Exam 2 - LA fracture, tendons, joints Flashcards
functional categories for fracture stabilization:
category 4 - shoulder/stifle/humerus & femur
no immobilization necessary
functional categories for fracture stabilization:
category 3 - radius/ulna & tibia/fibula
robert jones bandage with extended lateral splint
functional categories for fracture stabilization:
category 2 - metacarpal/metatarsal “cannon bone”
robert jones bandage with lateral and caudal/plantar splint
(caudal to lock carpus in extension)
functional categories for fracture stabilization:
category 1 - hoof/coffin bone
dorsal splint (forelimb)
plantar splint (hindlimb)
includes tendon injuries
what does emergency first aid management include
sedation
initial wound management
fracture stabilization
analgesia/anti-inflam (NSAIDs, opioids, caudal epidural)
antimicrobial prophylaxis (broad spectrum IV)
IV fluids
careful safe transport
transportation for LA fractures
minimize walking distance/need to use fx limb
use ramp with minimal slope & non-slip surface
lateral support to body wall
want “fracture in the back” so hindlimb fracture face forward and forelimb fracture face backward
caution with braking, acceleration and turns
unload using sound limbs first
how would you stabilize a forelimb phalangeal fracture?
dorsal splint
how would you stabilize an olecranon fracture “dropped elbow”?
caudal splint to lock carpus in extension - from elbow to fetlock
management for an olecranon fracture
internal fixation
strict stall rest for older horses or nondisplaced fractures
what is the prognosis for an olecranon fracture
good-excellent
if open - fair to good
tendon composition breakdown
cells
extracellular matrix 30%
- collagen (86%) + ground substance
water 60-80%
what type of collagen are tendon primarily made of
type I collagen
what makes up ground substance
elastin
proteoglycans
glycosaminoglycans
glycoproteins
describe the blood supply to tendons
what is their blood supply affected by?
avascular (long healing)
age (decreased with age)
exercise (increases)
injury (increases)
what collagen are ligaments made up of
type III collagen
tendons heal slowly due to ____
low blood supply (relative hypoxia)
healed tendons lack ______
elasticity and strength compared to healthy tendons
why do tendon injuries have a high incidence of recurrence?
due to impaired elasticity/strength due to increased collagen III vs I and reduced strength of scar tissue
contributing factors of tendon injuries
conformation
shoeing
fatigue related incoordination during performance
aging
exercise
predispositions in tendon injury
flexors > extensors
SDFT > DDFT because more external, smaller CSA and less vascular
forelimbs > hindlimbs
what does injury to the SDFT alone cause
mild hyperextension
what does injury to the SDFT and DDFT cause
moderate hyperextension
elevation of the toe off ground
what does injury to the SDFT, DDFT and suspensory ligament cause
complete loss of fetlock joint support
what suture patterns should you use for flexor tendon lacerations
three loop pulley
interlocking loop (not as strong)
treatment for flexor tendon lacerations
what % return to athletic function?
debride
suture
distal limb cast 6-8 weeks
55% return to athletic function
what is articular cartilage
central structure constituting joint function
provides frictionless movement of joints
articular cartilage lacks what?
vascular, lymphatic and neural suuply
articular cartilage depends on what?
diffusion for nutrients and waste removal
what does articular cartilage consist of
chondrocytes
extracellular matrix
articular cartilage has limited ability for what
shock absorption
what are the 5 zones of articular cartilage
which one is the most?
superficial/tangential zone
intermediate/transitional zone (MOST)
deep/radiate zone
calcified zone
tidemark
what collagen is articular cartilage made of
type II collagen
indications for arthroscopy
diagnostic
osteochondral fragments
intra-articular fractures
debride OCD/cystic lesions
synovectomy/lavage for sepsis
benefits of arthroscopy
less invasive
visualize more articular surface
arthroscopic closure…
tissue?
pattern?
skin only
simple interrupted or cruciate pattern
arthrotomy indications
large intra-articular fragments
large intra-articular fractures
sepsis
arthrotomy closure…
tissue?
pattern?
synovial layer use small diameter absorbable suture & simple continuous
ligaments - large diameter absorbable or non-absorbable suture + simple interrupted or vertical mattress
skin - interrupted or continuous
