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A U E R S & T > Chapter 74 - Emergency treatment > Flashcards

Chapter 74 - Emergency treatment Flashcards

1
Q
A

Figure 74-7. (A) A Kimzey splint with nylon straps fitted with hook-and-loop patches is shown on the left; (B) the splint is applied to the distal limb of a horse over a bandage. These splints are well suited for first-aid treatment of suspensory apparatus injuries

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2
Q
A

Illustration showing sites on the horse (shaded areas) where bones are covered only by skin with no muscle protection, making them susceptible to open fractures when kicked by another horse.

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3
Q
A

Figure 74-6. Illustration showing the biomechanically important divisions of the forelimb and hind limb from distal to proximal: Forelimb (I) distal to the distal quarter of third metacarpal (MCIII), (II) from the distal aspect of MCIII to the distal aspect of the radius, (III) from the distal aspect of the radius to the elbow joint, and (IV) proximal to the elbow joint. Hind limb (I) distal to the distal quarter of third metatarsal (MTIII), (II) from the distal aspect of MTIII to the tarsus, (III) from the tarsus to the stifle joint, and (IV) proximal to the stifle joint.

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4
Q

What has improved the success rate of fracture management?
A. New surgical techniques
B. Use of a rescue unit for transporting fracture patients
C. Advanced pharmaceutical treatments
D. Improved breeding practices

A

B. Use of a rescue unit for transporting fracture patients

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5
Q

What should be considered in rescuing horses from dangerous locations?

A

Avoiding additional trauma

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6
Q

What is mandatory for horses with fractures?

A

A thorough clinical examination

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7
Q

What can be overlooked, affecting the diagnosis and prognosis?

A

Lacerations or lesions

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8
Q

What is a concern in the distal limb of a horse with fractures?

A

Vasospasms and vascular compromise

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9
Q

What dictates the use of sedation in treating horses with fractures?

A

The fracture and character of the horse

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10
Q

What should be the primary focus of fracture stabilization?

A

Pain and anxiety reduction and partial weight bearing

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11
Q

What is essential to prevent in horses with fractures during transport?

A

Movement of the fractured limb

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12
Q

How should the joints related to a fractured bone be immobilized?

A

Using external coaptation

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13
Q

What is the importance of stabilizing the joints above and below the fracture?

A

To prevent further displacement

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14
Q

What is a key requirement for splints used in equine fracture stabilization?

A

Orthogonal planes application

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15
Q

Which material is mentioned as suitable for improvised splints?

A

Metal rods or wooden boards

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16
Q

What is critical for immobilizing long bone fractures in horses?

A

Regional immobilization

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17
Q

What is the recommended stabilization method for fractures of the proximal or middle phalanx, and distal MCIII/MTIII?

A

Elevating the heels with a wedge and applying a cast from heels to proximal MCIII/MTIII

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18
Q

What is the first step in stabilizing fractures of the radius and tibia?

A

Application of a sturdy splint or cast up to the elbow or stifle

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19
Q

What is a suitable alternative to casts for fractures for proximal and middle phalanx as well flexor tendon lacerations and some LSB injuries? in which case is contraindicated?

A

The Leg Saver splint –> NOT ADIVSED for CONDYLAR FRACTURES of MT or MCIII because minimal medial-to-lateral support

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20
Q

What type of fractures do not require a bandage or splint?

A

Fractures of the humerus and femur

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21
Q

What is critical for emergency treatment of fractures of the scapula?

A

Sedation and pain management

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22
Q

How are fractures of the ulna typically stabilized?

A

With a splint that includes the carpal region

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23
Q

What can fractures of the ulna in horses lead to?

A

Failure of the passive stay apparatus of the forelimb

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24
Q

What are the indications for using a tube/sleeve cast in emergency immobilization?

A

Multiple palmar cuboidal bone fractures

25
Q

how do you apply a cast in a fractured radius?

A
26
Q

in case of fracture of tibia with a edge that is coming out what do you do?

A
27
Q

Kimzey splint is used in which fractures?

A

The Kimzey splint (Figure 74-7) can be used in breakdown injuries of the suspensory apparatus instead of a cast. However, it provides no mediolateral stability.

28
Q

why flexion immobilization is important in case of biaxial mid-body fractures of proximal sesamoid bones?

A

stretching and tearing of the palmar vessels and nerves, this results in marked displacement of sharp bone fragments, which can lacerate the neurovascular bundle. Emergency support of the distal limb in a flexed position is therefore critical to maintain viability.

29
Q

Region II: fractures of MCIII, MTIII, carpal and tarsal bones requires what?

A

a cast or splint is applied from the hoof to the elbow or stifle joint, respectively (Figures 74-8 to 74-10)

30
Q

Distal condyle of metacarpus and metatarsus should be immobilized how?

A

Displaced fractures of distal condyle should be placed in CAST with LIMB in NEUTRAL POSIITION or splinted Robert Jones with MCP in extended weight bearing position
Use of temporary immobilisation tx that include flexion of
the MCP joint are contraindicated.

31
Q

what is the position adopted in ulnar fractures?

A
32
Q

acessory carpal bone what is the immobilization?

A

Fractures of the accessory carpal bone do not jeopardize axial stability of the limb and a simple bandage will suffice.

33
Q

In the presence of multiple palamr cuboidal bone fractures what is the immobilization?

A
34
Q

incomplete fractures of the proximal phalanx should be managed how?

A

Incomplete fractures that extend from the
sagittal groove of the proximal phalanx into the mid diaphysis before coursing laterally should be managed as complete fractures since propagation (at least from the appearance on acute phase radiographs) to the lateral cortex is common.

35
Q

What should be performed in complete metacarpal or metatarsal III fractures?

A

Complete fractures should be considered
potentially unstable (whether or not this is clinically evident)
and mediolateral distracting forces resisted by application of
medial and lateral splints to a Robert Jones bandage, use of
a compression boot, bandage cast or cast. All should be
fitted with the metacarpophalangeal joint in an extended
position with flat foot ground contact.

36
Q

What is the most common combination of fracture involving metacarapl condyles fracture?

A

conjunction with breakdown of the suspensory apparatus due to biaxial fracture of dehiscence of the** proximal sesamoid bone** –> preserve vasculature is mandatory –> immobilization in flexion is necessary
Dorsal splint with fibreglass casting to increase mediolateral stability

37
Q

Luxation of MCP joint can have also disal metacarpal condyles and or palmar process of P1. How to immobilize?

A

If open luxation of MCP many times euthanasia due to poor prognosis. Optimal in close luxation is:
bandage cast from hoof to proximal MC or if position reduced a Robert Jones or splinted Robert Jones

38
Q

Transverse or oblique fractures of the metacarpal diaphysis

A

The fractured MC/MT3 can be stabilized with a
Robert Jones bandage and the application of rigid splints
on the lateral and palmar/plantar aspects of the limb.
Two splints at 90° angles are necessary to counteract
both dorsopalmar/plantar and lateromedial bending
forces

39
Q

where should be placed the plates in metacarpal/metatarsal fracture?

A

The plates used for long bone fracture repair are placed
at 90° angles to each other to oppose bending forces.
Following the principles of internal fixation, one plate
should be placed on the tension surface. All sides of MC3
are compressed at various stages when the horse walks,
therefore the plates can be applied on any surface of the
bone except for the palmar surface, where soft tissues
preclude placement. The plates are usually placed dorsal
and lateral or dorsal and medial, based on the fracture
configuration. The tension side of the MT3 bone is the
dorsolateral surface, so plates are most often applied
dorsal and lateral on this bone.

40
Q

mention the fractures of the tarsus that do no jeopardise axial stabiliy

A
  1. fractures of the tibial (usually lateral) malleoli,
  2. fractures of the trochlear ridges of the talus,
  3. parasagittal fractures of the talus
  4. slab fractures of the central or third tarsal bones.
41
Q

how do you immobilize a tarsal luxation or subluxation of the TMT or talocalcaenal-centroquartral joint in case of collateral and short intertarsal ligament disruption?

A
42
Q

How do you immobilize a stifle fracture?

A

There is no adequate immobilisation
for such cases.

43
Q

Fractures of the pelvic girdle are common and potentially life
threatening training and racing injuries why?

A

Displaced fractures of ileal shaft are life threatening –> wing, commonly lacerate iliacofemoral arteries and may
lacerate the parent internal iliac artery or, less commonly, the
external iliac artery (Fig 19). This frequently is catastrophic
resulting in distressing haemorrhagic shock and
exsanguination.

44
Q

Region IIIA fractures of the radius and tibia what is the main risk?

A

contraction of the extensor tendons, located craniolaterally on the limb, causes abduction of the limb below the fracture line, which may lead to skin perforation on the medial aspect of the radius or tibia (Figure 74-11, A)

45
Q

how do you immobilize type IIIA fractures (radius and tibia)

A

stabilization up to the elbow or stifle joint is not sufficient and will not prevent abduction. In these fractures, a sturdy splint or cast should first be applied up to the level of the elbow or stifle joint (see Figure 74-11, B) or even higher, if possible
In foals, a cast can be applied proximal to the elbow and stifle joint (Figure 74-12),

46
Q

What is the optimal way to transport a tibia fracture?

A

Padding as high as possible
Cast up to the stifle or eblow and stifle joint
stabilization of a fracture of the radius and tibia
sedation and van

47
Q

Immobilization of fractures type IIIB: fractures of ulna?

A

Fractures of the ulna result in failure of the passive stay apparatus of the forelimb (triceps apparatus) - the limb should be stabilized with a splint that includes the carpal region so that the horse can bear weight on the limb. The splint should be applied caudally and extend from the MCP region to the level of the elbow joint (Figure 74-15).

48
Q

Region IV: fractures of the humerus, femur, scapula, and pelvis immobilization

A

Fractures of the humerus and femur do not require a bandage or a splint because they cannot be adequately immobilized and there is enough muscle mass to protect the bone
complete displaced fractures of the scapula in adult horses carry a hopeless prognosis for humane preservation of life - Horses transported in a sling show fewer signs of stress because the stabilization provided improves weight bearing and balance during transportation.
Pelvis fx (exception ilial shaft= quick death) place in sling

49
Q

Fractures of spinal column

A

Corticosteros is indicated to reduce inflammatory response
Fluidotherapy
Too much analgesia can relax muscle and promote movement of vertebral fragment

50
Q

Why IV fluids might be required in elbow or stifle fractures if there is no severe hemorrhage?

A

However, pain can induce neurologic shock (see Chapter 1) leading to substantial fluid shifts, which should be addressed by intravenous fluid therapy. An indwelling intravenous catheter is placed and secured to the skin and a solution of electrolytes and glucose (up to 2% of body weight) should be administered with the drip rate set at maximum. (See Chapter 3 for details on fluid administration.)

51
Q

What factor influences the prognosis of a spinal fracture?

A

Presence or absence of neurological signs

52
Q

Why is transporting a horse with a forelimb fracture facing backward sometimes considered?

A

To reduce stress on the forelimbs during braking

53
Q

What is the role of an assistant inside the trailer during transport?

A

To calm the horse and relay any problems to the driver

54
Q

What should be considered for the floor of the transport vehicle?

A

It should be padded

55
Q

What should the driver of the transport vehicle be able to do?

A

Observe the horse via a video camera

56
Q

What is the role of the ramp in horse trailers?

A

It should be long to minimize the slope

57
Q

What are the IV regions?

A

I) the hoof to the distal metacarpus,

(II) the distal metacarpus to the distal radius,

(III) the distal radius to the elbow joint, and

(IV) the region proximal to the elbow joint.

The regions for the hind limb are

(I) the hoof to the distal metatarsus,

(II) the distal metatarsus to the tarsus,

(III) the tarsus to the stifle, and

(IV) the region proximal to the stifle.

58
Q

A suspected ilial shaft what is the management?

A

appropriate sedation and analgesia to maintain control of the patient. Horses should be supervised at all times and not be allowed to lie down.Stabilization in a sling has proven to be very usefull.

A U E R S & T (122 decks)

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