Fracture stabilisation

Question 1

What adaptations of the AO principles of fracture management are made in horses? What are the challenges?

Answer 1

• 5.5mm screws
• Less use of external fixators
• Most fixation without plates

Challenges exist
* Size
* Soft tissue injury

Question 2

What are the 3 important steps in fracture management to achieve a positive outcome?

Answer 2

• Immediate pre-operative stabilization
• Methodical surgical planning
  
  • Use of diagnostic imaging (x-ray, CT)
  • Arthroscopy
  • Standing?
• Appropriate stabilisation techniques

Question 3

What are the 4 AO principles of fracture repair?

Answer 3

1. Fracture reduction and fixation to restore anatomical relationships
2. Fracture fixation providing absolute or relative stability as the “personality” of the fracture, the patient, and the injury requires
3. Preservation of the blood supply to soft tissues and bone by gentle reduction techniques and careful handling
4. Early and safe mobilization and rehabilitation of the injured part and the patient as a whole

Question 4

What are the 3 ways screws can be placed in fracture repair? What is their role?

Answer 4

• Lag screws - Achieve compression which is essential for direct healing
• Position screws - Each screw size has two drill diameters associated with it:
  
  • Thread hole diameter (smaller drill bit used - core diameter of the screw)
  • Glide hole diameter (same width as the screw)
  • additional screws to ensure stability of the fracture
• Plate screws
  
  • dynamic compression plates (DCP)
  • limited contact DCP
  • locking compression plate (improve stability as it fix in the bone and the plate with thread on screw head as well)

Question 5

What bones are most commonly repaired for fractures?

Answer 5

• 3rd metacarpal
• proximal phalanx

Using either a triangular or linear screw configuration

Question 6

What are other situations where screws are used ?

Answer 6

• severe osteoarthirtis
• apply compression on subchondral bone cysts