Diaphyseal Fracture Repair Flashcards
What are the important steps to take when presented with a possible fracture?
Stabilise the patient first and administer analgesics! Diagnose with palpation and rapid radiographs.
How is a fracture evaluated?
How much have the bones been displaced?
Can the fragments be reconstructed?
What forces are going to be acting on the fracture and how does can these be stabilised?
What forces could act on the fracture site?
Compression, tension, shear (these three from bending) and torsion (from the action of muscles)
What are the types of fixation methods available?
ESF, co-aption, plates and screws, intramedullary pin and interlocking nails
What is the most common reason for co-aption?
The animal is young and will heal rapidly.,
What are the problems with coaptation?
Gives little stability to the fracture so can result in greater malalignment. Can also result in cast associated injuries.
What are the ways in which an implant can support a fracture site?
Compression mode - squeeze bone together to promote primary union.
Neutralisation mode - used when reconstructing, this protects the reconstruction by neutralising the forces.
Buttress mode - taking the full load, this is when the fracture wouldn’t be able to withstand any loading at all.
When is an esf often used and why is it good?
To neutralise and in healing by secondary union. It is good because it is a very variable system.
What is the main advantage of an intramedullary pin?
It is very good at resisting bending forces.
When is a lag screw used?
To compress bone fragments towards each other. Note: doesn’t resist loading forces.
Why must an intramedullary pin be combined with other fixation methods?
Although it is very good at resisting bending forces it does not resist compression or rotational movements.
What are the 4 A’s?
Is ALIGNMENT the same as immediately post op?
Is the APPOSITION of the bones the same as post op?
Is the APPARATUS in working order?
ACTIVITY - is the bone healing?
