Fractures

Question 1

Green stick fractures

Answer 1

An incomplete fracture in young animals, because of the bending of the nonfractured cortex. In skeletally immature animals the periosteum is usually left intact.

Question 2

fracture AO numbering calssification

Answer 2

humerus -1
radius/ulna - 2
femur - 3
Tibia/fibula - 4

Proximal - 1
shaft -2
distal zone - 3

simple - A
wedge - B
Complex - c
degree of complexity - 1, 2, 3

Question 3

what is the numbering classification for the simplest shaft fracture of the humerus

Answer 3

1, 2, A1

Question 4

oblique fractures describe an angle greater than ____ degrees

Answer 4

30 degrees to the long axis of the bone

Question 5

Complete Articular Fractures.

Answer 5

The joint surface is fractured and completely
detached from the diaphysis (see Figure 2-2, C). Humeral T or Y fractures are
representative of this type (Figure 2-4, E).

Question 6

Partial Articular Fractures.

Answer 6

Only part of the joint surface is involved, with the
remaining portion still attached to the diaphysis (see Figure 2-2, B). Unicondylar
fractures are the most common example

Question 7

Avulsion Fracture.

Answer 7

A fragment of bone, which is the site of insertion of a muscle,
tendon, or ligament, is detached as a result of a forceful pull

Question 8

Some of the factors that may deter vascular response and thus bone healing
are …

Answer 8

Some of the factors that may deter vascular response and thus bone healing
are (1) trauma in connection with the original accident, (2) careless or improper
surgical handling of the soft tissues, (3) inadequate reduction, and (4) inadequate
stabilization of bone fragments

Question 9

The sequence of events results in a progressive replacement of the
tissue in the fracture gap with stiffer and stronger tissue, going from granulation tissue
to ____ tissue to ____tissue to cartilage to _____cartilage to
____bone to _____bone.

Answer 9

The sequence of events results in a progressive replacement of the
tissue in the fracture gap with stiffer and stronger tissue, going from granulation tissue
to connective tissue to fibrous tissue to cartilage to mineralized cartilage to
lamellar bone to cortical bone.

Question 10

In contrast, excessive
dynamic loading is responsible for _____union, where the transformation of
callus from cartilage to bone is delayed because of the poor blood supply within the
areas of excessive motion

Answer 10

In contrast, excessive
dynamic loading is responsible for delayed union, where the transformation of
callus from cartilage to bone is delayed because of the poor blood supply within the
areas of excessive motion

Question 11

Healing in areas of contact and high compression forces, as well as in very
small, stable gaps (<______ mm), is described as direct bone union

Answer 11

Healing in areas of contact and high compression forces, as well as in very
small, stable gaps (<0.1 mm), is described as direct bone union

Question 12

it is better not to reduce the fragments too closely
in order to ensure survival of the tissues in the fracture gap in the presence of
the micromotion inevitable in such a mechanical situation. This is the basis of the
concept of “______ osteosynthesis,”

Answer 12

it is better not to reduce the fragments too closely
in order to ensure survival of the tissues in the fracture gap in the presence of
the micromotion inevitable in such a mechanical situation. This is the basis of the
concept of “bridging osteosynthesis,”

Question 13

1. _____reduction of fracture fragments, especially in articular fractures.
2. __fixation, suitable to the biomechanical and clinical situation.
3. Preservation of the blood supply to the bone fragments and surrounding
   soft tissues through ___reduction and surgical technique.
4. Early active pain-free ____of muscles and joints adjacent to the
   fracture to prevent development of fracture disease.

Answer 13

1. Anatomical reduction of fracture fragments, especially in articular fractures.
2. Stable fixation, suitable to the biomechanical and clinical situation.
3. Preservation of the blood supply to the bone fragments and surrounding
   soft tissues through atraumatic reduction and surgical technique.
4. Early active pain-free mobilization of muscles and joints adjacent to the
   fracture to prevent development of fracture disease.

Question 14

biological fixation

Answer 14

biological fixation.
The primary consideration in this concept is the protection of the soft tissues and
the blood supply of the fracture fragments. Direct bone union without callus is to be expected under this protocol.

Question 15

_____technique has received increased emphasis in the
employment of bridging osteosynthesis strategies, especially as applied to preservation
of blood supply to bone fragments. Providing sufficiently strong internal fixation
to allow early pain-free mobilization of the limb has always been and continues
to be of primary importance to the veterinary orthopedic surgeon.

Answer 15

atraumatic technique has received increased emphasis in the
employment of bridging osteosynthesis strategies, especially as applied to preservation
of blood supply to bone fragments. allow callus formation. Small amounts of interfragmentar motion are not only
probable but also even desirable for callus formation, which actively enters into
the role of stabilizer of the fracture, thus protecting the internal fixation from
mechanical overload and failure.Providing sufficiently strong internal fixation
to allow early pain-free mobilization of the limb has always been and continues
to be of primary importance to the veterinary orthopedic surgeon.

Question 16

When
all other factors are equal and the fracture is optimally treated, _____of the patient is
the most influential factor affecting the rate of healing.

Answer 16

When
all other factors are equal and the fracture is optimally treated, age of the patient is
the most influential factor affecting the rate of healing.

Question 17

________union refers to the period in the recovery process of a fracture when
healing has progressed to the point in strength that the fixation can be removed.

Answer 17

Clinical union refers to the period in the recovery process of a fracture when
healing has progressed to the point in strength that the fixation can be removed.

Question 18

Fractures immobilized with external fixation, skeletal fixation,
and intramedullary pins heal with the development of an ____and _____
bridging callus. The bridging callus does give added early strength to the fracture
site. Fractures immobilized with rigid fixation (_____) heal primarily by _____
union and some internal callus, and animals with fractures treated by this method
should have the fixation in place for a longer period.

Answer 18

Fractures immobilized with external fixation, skeletal fixation,
and intramedullary pins heal with the development of an external and internal
bridging callus. The bridging callus does give added early strength to the fracture
site. Fractures immobilized with rigid fixation (bone plate) heal primarily by direct
union and some internal callus, and animals with fractures treated by this method
should have the fixation in place for a longer period.

Question 19

rate of union in terms of clinical union:
under 3 months -
3-6 months - 
6-12 months - 
over 1 year-

Answer 19

ESF and IM pin
2-3 weeks, 4-6 weeks, 5-8 weeks, 7-12 weeks

Fixation with bone plates
4 weeks, 2-3 months, 3-5 months, 5-12 months

Question 20

AAAA

Answer 20

Alignment, Apposition, Apparatus, Activity
1. Alignment. This is basically an assessment of the restoration of the bone as a
whole. Alignment is evaluated in relation to angular and torsional
displacement relative to normal. Return to normal alignment is necessary for
normal long-term function.
2. Apposition. Looking more directly at the fracture site, the examiner here is
evaluating the degree of realignment of the fracture fragments. A certain degree
of apposition is required for routine bone healing, but this degree is highly
dependent on the type of fixation employed; thus, no single definition can be
used in all situations.
3. Apparatus. Is the fixation device functioning as intended to maintain stability
of the fracture until healed? Were applicable protocols for the device followed?
Is there evidence of loosening of implants? Is there evidence of impending
failure of the implant, such as bending or screw loosening?
4. Activity. This is the biological activity of the bone in response to the fixation
used. To evaluate activity, it is necessary to know the age of the animal, the
length of time since the fracture was stabilized, and the degree of functional
use of the limb. It is also useful to consider such factors as preexisting infection
and open wounds or other devascularizing injuries. This is the area where the
type and amount of callus formation are evaluated. The examiner must search
for signs of infection (e.g., bone lysis) and periosteal, new bone formation.
Bone resorption is evaluated to decide if this represents normal
revascularization of bone fragment edges or indicates infection or loosening of
an implant. Table 2-4 details typical radiographic signs of healing.