Fracture Treatment

Question 1

Stable fracture

Answer 1

Fragments that interlock and resist shortening of the area .

Limb could be at risk of angular and rotational deformity.

Question 2

Unstable fracture

Answer 2

Fragments that do not oppose each other or interlock and therefore ends of the bone may slide past each other and out of position.
-At risk of shortening, increased tissue damage and rotation.

Question 3

Order of events after fracture includes:

Answer 3

Haemorrhage to the area, clot formation, inflammation, oedema formation, proliferation of mesenchymal cells, cartilage and bone formation and finally remodelling of callus back to normal bone.

Question 4

What is a fracture repair called?

Answer 4

Reduction

Question 5

What should the method of repair allow?

Answer 5

1) provide continuous immobilisation
2) permit early ambulation
3) Protect surrounding soft tissues
4) Permit movement of as many joints as possible

Question 6

What happens when there is a delay in fracture repair?

Answer 6

1) Spastic contraction of the muscles
2) Inflammatory thickening of tissues
3) obstruction of fracture line due to callus formation
4) Increased hemorrhage due to increased vascularization at the fracture site

Question 7

Close reduction without surgery needs external coaptation. What are some of the examples?

Answer 7

Bandage, cast, splints, or slings

Question 8

When are closed reduction most successful in?

Answer 8

Small, long legged breeds

Question 9

External coaptation application criteria

Answer 9

1) Protect from further trauma
2) Absorption of discharge
3) compression to limit dead space formation
4) stabilisation of fracture to promote bone healing
5) Apply all materials in normal standing, and weight bearing position
6) Must stabilise the joint above and below the fracture
7) Cast and splints must be used below the elbow or stifle

Question 10

Spica splint

Answer 10

The only acceptable external coaptation for a femur or humerus

• usually better off internal fixation if client compliance is not there
• expensive, time consuming and non-rewarding
• complications

Question 11

Internal reduction

Answer 11

Surgery to correct fracture. Methods include: intramuscular your (IM) pins, Kirschner wires (K-wires), cerclage wires, bone screws, interlocking nails, bone plates, compression plates

Question 12

External fixatior

Answer 12

• a form of INTERNAL reduction with connecting bar and clamps are external of the limb
• Invasive surgery to place a large IM pin within the medullary canal of a bone, drill small K-wires into the cortices, and connect them using clamps to a large external connecting bar running parallel to the bone

Question 13

Complication with external fixation

Answer 13

Drainage from a pin track

Loosen pins = bone instability and non-healing conditions or bone resorption

Question 14

Bone plates

Answer 14

• Early return to full function of the limb
• Required in multiple or complex fractures, large breed dogs, heavily muscled dogs
• Complications: loose or broken plate, infection, growing immature pet, vascular interference resulting in osteoporosis, cold reactivity, or irritation leading to lick granuloma

Question 15

Average time for bone healing

Answer 15

2-30weeks before clinical union is evident

Question 16

Delayed union

Answer 16

Fracture that has not healed in the usual time given to that type of fracture

Question 17

Non-union

Answer 17

No further evidence of osteogenic activity, movement of the fracture present, and healing will not occur without surgical intervention