Complications of orthopedic surgery (McConky) Flashcards
Delayed unions
Failure to heal in time frame
Slow progression
Eventual union possible without surgical intervention
Where does the blood supply originate from in a fracture to the callus
Soft tissue around the fracture
What must happen for a soft callus to become a hard callus
Stable conditions
Biologic causes of delayed union
insufficient vascularity
infection
Mechanical causes of delayed union
Inadequate reduction and fixation
Excessive activity
Nonunion
failure to achieve bony union with no evidence of progression
Nonunion etiology
Instability Poor blood supply Large gap between segments Soft tissue between segments Infection and sequestration
Clinical signs of nonunion
Palpable Muscle atrophy Limb deformity Impaired function Lameness Pain
Viable nonunions
Hypertrophic
Slightly hypertrophic
Oligotrophic
Nonviable nonunions
Dystrophic
Necrotic
Defect
atrophic
Hypertrophic nonunion looks like
elephant foot
Slightly hypertrophic nonunion looks like
horse foot
Oligotrophic nonunion
no signs of healing
Treated as nonviable
Dystropic nonunion
poorly vascularized fragment with partial healing
Necrotic nonunion
dead fragments
Atrophic nonunion
resorption of adjacent bone ends
Treatments of nonunion depend on
Lack of stability or vascularity or both
Treatments for nonunion fractures
Debridement of necrotic bone
Opening of medullary canal
Rigid internal fixation
Autogenous canellous bone graft
Malunion
inadequate fracture reduction or stabilization
Progress to bony union
Deformities
Clinical findings of malunion
Malalignement of limb
Fx site stable and non-painful
Lameness
Does not always cause clinical problems
Treatments for malunion
Corrective osteotomy
realignment
Rigid fixation
Surgery is indicated when
Impaired limb function
Stenosis of pelvic canal
Jaw malocclusion
patellar luxation
Osteomyelitis
Inflammation of bone marrow
Usually infectious
Adjacent soft tissues usually involved
Most common form of osteomyelitis in small animal practice
chronic, post-traumatic osteomyelitis
What is required for osteomyelitis
vascular compromise and bacterial contamination
Sequestrum
necrotic bone fragment
Involucrum
periosteal reaction surrounding the sequestrum
Cloaca
opening in involucrum resulting in drainage
How do you diagnose osteomyelitis
Positive culture
Will antibiotics alone cure osteomyelitis
NO
Treatment of osteomyelitis
Debridement Removal of foreign material Drainage Rigid stabilization Long term antimicrobial
When makes quadricepts contracture more likely to happen
young growing dogs
Femoral fractures
Excessive fibrous tissues
What causes quad contracture
quad muscle trauma
Prolonged immobilization
Treatment of quad contracture
Hack the leg off
