Orthopedic Primary Care: Musculoskeletal Skills & Procedures

This course provides online content covering the scientific underpinnings and evidence for advanced clinical skills specific to treating stable MSK conditions in primary care settings. The course also discusses the evidence for a wide range of techniques for pain management and functional rehabilitation available to primary care providers.

In the associated workshop, a combination of demonstration and simulation is used to build skills for performing arthrocentesis, joint and trigger point injections, casting and splinting, assistive devices use, and exercise instruction.

Specifically, the MSK Skills and Procedures Workshop covers:

INJECTIONS & ARTHROCENTESIS

Evidence-based techniques for corticosteroid injections are presented emphasizing principles of safety and efficacy. Skill lab sessions provide students with time to practice every injection technique on anatomical simulator models that provide audio feedback when needle placement is accurate. Lab sessions will cover:

  • The scientific foundation for arthrocentesis, joint injections, and trigger point injections
  • Indications for arthrocentesis, joint injections, and trigger point injections
  • Contraindications for arthrocentesis, joint injections, and trigger point injections
  • Indications for orthopedic consultation and referral
  • Review of the evidence for optimal dose and medication selection for MSK injections
  • Simulation of common upper and lower extremity injections using anatomical models

Injection techniques are presented for the following joints:

Upper Extremity

Subacromial space Olecranon bursa
Glenohumeral jointCarpal tunnel
Acromioclavicular joint De Quervain’s tenosynovitis
Bicipital grooveTrigger finger
Medial epicondyleFirst carpometacarpal joint
Lateral epicondyleTrigger point injections

Lower Extremity

Trochaneric Bursa 
Foot & Ankle:Tibiotalar joint
First metatarsophalangeal joint
Morton’s neuroma
Heel spurs
Knee injection/aspiration:Tibiofemoral joint space
Pes anserine bursa
Iliotibial band bu

SPLINTING & CASTING

The casting and splinting skills lab covers basic musculoskeletal injury immobilization and management in accordance with the National Association of Orthopaedic Technologists curriculum. Participants practice applying and removing splints and casts with coaching and feedback from experienced clinicians. Lab sessions cover:

  • Evaluation and management of patients with acute musculoskeletal injuries
  • Fundamentals of casting and splinting procedures Complications of casting and splintingFundamentals of casting and splinting procedures
  • Complications of casting and splinting
  • Common upper extremity immobilization techniques: splint and cast application
    • Short-arm splint and cast
    • Long-arm splint and cast
    • Thumb spica cast
    • Boxers cast/radial/ulnar gutter splints/casts
    • Sugar tong splint
  • Common lower extremity immobilization techniques: splint and cast application
    • Short-leg stirrup splinting/casting
    • Long-leg cast application
  • Cast removal: safety and proper use of the cast saw

MAXIMIZING FUNCTION & MANAGING PAIN

This lab focuses on interventions aimed at increasing  patients’ ability to control MSK pain, maximize function, and prevent further injury through a variety of self-management and lifestyle changes.  Participants will learn to discuss, use, demonstrate, and prescribe evidence-based modalities and devices including:

  • Non-narcotic medications, nutriceuticals, and supplements
  • Safe, progressive exercise programs for strength, flexibility, and balance
  • Soft tissue manipulation tools and techniques
  • Canes, walkers, crutches and other mobility supports
  • Adaptive devices
  • Ergonomic modifications
  • Weight management

 

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