A Perfect Storm
Betty is a 66-year-old woman living in an Intermediate
Care Facility for the Developmentally Disabled
(ICF-DD), also known as a residential group home setting.
Besides being elderly, Betty is challenged both
mentally and physically; she is classifi ed as one who has
I/DD. From birth, Betty has suffered with spastic cerebral
palsy as well as visual and verbal communication
defi cits. Because of her age, gender, and state of immobility,
she suffers from osteoporosis. These factors predisposed
Betty to a fracture of the right hip, which occurred
without known injury. Upon discovery of the
fracture, Betty was transported to the local community
hospital where a hemiarthroplasty with a posterior approach
was performed. With this type of surgical repair,
there is an increased risk of postoperative dislocation
within the fi rst 3 months; therefore, it is important to
follow the set precautions of no hip fl exion greater than
90º, no adduction past neutral, and no internal rotation
beyond neutral ( Beagan, 2010 ).
A Perfect StormBetty is a 66-year-old woman living in an IntermediateCare Facility for the Developmentally Disabled(ICF-DD), also known as a residential group home setting.Besides being elderly, Betty is challenged bothmentally and physically; she is classifi ed as one who hasI/DD. From birth, Betty has suffered with spastic cerebralpalsy as well as visual and verbal communicationdefi cits. Because of her age, gender, and state of immobility,she suffers from osteoporosis. These factors predisposedBetty to a fracture of the right hip, which occurredwithout known injury. Upon discovery of thefracture, Betty was transported to the local communityhospital where a hemiarthroplasty with a posterior approachwas performed. With this type of surgical repair,there is an increased risk of postoperative dislocationwithin the fi rst 3 months; therefore, it is important tofollow the set precautions of no hip fl exion greater than90º, no adduction past neutral, and no internal rotationbeyond neutral ( Beagan, 2010 ).
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