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RUSVM Large Animal Surgery 2017 > Fractures > Flashcards

Fractures Flashcards

1
Q

What is the etiology of condylar fractures?

A

High compressive load
Leads to osseous adaptation/sclerosis
Microtrauma/Microfracture
Condylar fracture

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2
Q

Clinical signs of Non displaced incomplete fracture

A

Acute onset of severe lameness after intense exercise
Effusion of MCP/MTP joint
Pain on palpation

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3
Q

Treatment of Condylar fracture

A

Internal fixation with transcortical screws in lag fashion
bandage
NSAIDs
Absolute stall rest

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4
Q

Prognosis of Condylar fracture Return to Race

A

Favorable for non-displaced and incomplete
less for displaced (50%)
Less if joint comminution exists

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5
Q

What is the most common long bone fracture of the equine?

A

Diaphyseal fracture of MCIII and MT III

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6
Q

Prognosis of Diaphyseal fracture of MCIII and MT III

A

Dependent upon immediate 1st aid

External coaptation

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7
Q

Optimal treatment of Diaphyseal fracture of MCIII and MT III

A

Double plate fixation

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8
Q

Where are the plates placed on Diaphyseal fracture of MCIII and MT III?

A

tension side of the bone

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9
Q

What is important to maintain in the treatment of Diaphyseal fracture of MCIII and MT III?

A

Inter-fragmentary compression

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10
Q

Complications of Treatment of Diaphyseal fracture of MCIII and MT III

A 
Infection 
Survive recovery 
Pain 
contralateral limb laminitis
colic
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11
Q

What types of plates are used for the treatment of a Diaphyseal fracture of MCIII and MT III?

A

Dynamic compression plate
Limited contact - dynamic compression plate
Locking compression plate
Anatomic specialty plate

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12
Q

What is the advantage of using the Limited contact - dynamic compression plate?

A

Continuity of bending stiffness

Improved blood supply under plate

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13
Q

Compression

A

Maximum 2 screws on either side of fracture are placed under load

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14
Q

Neutralization

A

Placed under anatomic reconstruction

screws inserted in neutral position

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15
Q

Tension band

A

transforms tensile forces into compressive forces

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16
Q

Buttressing

A

placed to bridge area of bone defect even after reconstruction

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17
Q

Dynamic compression plate characteristics

A

Sell-compressing plate
Screws can be angled in many directions
Can be adapted to different internal fixation needs
Screws can be placed orthogonally or at an angle (up to 25 degrees)

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18
Q

Limited contact -

Dynamic compression plate characteristics

A

Adaptable for different internal fixation needs
Limited contact/ grooved surface
Uniform stiffness
DCU hole for screws to be placed at 40 degrees

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19
Q

Locking compression plate characteristics

A 
Dynamic compression 
Limited contact/grooved under surface
Combi-holes permit the combination of conventional or locking screw
Minimally invasive 
locking or cortex screws used
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20
Q

What is the advantage of using locking screws?

A

increase the stability and the fixation strength of the plate screw

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21
Q

What are the challenges of using a fixation?

A

Large plates occupy space making skin closure difficult
implant failure
Post operative lameness
Contralateral limb lameness

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22
Q

What inserts on the olecranon?

A

Triceps

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23
Q

What is the cause if olecranon fracture in the equine?

A

Direct trauma - injury during halter training

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24
Q

How do the animal present with ulnar fracture?

A

dropped elbow with carpus in flexion

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25
Q

What is a complication of ulnar fracture in horses?

A

Disruption of the stay apparatus

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26
Q

How do you prepare an ulnar fracture for transportation?

A

Splint to fix carpus in extension

Apply the splint palmarly extending from the fetlock to the level of the elbow with adequate padding

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27
Q

What is the treatment for Salter Harris Type I minimal displacement in equine less than 250 kg ?

A

tension band technique repair

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28
Q

what is the treatment for Salter Harris Type I minimal displacement in equine that is greater than 250 kg?

A

apply a plate

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29
Q

What is the treatment of choice for olecranon fracture?

A

ORIF - Open Reduction Internal Fixation

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30
Q

What is important in horses less than 1 year with distal screws in the olecranon?

A

should not engage the radius

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31
Q

If you engage the radius in horse for olecranon fixation what will happen?

A

Subluxation of the elbow

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32
Q

What is the etiology of Femoral Physeal fracture?

A

Dystocia

Group housed juvenile cattle

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33
Q

Treatment of Femoral Physeal fracture

A

Stall rest

ORIF - pins/screws

34
Q

Treatment for displaced proximal tibial physeal fracture with a large metapyseal fragment laterally in a ruminant

A

External coaptation

Thomas schroeder splint/cast

35
Q

Why can you not use pins and screws in young ruminants?

A

Their bones are soft and not amenable to plates, screws or wires

36
Q

Treatment of a Salter Harris Type II fracture of the proximal tibial physis in a foal

A

Bone Plate with cancellous screws fixation with tension band wiring

37
Q

What are the complications of Bone plate and screw use?

A

Osteolytic lesions of the bone
Osteopenia and lysis and sclerosis of the bone
Loosening of screws due to screw osteolysis around the screw tracks

38
Q

Treatment of Close comminuted mid-diaphyseal fracture of the humerus with displacement

A

Stall rest for 2-3 months

Nursing care

39
Q

Potential complications of stall confinement

A

Non union and mal union
breakdown or laminitis of the opposite limb
Negative effect of the age and weight of the patient

40
Q

What are the risks of humeral fracture with ORIF with plates?

A

injury to the radial nerve

irregular contour of the humerus

41
Q

On what type of animal can you not use an interlocking nail?

A

Adult large animals

42
Q

Treatment of Closed mid-diaphyseal short oblique tibial fracture

A

Transfixation pin cast placement
Type 2 or 3 External fixator
Pin removal at 6-8 weeks
Stall rest for an additional 2 weeks

43
Q

How do you treat pin tract sequestrum?

A

Debride and curette

44
Q

Advantages of Transfixation Pin Casting in farm animals

A

Maintenance of reduction
Early weight bearing
Flexibility in pin positioning
Availability of pins and casting material
Comparable to side bar/clamp and plates/screws

45
Q

Disadvantages of Transfixation Pin Casts in farm animals

A

no adjustment after application
Restricted access to soft tissue
Requires GA

46
Q

What is the treatment for comminuted phalangeal fracture and MTIII/MCIII?

A

Transfixation Pin Casting

47
Q

What are the possibilities for repair of a Closed transverse, mid diaphyseal fracture of the radius and ulna?

A

External fixator/TPC
Double plating
Thomas-schroeder cast/combo

48
Q

Treatment of an oblique fracture of the distal tibia in a horse

A

Double plate fixation with DCP

Plates luted to increase stability

49
Q

Plate luting

A

Bone cement applied between the plate and the bone after plate/screw placement
Creates 100% plate-bone contact and increase strength of repair

50
Q

Lute

A

a substance like cement for packing a joint or coating a porous surface

51
Q

Treatment of Transverse fracture of the femoral distal diaphysis with severe displacement in a calf

A

Stack pinning and cerclage wire

52
Q

Young ruminant fracture repair

A

Difficulties with plate and screw repair due to soft and thin bones
Screw and plate loosening

53
Q

How do you repair femur fractures in young ruminants?

A 
2 cerclage wires
3 IM threaded-
 end pins 
Skin closed with staples
Drain
54
Q

Femoral fracture repair in the adult large animal

A

Double plating

55
Q

Femoral fracture repair in foals

A

Double plating on the cranial and lateral aspect of the cortex

56
Q

Treatment of comminution and severe displacement

A

Double plating and cerclage wires for repair of femoral fracture

57
Q

Surgical complications of ORIF with double plating

A

hemorrhage during reduction

58
Q

Post op treatment of ORIF with double plating

A

Blood transfusion

Broad spectrum abx

59
Q

Complications of fracture repair

A 
Implant breakage 
Implant loosening 
infection 
sequestration 
delayed union/non-union 
contralateral limb laminitis
contralateral angular limb deformity
60
Q

Treatment of open/infected fracture

A

local debridement
systemic and local abx: RLP and Abx impregnated PMMA beads
cancellous bone graft

61
Q

Treatment of open fracture distal radius of food animal

A

Trans-articular type 2 external fixator

3 pins in radius, 3 pins in MCIII/IV

62
Q

Treatment of open fracture distal radius in a heavier patient

A

Tubing with acrylic PMMA and external frames are not strong enough

63
Q

Common cause of Mandibular fractures

A

Trauma

64
Q

Treatment of Mandibular fractures

A 
Loos teeth should never be removed until the fracture has healed 
Intraoral wiring 
Tension band wiring to cheek teeth 
External fixators
plates
65
Q

Indications for plating mandible

A

Fracture of body and vertical ramus of mandible
Fracture of caudal aspect of horizontal ramus
LCP

66
Q

Disadvantages of mandibular plating

A

Can only place on compression side of the bone
Screw placement is difficult due to tooth roots
Exposure of caudal ventrolateral mandible difficult due to parotid duct
Most fractures of mandible are open: infection or implant removal

67
Q

Aftercare of mandibular fracture repair

A 
No diet modification for incisor fractures
Lavage 
Bute
Abx
implant removal after 6-8 weeks
68
Q

Complications of mandibular fractures

A 
Implant failure
breakage of plates
Loosening/breakage of wires
Drainage 
Sequestra
69
Q

What is contraindicated in patients with suspected head trauma and increased intracranial pressure?

A

Ketamine

70
Q

Dacryocysto-Rhinography

A

Radiographic contract evaluation of the nasolacrimal duct

71
Q

What does fracture of the zygomatic process cause in horses?

A

Chemosis

72
Q

Treatment option for zygomatic process fracture

A

Cerclage - anchoring the tooth to the neighboring teeth
screws
plates
fixateur extern

73
Q

Treatment for vertical ramus fracture in equine

A

Plate

74
Q

What is the strongest treatment for mandibular fracture?

A

Double plating

75
Q

What are the causes of Neck vertebrae fractures?

A

Trauma

Electrocution

76
Q

Treatment options for Neck vertebrae fractures

A

Screws
Plates
Fixateur extern

77
Q

Causes of Static compressive spinal cord lesions

A

Degenerative joint disease (DJD) of diarthrodial articulations of caudal cervical vertebrae

78
Q

Treatments for Static compressive spinal cord lesions in an animal less tahn 1 year of age

A

Treat symptomatically

surgery: ventral stabilization or dorsal decompression

79
Q

What is the best surgical option for Static compressive spinal cord lesions?

A

Ventral stabilization

80
Q

What is the best treatment option for Static compressive spinal cord lesions?

A

Dorsal laminectomy

Cervical ventral interbody fusion

RUSVM Large Animal Surgery 2017 (14 decks)

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