Fractures- Sparks Lecture Flashcards
what is the clinical approach to fracture management?
what is it, is treatment required, is external coaptation suitable or does it require other forms of fixation or reduction, should i even try to fix it, and how can I give my treatment the best chance of success?
list all the treatment options for fractures
euthanasia, stall confinement, external coaptation (splint or cast), ex fix, internal fix
splints are more commonly indicated for______. proper way to put one on?
temporary emergency coaptation or as a follow up to other forms of fixation
stabilize the joint above and below, place at 90 degrees, and extend them to the ground
when are casts commonly indicated?
- in metacarpal/tarsal fractures
- in closed fractures with good blood supply
- prognosis is GOOD!
prinicples for proper cast application
- include joint above and below
- the most proximal portion should end at the end of a long bone
- include the foot
- allow limb to be in a neutral position
- overlap with 50%
how to prepare a limb for a cast
make sure its clean and dry, make sure no circumfrential tape
what should you consider if you need to do fracture reduction?
will probs need heavy sedation since its so painful, use a heavy guage wire through the tip of the hoof, ideally you should have radiographs
easy way to get cast off?
when putting it on, use OB wire threaded through old IV lines
when should you remove a cast?
rapidly growing calves: q 2-4 weeks
adults: q 6-8 weeks
ideally based on radiographs
signs that a cast needs to come off asap
swelling above cast, worse lameness, drainage visible, smell
pros and cons of a cast
pros: cheaper, can be done in the field, good prognosis with some fractures
cons: cast sores, no protection against compression, malalignment of fracture possibly, tendon/ligamrnt laxity
thomas splints are sort of like what in humans? how do they work? when are they indicated?
crutches!
specialized splints, idea is to distribute forces with the leg not actually touching the ground i honestly dont know leave me alone fam
mostly for RADIAL & TIBIAL fractures!!
how high can you get a full limb cast?
to the olecranon
pros and cons to thomas splints
pros: cheaper than surgery, can be applied in the field
cons: issues with alignment, what if the fracture opens, can cause prolonged recumbency, pressure sores, contralteral varus
ex fix can be used on what fracture types?
long obliques or comminuted fractures or spiral
what is transfixation?
a cast + external fixator
idea is to suspend the limb in the cast and take weight off the cast tip (idk what this means)
good for fractures that will collapse like long boliques, comminuted, or spiral fractures
what anatomical location can be fixed with transfixation pin casting?
metacarpals and metatarsals, occasionally the distal radius and distal tibia
DO NOT work for fractures proximal to the radius or tibia
pros and cons of transfix
pros: can do in GP
cons: pin complications, more technically involved, cast sores, imperfect reduction and alignment, infection,
when is external fixation useful?
when youre attempting to repair an open fracture–>because you can provide wound care!
whaat are some indications for using internal fixation?
- if you want a cosmetic outcome
- when near perfect reduction is possible
- in LIGHT animals
- in an articular fracture?
- in areas that you can’t reach with other methods (like a femur fracture)
pros and cons to internal fixation
pros: early return to WB, accurate alignment
cons: expense, referral, implant failure, infection
list best way to treat the following fractures:
MC/MT
tibia
radius/ulna
femur
MC/MT: cast, transfix if communitied, oblique, ir spiral, and ex fix if open
tibia: thomas splint, cast if distal tibia
radius ulna: thomas splint
femur: ex fix or int fix
