematosus 83
e. Scleroderma 87
f. Sjogren’s Syndrome 90
g. Mixed Connective Tissue Disease 92
h. Polymyositis and Dermatomyositis 94
i. Relapsing Polychonditis 97
j. Vasculitis 98
k. Polyarteritis Nodosa 99
l. Temporal Arteritis 100
m. Wegener’s Granulomatosis 102
n. Reiter’s Syndrome 103
o. Behcet’s Syndrome 105
p. Ankylosing Spondylitis 107
q. Gout and Pseudogout 108
Bone and Joint Infections 113
a. Osteomyelitis 114
b. Infection Arthritis 117
c. Charcot’s Joints 119
Disorders of Muscles, Bones and Tendons 120
a. Spasmodic Torticollis 121
b. Fibromyalgia Syndrome 122
c. Bursitis 124
d. Tendinitis and Synovitis 126
Fracture 129
Spinal Cord Injury 136
Osteomyelitis 142
Herniated Nucleus Pulposus 145

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Osteosarcoma 149
Pott’s Disease 153
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Buerger’s Disease 155
Gouty Arthritis 160
Scoliosis 165
Osteomalacia 171
Clubfoot 172
Spina Bifida 173
Congenital Hip Dysplasia 176
Coxa Plana 177
Hydrocephalus 178
Foot Problems 180
a. Ankle Sprain 180
b. Foot Fracture 182
c. Heel Spurs 184
d. Sever’s Disease 185
e. Posterior Achilles Tendon Bursitis 186
f. Anterior Achilles Tendon Bursitis 187
g. Posterior Tibial Neuralgia 187
h. Pain in the Ball of the Foot 188
i. Ingron Toenail 190
j. Onychomycosis 190
k. Nail Discoloration 191
Sports injuries 192
a. Stress Fracture of the Foot 197
b. Shin Splints 198
c. Popliteus Tendinitis 200
d. Achilles Tendinitis 201
e. Runner’s Knee 202
f. Hamstring Injury 204
g. Weight Lifter’s Back 205
h. Backhand Tennis Elbow 207
i. Forehand Tennis Elbow 208
j. Rotator Cuff Tendinitis 210
Exercise and Fitness 212
a. Starting an Exercise Program 212
b. Preventing Injuries 214
c. Choosing the Right Exercise 217

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Preventing Infection and Promoting Healing 220
Balance Skeletal Traction Application 221
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How to Tie a Knot 230
Casting 231
BST Equipments 237
The Gadgets 238
Tractions 247
Hardware 253
a. Screws and Plates 253
b. Implants 256
Braces 258
Common Abbreviations in Surgery 260
Surgeries 261
Anesthesia Abbreviation 261
Exercises 263
Review Questions Related to Musculoskletal 267
Disorders
Nursing Care Plan 280
BIBLIOGRAPHY 286