Emergency fracture management and casting Flashcards
Why is soft tissue damage important?
supply to limb (blood etc)
Is hemorrhage usually a problem?
no
What is bad about an open fracture?
can get infected
What should you do with an open fracture?
lavage topical/systemic antibiotic careful what put on wound careful about clipping sterile wrap
What are the benefits of immobilization?
- decrease bone damage (eburnation)
- decrease soft tissue damage
- slight weight bearing–lower stress
- safer transport
What are the types of immobilization?
- cast
- cast material over modified robert jones bandage/splint
- modified robert jones bandage/splint
- robert jones bandage–poor
- plain stable wrap–useless
What is a modified robert jones bandage?
multiple tight layers. Do one layer at a time and get nice and tight
What allows best immobilization for lower limb?
cast (but usually do it when horse recumbent and that is easier to put cast on properly)
What is the best choice for long transport and severe comminution?
cast
What are the four areas of the leg?
area 1: fetlock and below
area 2: canon bone
area 3: hock in back and above carpus and below elbow in front? (or including elbow?
area 4: shoulder, hip/pelvis
What should you do for area 1 front leg?
light wrap
NON elastic tape (not too tight!)
dorsal splint
What should you do for area 1 beack leg?
light bandage
fetlock flexes so hard to apply cranial splint
can apply caudal or cranial splint
non elastic tape
What should you do for an area two (cannon bone)
modified robert jones bandage–snug, not too much pressure
2 splints: lateral and caudal
What do you do for area 3 front leg?
- modified robert jones bandage
- lateral splint with padding–incorporate
- deceases abduction and medial compounding
What tends to happen in the front leg fracture in area 3 is not immobilized?
it tends to go medially and proximally (the proximal end)
as the distal end of leg abducts
What do you do for area 3 back leg?
modified robert jones wrap
lateral thigh suport, padded top
Why should you travel with the fractured leg caudally?
because if have to stop, then horse’s weight will be loaded on the cranial facing legs so want two good legs cranially
Why is it better t have dividiers, chest and rump ropes when travelling with horse?
less work for horse, can lean against things, something to support if stop quickly
Why should you call the referral center?
because they should be prepared and to ask what they want–how you should send the horse (feed, antibiotics, analgesics?)
What are the types of casts?
- ? foot casts–below fetlock
- 1/2 leg cast–below hock/carpus
- full leg cast–elbow/stifle
- tube cast–no bottom, not for fracture repair, can cause rubsores
How can you apply casts
standing or recumbent
How do you put a cast on?
put a LIGHT wrap on if wound, NOT a lot of material!!!!
stockingette, felt at top
Why do you want stockinette the appropriate diameter for casting?
so there aren’t wrinkles so dont get a sore
What is a walking bar?
bar for horse to walk on. can incorporate into cast
make so no part of leg touches ground? Put in the middle between heel and toe and make the bar the lowest point so it contacts the ground.
