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Ortho sx > FX repair horses-techniques (Bauck) > Flashcards

FX repair horses-techniques (Bauck) Flashcards

1
Q

Factors that determine prognosis

A
  • time/location
  • Open vs closed
  • soft tissue damage
  • Age, breed, weight, temperament
  • Number of fractures
  • Time
  • first-aid
  • hospital set-up
    • equipment, implants, recovery system, experience of surgeon
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2
Q

Condylar fracture means

A

distal condyle of Metatarsal/matacarpal 3

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3
Q

Medial condylar fractures tend to…..

A

Propogate

-lateral condylar fractures usually don’t

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4
Q

Classification of fractures

A
  • Complete vs. incomplete
  • Stable vs unstable
    • displaced vs nondisplaced
  • Open vs. closed
  • Configuration
    • greenstick
    • transverse
    • oblique
    • spiral
    • comminuted
    • avulsion
    • crush
  • Location
    • diaphyseal
    • metaphyseal
    • physeal
    • articular
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5
Q

Foals

A
  • Faster healing than adults
  • Angular limb deformities
    • secondary limb deformities
  • Salter-Harris fractures
  • Casts
    • More prone to cast sores
    • tendon laxity if casted long periods
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6
Q

Cis cortex

A

near cortex

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7
Q

Trans cortex

A

far cortex

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8
Q

MCP

A

Metacarpophalangeal joint

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9
Q

Stall rest

A
  • Used for
    • stress fractures
    • non-displaced pelvic fx
    • Third trochanter, patellar, detoid tubercle
  • Risks
    • catastrophic propagation

*depends on temperment

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10
Q

External Coaptation

A
  • Casts or splints
  • Often used as a supplement to
    • internal fixation
    • emergency stabilizatoin
  • Not used alone
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11
Q

External fixation

A
  • distal limb fx only
  • Transfixation-pin casts
  • external skeletal fixators
  • ESFD: external skeletal fixation device
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12
Q

Transfixation-pin casts

A
  • Provides additional axial support
    • dec rotation
  • Indications
    • comminuted phalangeal fx
    • distal MC/MT III fx
    • MCP breakdown
  • 2-3 cross pins proximal to fx
    • incorporated into cast
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13
Q

External Skeletal fixators

A
  • Allow immediate weight-bearing
    • Access to wounds
  • Often don’t provide enough axial support
  • used in
    • foals
    • non-weight bearing fractures
      • ie: mandibular
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14
Q

Internal fixation

A
  • Key principles
    • anatomical reduction
    • rigid fixation
    • preservation blod supply
    • early mobilization
  • Screws and plates
    • +/- wire, pins
  • Intra-operative imaging
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15
Q

Cortex screw

A
  • Features
    • Large core diameter
    • Small thread diameter = stronger, more rigid
  • Position, implant or lag fashion
  • 4.5 ‘work horse’ of equine fx repair
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16
Q

Cancellous screw

A
  • Features
    • small core diameter
    • Large thread diameter
  • Not as common in equine fx repair
  • 3.5 cortical screw
17
Q

Screws placed in lag fashion

A
  • Screw head engaged in cis cortex, screw threads engaged in transcortex
  • hole drilled in cis cortex
  • Smaller hole in transcortex
  • Row row row your boat
    • DRILL (glide hole)
    • DRIL (thread hole)
    • COUNTERSINK
    • MEASURE
    • TAP
    • SCREW
18
Q

Drilling technique

A
  • 1 mm/s
  • slower drill speeds and accumulatio of ‘swath’
    • => overheating of bone
    • => bone necrosis
    • => implant failure
  • Saline flush acts as lubricant/cooling
19
Q

Tapping

A
  • Creates thread holes in drill holes
  • Improves bone-screw interface
20
Q

Plate fixation

A
  • Most common
    • DCP: Dynamic compression plate
      • squeezes fracture together
    • LC-DCP: Limited Contact; Dynamic compression plate
      • can place screws in neutral or compression
      • cutouts make it stronger?!?!
      • eaiser to bend/contour
      • preserves some periosteum
    • LCP: locking compression plate
  • Minimum of 4 scres on each side of fx is ideal
  • Apply to tension side where possible
21
Q

Plates are strong in …..

A

tension

22
Q

Plate fixation

LCP

A
  • Locking compression plates
    • Inc stiffness and rigidity
    • LCP screws
      • bigger core
      • smaller threads
      • inserted perpendicular to plate, not accross fx
    • Can use
      • LCP (locking) screws
      • cortical screws
    • Less bone-plate contact required
23
Q

Strongest type of screws biomechanically

A

LCP screws

24
Q

Implant Removal

A
  • When to remove
    • infection/loosening/lameness
    • Return to exercise (if problems)
      • Except arthrodesis
  • Screws
    • generally don’t remove
  • Staggered removal
25
Q

Complications

A
  • implant infection
    • becomes loose and thus painful
  • Catastrophic breakdown
    • recovery from anesthesia or post-op
  • Osteoarthritis
  • Foals
    • angular limb deformities
    • flexural limb deformities
  • Supporting limb laminitis
    • sinking/rotation of P3
    • common
    • life-threatening

Ortho sx (11 decks)

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