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Equine BCM > Fractures > Flashcards

Fractures Flashcards

1
Q

Name some challenges when it comes to equine fractures.

A

Horses need to bear weight on the leg with fracture, when they cant it causes laminitis on the other limb

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2
Q

What are common acute traumas that can cause fractures in horses?

A

Kick injuries, falls, gunshot wounds

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3
Q

What is the pathogenesis of stress fractures?

A

High intensity exercise leads to subchondral bone sclerosis leading to microdamage leading to ischemia leading to necrosis leading to osteochondral collapse

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4
Q

What factors are essential for fracture repair?

A

Location, blood supply, soft tissue damage, contamination, infection, early recognition, first aid, patient behavior, owner compliance

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5
Q

What do the owners need to be aware of before pursuing treatment?

A

-prognosis for life, athletic prognosis, cost, whether it can be managed conservatively or if its surgical

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6
Q

What is a good initial treatment for a fracture?

A

NSAIDs, wound care (clip and clean, water soluble dressing), antimicrobials (after culture), feed (dont delay as if referring wont do surgery that day)

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7
Q

Should you apply a splint before or after taking radiographs?

A

Before! Especially if horse is non weight bearing

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8
Q

T/F What happens before surgery is just as important as what happens in the operating room

A

True! If fracture is not stabilized early it may become a lot worse

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9
Q

What should always be included in the splint of a horse?

A

The foot

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10
Q

Name the goals of limb stabalization

A
  1. Prevent damage to neurovascular structures
  2. Prevent skin penetration
  3. Minimize bone, soft tissue, and articular damage
  4. Relieve patient anxiety
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11
Q

What attributes should field splints have?

A

-Easily controlled by patient (lightweight and non-bulky), easy to apply, economical, easily fashioned from common materials

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12
Q

What forces are minimized by splints?

A

tension, compression, shear, torsion, bending
-function of muscles will be different with splints on

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13
Q

How many splints are required for a mid-forelimb fracture?

A

2- one caudal and one lateral from the ground all the way to the elbow

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14
Q

With fractures of the mid to proximal radius, which side do you worry about becoming open?

A

Medial due to minimal soft tissue coverage and abduction of the limb

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15
Q

Can you apply a splint proximal to the elbow?

A

Not really. Can use in some cases to help with the extensor function of the limb, rather than for stabalization

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16
Q

What can cause the dropped elbow stance?

A

Radial nerve damage –> triceps apparatus disruption
- caused by humeral fracture, olecranon fracture or radial nerve paralysis

17
Q

How is splinting of the distal hindlimb different than the forelimb?

A

limb is flexed due to reciprocol apparatus

18
Q

If you dont see radiographic changes but a horse is grade 4/5 lame what should be your recommendation to the owner?

A

Wait 2 weeks on stall rest then repeat radiographs

19
Q

What are the ideal trailer characteristics when moving horse with a fracture?

A
  1. Large trailer
  2. No stock trailers-need partitions so horses have something to lean on
  3. Put horse with fracture towards rear of the trailer
19
Q

What phase of anesthesia is most concerning in horses?

A

Recovery!

19
Q

What are the goals of horse orthopedic surgery

A

Horse must be able to bear weight and walk after surgery, must reconstruct bone column before putting in implants, reconstruct joint surfaces if needed

20
Q

Goal of casting

A

To stabalize the fracture post surgery

21
Q

How long does bone take to heal?

A

4 months

22
Q

What are some of the main post-op complications after fracture repair in horses?

A

Sepsis (most likely if wounds are open), contralateral laminitis, contralateral soft tissue overload, implant/repair instability, implant failure, systemic disease (colitis, pneumonia due to stress/GA/transport)

23
Q

How do you prevent laminitis post-op?

A

Even weightbearing, sole support, rockered toe, cryotherapy (best applied when laminitis due to sepsis)

24
Q

How are coffin bone fractures stabilized?

A

Lag screw technique- difficult due to inaccessibility but can apply with intraoperative CT
-often managed conservatively with a rim shoe or bar shoe with clips

25
Q

How do you fix P2 fractures?

A

Pastern arthrodesis
- joint prone to arthritis without fusion
-if they also affect coffin joint, prognosis greatly decreases (cant arthodese this one)

26
Q

Long pastern bone fractures- how to repair?

A

Usually start at sagittal ridge
-use screws! Preserve as much as P1 as possible

27
Q

What is a breakdown injury of fetlock?

A

Catastrophic fractures affecting several bones and soft tissues
- fetlock arthrodesis is indicated and athletic performance is poor

28
Q

Medial condylar fractures (MC III)- treatment

A

Medial plate with screws preferred
- much more likely to spiral than the lateral

29
Q

Lateral condylar fracture trt

A

Lag screw fixation
- unlikely to spiral
-can be done standing if non-displaced

30
Q

Splint bone fractures-etiologies and trt

A

Often due to kick injuries
-usually dont have to repair- conservative management when possible

31
Q

Metacarpal/Tarsal fracture- trt

A

Need both screws and plates
- plates should be 90 degrees from one another

32
Q

What carpal fractures do you fix?

A

Screw repair for slab fractures
-small fragments removed arthoscopically

33
Q

What causes injury to the sesamoid bones?

A

Hyperextension injury with various avulsion trauma
-often apical, mid-body, basilar or comminuted fractures

34
Q

How to treat apical sesamoid fractures?

A

Remove fracture through arthroscopy or through arthrotomy
-prognosis depends on if there are any suspensory ligament damage

35
Q

How to treat mid body sesamoid fracture?

A

Reduce and repair with lag screws, wire or with bone graft
-prognosis is unfavorable for soundness

36
Q

How to treat basilar sesamoid fracture?

A

Repair with screws
-distal attachment concern for prognosis

37
Q

What is the main fracture cause at the olecranon and what are the main forces at play?

A

A- kick injuries
B- tension from triceps attachment

Equine BCM (13 decks)

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