Exam 1-Lecture Flashcards
Why would you do a cortical fenestration?
Speed granuylation tissue formation over exposed bone
What is the process by which epiphyseal cartilage becomes bone?
Endochondral ossification
Preferred antibiotic for non-GI surgeries
Cefazolin
What mode: Plates are used in addition to primarily placed lag or positional screws
Neutralization mode
T/F: Dogs with MCD will experience pain with flexion and supination of the elbow
True
What agent of granulex helps stimulate capillary formation?
Balsam of Peru
Which type of screw has a more shallow thread? Cancellous or cortical
Cortical screw
What are some indications for skin grafting?
Skin defects on the extremities
Extensive burn wounds
Adjunct to other reconstructive procedures
Antibiotic use when an infection is already present. What type of wounds?
Therapeutic
Contaminated/Dirty
Definition: spontaneous fusion of a joint - end stage of joint disease
Ankylosis
Which is stronger? Lag screw or position screw?
Lag screw
Under what circumstance would you use cross pinning?
Simple transverse fractures close to the joint
What is determined by the core diameter of the screw?
Bending strength
When using IM pins with a plate, what diameter pin should you use?
35-40% canal fill
Which is the preffered surgical technique for osteochondritis dissecans? Arthroscopy or arthrotomy
Arthroscopy
When is it most appropriate to use an external skeletal fixator for fracture fixation?
Fractures below the stifle and elbow
What are the benefits of negative wound pressure therapy for acute vs chronic wounds?
Acute = promote granulation tissue formation
Chronic = improves second intention healing
What type of degloving injury is it when the skin is devitalized but still in place?
Physiologic
When is prophylactic antibiotic use encouraged?
High infection risk
Catastrophic infection risk
An infection involving implants can be classified as a surgical infection for how long post-op?
1y
Definition: elastic modulus is dependent upon the direction of loading
Anisotropic
T/F: If there is glenoid dysplasia with congenital shoulder luxation, reduction is not possible
True
What is determined by the outer diameter of the screw?
Oull out strength
T/F: If the etiology is repetitive trauma or overuse, it is probably seen bilaterally in adult dogs
False
Seen unilaterally
What type of internal fixation do you want to avoid disruption of fracture hematoma?
Biological osteosynthesis
What are the indications for surgery to treat biceps tendinopathy?
Refractory to medical therapy
Radiographic changes
Mechanical deficits
Moderate to severe lameness
T/F: The outcome of joint surgery is based on the cause rather than the procedure/technique
False
Based on procedure/technique rather than the cause
What size dogs are associated with congenital shoulder luxation?
Small and toy breeds
Shetland sheepdog
Collie
Elkhound
What technique would you use for Salter Harris Type 1 fractures of the proximal humerus or femoral head?
Diverging pin technique
Whe is calcium alginate dressing indicated?
Moderate to heavily exudative wounds in early stages of healing
Wound adequately debrided but not amenable for closure
What agent of granulex helps minimize tissue desiccation?
Castor oil
How do the lengths of the radius and ulna compare in a dog with UAP?
Short ulna/long radius
When cross pinning, should the pins cross above or below the fracture line?
Above
T/F: Dogs usually show good response to NSAIDs for shoulder instability
False
Interlocking nail cannot be used in what bone?
Radius
What is the exception to using orthopedic wire as the sole method of fracture fixation?
Some mandibular fractures
What type of strain: Combination of compressive, tensile, and shear loading forces
Torsion
What is the debriding agent of granulex?
Trypsin
What is the ideal number of transfixation pins used above and below the fracture?
3-4
Definition: surgical fusion of a joint
Arthrodesis
What are some examples of secondary osteoarthritis?
Developmental: OCD, hip dysplasia
Acquired: trauma, neoplasia
What size dogs are associated with biceps brachii tendinopathy?
Medium and large breed
Middle-aged
Wound containing pus, or perforation of hollow viscus.
Dirty
How many screws do you need to place above and below a fracture when using locking plates?
2 above and 2 below (4 cortices)
Femoral head and neck excision and glenoid excision are what types of surgery?
Partial excision arthroplasty
What is the common age of presentation for elbow dysplasia?
5-12 months
What is the major disavantage of surgical drains?
Increased risk of secondary infection
Open fracture classification:
Open wound >1cm
Wound from external source
Mild soft tissue traume
No flaps or avulsions
Type 2
What type of ESF?
Type 2A
Bilateral-Uniplanar
Most common source of operative infections?
Endogenous flora
Definition: incision into a joint
Arthrotomy
How do the lengths of the radius and ulna compare in a dog with FCP?
Short radius/long ulna
What are two advantages of limited contact DCP over DCP?
Allows stress to be more evenly distributed across the plate
Less contact with bone = less disruption of periosteal vascularity
What antibiotic is used for type 1 and 2 wounds?
Cefazolin
What type of ESF?
Type 2B
Bilateral-Uniplanar
How far should cerclage wire be placed from the fracture ends?
0.5cm
Wound that is created surgically, but there is gross bacterial spillage. Major aseptic technique breaks.
Contamined Wound
How far should transfixation pins be placed from the fracture and each other?
1/2 bone diameter
What would you use for mandibular and maxillary fractures?
Interfragmentary wire
When would you use rush pinning?
Some Salter Harris fractures
Supracondylar fractures
What are Burows triangles?
Triangles of skin removed at base of flap to precent dog ears form forming when flap is advanced
What type of fractures would you use a hybrid fixator for?
Metaphyseal
What surgical procedures can be done for biceps tendinopathy?
Tenotomy
Tenodesis
What type of fractures can you use cerclage wire on?
Oblique
Spiral
When is surgical treatment of joint disease indicated?
When severe DJD is present
What is the max size of a transfixation pin?
25% of the bone diameter
When using IM pins with cerclage wire, what diameter pin should you use?
70% canal fill
Open fracture classification:
Adequate soft tissue for wound coverage
Large soft tissue laceration/flap
Type 3A
What are the only types of ESF that can be placed on the humerus and femure?
Type 1A and 1B
What are examples of secondary implants?
Kirschner wires
Cerclage wire
Interfragmentary screws
What are some indications for external coaptation?
Fractures below the elbow and knee
Minimally displaced fractures
Transverse, simple, closed fractures
Greenstick fractures
Non-articular fractures
What is the etiology of FCP?
Microtrauma
An infection at a surgical site can be classified as a surgical infection for how many days post-op?
30d
Advantage and disadvantage of ipsilateral flap?
Adv - increases distance flap can extend
Dis - increases risk of kinking vessels
T/F: Plastic deformation is a reversible change in shape
False
Permanent change in shape
Wound that is surgically created and asepsis is maintained throughout the procedure. No bacterial structures opened.
Clean Wound
Which type of screw has a larger pitch? Cancellous or cortical
Cancellous screw
Which type of screw has a larger outer diameter to core diameter ratio? Cancellous or cortical
Cancellous
T/F: If its a developmental joint disease, its probably bilateral with biphasic age grouping
True
What type of sling would you use for a medial traumatic shoulder luxation?
Velpeau sling
What type of fractures would you use compression mode of a plate?
Transverse
Short oblique
Is it better to use a combo of antibiotics for wounds or a single agent?
Single agent
Tx for acute biceps brachii tendinopathy?
Cinfinement for 4-6 weeks
NSAIDs
Open fracture classification:
Wound smaller than 1cm
Typically created by bone fragment from inside that retracts back through skin
Mild/moderate soft tissue contusion
Type 1
As time increases, what happens to infection rate. How much?
Increases….Doubles every hour
Antibiotic use prior to wound contamination. This is used with what type of wounds?
Prophylactic
Clean or C-C
Tx for moderate shoulder instability?
Capsulorrhaphy
Rest
PT
Hobbles
What type of flap incorporates a direct cutaneous artery and vein?
Axial pattern flap
What type of ESF is this?
Type 1A
Unilateral-Uniplanar
What function is expected after surgical treatment for osteochondritis dissecans?
Near-normal to normal function
What are the two types of biological osteosynthesis?
Open but do not touch
Minimally invasive osteosynthesis
What would you use to treat diaphyseal comminuted fractures?
Interlocking nail
What type of sling would you use for a lateral/cranial/caudal traumatic shoulder luxation?
Spica sling
What bone is it contraindicated to use IM pins for?
Radius
Tx for mild shoulder instability?
Rest
PT
Hobbles
What type of internal fixation would you use for articular fractures?
Open anatomic reconstruction
What type of fracture would you use a tension band wire for?
Avulsion fractures
Some osteotomies
What type of ESF?
Type 3
Bilateral-Biplanar
All traumatic wounds are classified as this type of wound…
Contaminated
What are the indications for using a locking plate?
Osteoporotic bone
Soft bone
Comminuted fractures
How far apart should cerclage wire be placed?
0.5-1x bone diameter
What type of fractures would you use a lag screw for?
Certain articular fractures
Oblique fractures
What type of degloving injury is it when the skin is avulsed from underlying tissue?
Anatomic
What plate mode would you use in a metaphyseal fracture to prevent collapse of the adjacent articular surface?
Buttress mode
Point when material begins to deform plastically
Yield point
Wound that is created surgically, bacterial organ opened…but no spillage. Minor breaks in aseptic technique, such as a hole in a glove.
Clean-Contaminated
Open fracture classification:
Arterial +/- nerve supply compromised
Requires microvascular anastomosis or amputation
Type 3C
What dog breeds are associated with osteochondritis dessicans?
Large and giant breed dogs
What is the best diagnostic tool to diagnose biceps tendinopathy?
Arthroscopy
Is primary osteoarthritis more common in dogs or cats?
Cats
Why are back cuts used for rotation flaps? What is one negative effect of back cuts?
Increase mobility of the flap
Decrease dog ear formation
Negative - increases risk of vascular compromise
What type of ESF is this?
Type 1B
Unilateral-Biplanar
Definition: Increased speed of loading increases material stiffness
Viscoelastic
Think tempurpedic
What is the max size of a screw that can be placed in bone?
40% of the bone diameter
Advantage of contralateral flap over ipsilateral flap?
Less risk of kinking vessels
Which strain characteristic: Combination of tensile and compressive loading forces
Bending
Does the bone or the plate carry most of the load with compression mode?
Bone
When would you use dynamization?
6 weeks post repair
What is the best diagnostic method for shoulder instability?
Arthroscopy
What is the cause of pain in old dogs with elbow dysplasia?
Osteoarthritis
What breeds are associated with elbow dysplasia?
GSD
Labs
Goldens
Bernese mtn
What is the only force that steinmann pins resist?
Bending
What screw has the largest core diameter?
Locking screw
T/F: Dogs with UAP will experience pain when the elbow is extended
True
Preferred antibiotic for GI surgeries
Cefoxitin
What kind of dressings are used for mechanical debridement?
Wet-to-dry or dry-to-dry
(covered in antiseptics if infected)
The “toed out” posture is associated with what condition?
MCD
How many screws do you need to place above and below the fracture when using conventional plates?
3 above and 3 below (6 cortices)
What mode: Plate spans fractured area which cannot be anatomically reconstructed (comminuted area)
Bridging mode
Tx for recurrent/persistent lameness associated with biceps brachii tendinopathy?
IA injection of methylpred
Confinement 4-6 weeks
PT
When is mechanical debridement indicated?
For wounds in lag phase with heavy contamination or thick viscous exudate
What are examples of primary implants?
Bone plates
Interlocking nails
External skeletal fixators
What is the strongest and most commonly used pin for ESF?
Positive profile
How would you elicit a pain response in an animal with biceps brachii tendinopathy?
Maximally flex shoulder and extend elbow
Press on biceps at insertion while standing
What type of fractures would be good for circular external skeletal fixators?
Tibia
Radius
PE findings for traumatic shoulder luxation
NWB lameness
Pain when palpate shoulder
Malpositioning of greater tubercle
Since osteochondritis dessicans is usually a bilateral disease, why is there unilateral lameness?
Because one side tends to be worse than the other
What PE tests can be perfromed for craniocaudal shoulder instability?
Biceps tendon test
Shoulder drawer test
What is the cause of the pain in young dogs with elbow dysplasia?
Defect in joint surface
Is there compression when using position screws?
No
How long does the fracture line need to be in order to use cerclage wire?
≥2x the diameter of the bone
Open fracture classification:
Extensive soft tissue loss
Bone exposure
Stripped periosteum
Type 3B
T/F: Elastic deformation is a reversible change in shape
True
Tx for severe shoulder instability?
Medial glenohumeral ligament reconstruction
Velpeau sling instead of hobbles
What are some indications for drains?
Dead space cannot be obliterated
Fluid accumulation if likely
Infection
When using bridging mode, does the plate or the bone bear all of the load at the level of the fracture?
Plate
