A1 Introduction to fracture repair Flashcards
Practice your knowledge and understanding how to assess a small animal patient with a fracture, classify a fracture following the 10 principles of fracture classification, know the basic principles of fracture repair, understand and describe the basic steps of decision making in SA fracture patients
Describing Fractures:
When describing the displacement of bone, you always describe the direction the most _____ fragment has displaced in relation to the ______ fragment
When describing the displacement of bone, you always describe the direction the most distal fragment has displaced in relation to the proximal fragment
Distinguish between
- Comminuted fractures
and
- Segmental fractures
Both: at least 3 fracture fragments
Comminuted: all fracture lines are communicating
Segmental: fracture lines do not connect
What force(s) are most likely to result in an
1. oblique fracture
and
2. transverse fracture
Compressive force = oblique fracture
Tension/avulsion = transverse fracture
In a fracture patient, what might make the neurological examination unreliable and what should you do about it?
Results of the neurological examination may not be reliable if the animal is painful - repeat when pain medication on board.
What force(s) will a transverse, oblique/spiral and comminuted fracture resist? (bending, shear, axial compression or torsion)
Transverse = Shear (+) and axial compression (+++)
Oblique/spiral = bending (+) and torsion (+)
Comminuted = none
How can you tell radiographically whether a fracture is open or closed?
The presence of air (black) around the fracture site indicates it is an open fracture.
(however, these may not always be present if there are only very small wounds, e.g. grade 1 open fracture - therefore inspection after clipping is required clinically).
Differentiate between an open and a closed fracture. Under what two conditions can you treat an open fracture as if it were a closed fracture?
An open fracture has communication with the external environment, whereas a closed fracture does not.
1. Grade 1 open fracture
2. Early treatment
3. Minimal contamination of the fracture site.
Unless these conditions are met the fracture must be considered infected.
A patient presents with multiple fractures after a road accident. Order the following fractures based on the urgency with which they should be treated:
- Articular Fractures
- Long Bone Fractures
- Open Fractures
- Open Fractures – these require the most urgent treatment (along with fractures of the skull and spine).
- Articular Fractures – should be dealt with within 24-48 hours, as should any dislocations.
- Long Bone Fractures – should be treated within 5-7 days of the injury.
Describe the difference between stable and unstable fractures.
The fragments in stable fractures interlock providing resistance to collapse. External treatment may be sufficient in stable fractures to prevent disruption during healing. The fragments in unstable fractures do not interlock.
Which orthopaedic implant offers excellent resistance to bending?
External skeletal fixation
How do you distinguish difference between a new and older fracture on a radiograph?
Recent fractures have sharper fracture edges whilst older fractures have resorption of sharp edges with some possible callus formation.
How should articular fractures be treated (3 points)
- reduction of the articular surface
- use of rigid internal fixation
- interfragmentary compression of the fracture gap using lag screws (+/- plates)
