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Animal Diseases 2 > Fractures > Flashcards

Fractures Flashcards

1
Q

What are the 5 forces that act on fractures/can cause fractures

A

Bending
Torsion
Compression
Shearing
Tension

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2
Q

What is the most common force that acts on fractures

A

Bending

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3
Q

What type of fracture results from bending

A

Angulation

Breaks opposite to where the force is applied

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4
Q

What type of fracture does torsion result in, what bones are they most common in?

A

Rotation

Tends to cause spiral fractures

Most common in long bones

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5
Q

What type of fractures does compression usually result in

A

Oblique/comminuted fractures as well as shearing fractures

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6
Q

What type of fracture does tension result in

A

Avulsion

Distraction (pulling apart)

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7
Q

True or false
Fractures normally only involve one force

A

False
They normally involve a combination of forces

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8
Q

Why is it important to understand the forces that caused a fracture

A

Because the same forces will prevent it from healing

Neutralizing the forces is key in healing

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9
Q

Bone is Viscoelastic, what does this mean

A

Can take a certain amount of force/load/bending before it breaks

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10
Q

What does it mean when you see translucent lines on the ends of bones on a radiograph

A

These are the growth plates and it indicates the animal is still growing

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11
Q

What is a closed fracture

A

When the fracture has no connection to the outside world (the skin is intact)

The way to tell is with physical manipulation and observation

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12
Q

What is an open fracture AKA compound fractures

A

The wound connects the bone to the outside world (skin is open) often bone is sticking out

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13
Q

Which type of fracture often need antibiotics? Why?

A

Open fractures

Because of the open wounds, and because there is often an infection present

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14
Q

What is a fissure fracture?

A

Cracks or incomplete fractures

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15
Q

Why do you need multiple views on radiographs with fissure fractures

A

Because it can be hidden depending on how you look at it

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16
Q

What is a green stick fracture

A

Young animal fractures

These are incomplete due to elasticity of young bones (bending a green stick from a tree)

These heal very rapidly and have a good prognosis

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17
Q

How do you often need to treat fissure and green stick fractures

A

Often just need a splint

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18
Q

What defines a “complete” fracture

A

When both cortexes of the bone are affected (goes all the way through)

Can be displaced or not

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19
Q

What does it mean when a fracture causes the bones to be “displaced”

A

Being moved from their correct/original position

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20
Q

What is a comminuted fracture? What force often causes it? How is it corrected?

A

When the fracture results in more than 2 fragments

These require surgical fixation

Often from compression

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21
Q

What are physeal/growth plate fractures (AKA Salter Harris Fractures)? What does it result in?

A

These are fracture that in some way affect the growth plates of young animals

Often results in abnormal growth and formation of the bones or early closure of the growth plates

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22
Q

What is a transverse fracture versus an oblique fracture

A

Transverse: across the bone

Oblique: at an angle through the bone

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23
Q

What is a long versus short oblique fracture

A

Long: the fracture is at least twice the diameter of the bone

Short: the fracture is less than twice the diameter of the bone

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24
Q

Spiral fractures are often caused by ___ forces

A

Twisting / torsion

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25
Q

What is a concern when the edges of a fracture are flat versus jagged

A

Torsion or sliding is an issue with flat edge fractures because the bones will slide on one another which prevent healing

Jagged edge fractures fit together like puzzle pieces and sliding does not occur

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26
Q

What are the factors that affect fracture geometry

A

The energy applied

The type and direction of the force applied

Which bone is fractured

Age of the animal (viscosity)

27
Q

Knowing the type of fracture and what types of forces to avoid and which forces work in your favour comes in hand when you ___

A

Reapply a splint

Restrain

Take radiographs

Provide nursing care

28
Q

What is the fracture considered if it happens to a healthy bone

A

Traumatic fracture

29
Q

What is the fracture considered when it happens to a diseased bone, why?

A

Pathological fracture

Diseased bones cannot withstand normal amounts of force like healthy bones can and can break easier

30
Q

What does fracture healing rely on the most

A

The formation of new bone

31
Q

What are the 5 steps in fracture healing

A

1: fracture is reduced and immobilized

2: gap must be made small enough for blood vessels to grow across it because blood vessels bring in cells and healing factors

3: fibroblasts and chondrocytes enter the gap and fill in with fibrocartilagenous tissue scaffolding

4: osteoblasts enter and fill the gap in with new bone

5: get rid of infections (infected bone will not heal)

32
Q

Why is it normal to see a wider gap a little while after a fracture was reduced on x ray?

A

Osteoclasts come in and eat away dead and damaged bone tissue, this makes the gap wider but also promotes new bone growth

This is why 2 week X-rays are need in check ups

33
Q

What forms around the fracture but will go down with time

A

Bone calluses (this is where the bone is healing)

34
Q

Fractures must be ___ and ___ in order to heal

A

Reduced and stable

35
Q

What are the healing times of fractures in healthy adults versus young animals

A

Adults: 8-12 weeks

Young: 4-6 weeks

36
Q

What are the 3 ways fractures are repaired

A

External coaptation
External fixation
Internal fixation

37
Q

What forces are external coaptation good at correcting

A

Bending (best)

Torsion (fair)

38
Q

What are the advantages of external coaptation

A

Non invasive (no disruption of blood supply or growth plates and no surgery)

Moderate expense

Can be done anywhere and with anything

Good temporary measure (prevents further damage)

39
Q

What are the limitations to external coaptation

A

Poor control of tensile and compressive forces

Less rigid stabilization

Alignment and reduction can be difficult or impossible to attain

40
Q

What are the disadvantages of external coaptation

A

Rub sources and dermatitis is common (mostly in skinny limbs)

Constrictive coaptation can lead to swelling and necrosis

41
Q

What are the rules of external coaptation

A

Go at least 1 joint above and below the fracture

Don’t put on too tight or too loose (rubbing)

Add padding on pressure points

Include the foot but leave the 2nd and 3rd digits exposed

Splint in normal position but slightly flexed

Splint changes regularly and require many people for restraint

Take X-rays BEFORE removing the splint

42
Q

What is internal fixation

A

When hardware is placed inside the limb or bone

These are sometimes left in for life

43
Q

What are the different options for internal fixation

A

Intramedullary pins (left in for life) (only neutralizes bending)

Interlocking nails with or without a bone plate

Cerclage wiring (only works on long oblique fractures)

44
Q

What is external fixation

A

Hardware being place internally that are connected to hardware externally

45
Q

What are some examples of external fixation

A

Intramedullary pin with ESF tie in

Screws and bone plates

46
Q

What forces do screws and bone plates control

A

ALL OF THEM

47
Q

What is locking vs non-locking plating

A

Locking: fracture fixation devices with threaded screw holes. This threads the screws to the plate and acts as a fixed angle device. The screws and the plate work as a unit

Non locking: these systems require the plate to be directly on the bone in close contact to prevent the bones from being displaced. Force is transferred from bone to plate via friction at each screw site

48
Q

What are the advantages of internal AND external coaptation

A

Most rigid support (external > internal > coaptation)

Animal can use the limb sooner

Allows skin to be exposed to air and wounds can be exposed

Better fragment reduction which results in faster healing

49
Q

What are some disadvantages and possible complications of internal and external coaptation

A

Risks with GA

very expensive

More specialized surgeries

Risk of iatrogenic fractures and disrupted blood supply

External requires second procedure for hardware removal

Hardware causes discomfort in cold temps

Pins can shift over time and cause pain

Higher risks of infection due to foreign material in the body

50
Q

What are the limitations to internal and external fixation

A

Need to monitor for infections (harder to treat, may result in hardware removal, impedes bone healing)

Still need post operative care (bandage changes, analgesia, physical therapy)

51
Q

True or false
Infections are not always an emergency

A

FALSE

they are always an emergency

52
Q

How often must you recheck external coaptation fixture versus surgical repairs

A

Coaptation: every 2-3 days Initially then weekly

Surgical: at 2 weeks and then every 2-4 weeks

53
Q

When must rechecks happen sooner

A

If the splints or hardware slips

If they aren’t using the limb

Infections

Pain

54
Q

What are some possible complications associated with fracture healing

A

Rub sores

Tendon contracture

Quadriceps contraction or tie down

Osteomyelitis (bone infection)

Malunion

Nonunion

55
Q

What are the 5 categories of physical therapy used after fractures heal

A

Warm packs
Passive range of motion
Active motion (recumbent)
Active motion (mobile)
Cool packs

56
Q

Describe the use of warm packs in physical therapy

A

Used on tight muscles to loosen/relax them

Used before exercise

Avoid on joint/inflamed tissue/incisions (increases swelling)

40-45 degrees Celsius for 15-20 minutes

Works well with massaging

57
Q

Describe passive range of motion (PROM) in physical therapy

A

Movement of the muscles while the patient is not moving via physical manipulation

Prevents contracture of muscles, ligaments, tendons and scar tissue

Prevents muscle atrophy And increases blood flow and Strengthens innervation

Must support either side of the joint

20x 1-3 reps minimum 3x a day

58
Q

Describe active motion for recumbent patients in physical therapy

A

Used for animals that can’t walk on their own

Maintains muscle mass, encourages nerve memory

Includes standing, rocking, balancing

Must keep the patient supported at all time

59
Q

How often should you flip recumbent patients, why do we do this?

A

Every 2-3 hours

Prevents sores and necrosis

60
Q

Describe active motion for mobile patients in physical therapy

A

Includes slow walks, underwater treadmills and swimming

Start on flat, non slippery surfaces for 2-4 weeks for 5-10 minutes And gradually increase duration/frequency/ incline

Must keep patient supported

61
Q

What are slings used for in physical therapy

A

For support

Remember to not carry the patient, only support

62
Q

How are cool packs used in physical therapy

A

Decreases inflammation, swelling and bleeding (vasoconstriction)

10-15 minutes 3x a day

Watch shaved areas

Use after any active motion or PROM

63
Q

When talking about displacement what portion of the bone do you refer to?

A

The distal portion

If it is moved caudally, it’s considered a caudal displacement

Animal Diseases 2 (4 decks)

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