General Knowledge

Question 1

You perform surgery to stabilise a spiral fracture of the tibial diaphysis in a Yorkshire terrier. Which technique is adequate to be used to help with reduction?

Answer 1

Countertraction

Question 2

You perform surgery to stabilise a long oblique fracture of the tibial diaphysis in a Yorkshire terrier. After reduction, you place two lag screws and apply a dynamic compression plate. What function does the plate serve in this scenario?

Answer 2

Neutralisation

Question 3

What is the name of the framework to help assess radiographs of treated bone fractures comprehensively?

Answer 3

The four A’s

Question 4

A mid-diaphyseal transverse femoral fracture in a Rottweiler heals with some degree of cranio-caudal angulation. The dog is walking well with no lameness. What is the diagnosis?

Answer 4

Functional malunion

Question 5

You plan to apply a plate to a fractured radius minimally invasive. What tool can be used to help to slide the locking plate used under the soft tissues

Answer 5

Locking drill guide

Question 6

Which method stimulates bone healing involves acoustic waves of high pressure?

Answer 6

:
Extracorporal Shock Wave Therapy

Question 7

Which of the “four A’s” can be assessed on direct post-operative radiographs?

Answer 7

• Apposition
• Alignement
• Apparatus

Question 8

How would you correctly describe a hypertrophic non-union?

A) Minimal callus related with instability following plate fixation.
B) No callus and wide separation of the fragments which are joined by fibrous tissue only.
C) Non-viable sequestra at the fracture site impede healing.
D) Well-developed callus which does not bridge the fracture gap, which contains cartilage and fibrous tissue.

Answer 8

D) Well-developed callus which does not bridge the fracture gap, which contains cartilage and fibrous tissue.

Question 9

Please select the three most common patterns of diaphyseal tibial fractures.

Answer 9

Comminuted
Spiral
Pblique

Question 10

What anatomic structures cross the medial aspect of the tibia approximately at the level of the mid diaphysis?

Answer 10

Median saphenous a
Saphenous a

Question 11

Which of the following instruments are helpful to reduce fractures?

Adson forceps

Kern bone holding forceps

Gelpi retractors

DeBakey forceps

Pointed reduction forceps

Blunt Hohmann retractor

AO periosteal elevator

Langenbeck retractor

Freer periosteal elevator

Answer 11

Kern bone holding forceps

Gelpi retractors

Pointed reduction forceps

Blunt Hohmann retractor

AO periosteal elevator

Freer periosteal elevator

Question 12

How to you expect a dog’s lameness to develop after fixation of a transverse mid-diaphyseal fracture with a plate?

Answer 12

The dog is expected to start weightbearing 24-48 hours after surgery.

Question 13

Put the following storage options for a cancellous bone graft in order of preference.
A) Sterile metal pot
B) Blood soaked swab
C) Sterile syringe case
D) Saline soaked swab

Answer 13

B) Blood-soaked swab
C) Sterile syringe case
A) Sterile metal pot
D) Saline-soaked swab

Question 14

Which of the following animals is more at risk of developing a quadriceps contracture, which is a serious complication ending in limb amputation in most cases?

A) 4-month-old kitten with a fracture of the distal femoral growth plate
B) 4-year-old dog with a fracture of the femoral mid-diaphysis
C) 4-month-old puppy with a fracture of the femoral greater trochanter
D) 4-month-old kitten with a fracture of the proximal metaphysis of the femur

Answer 14

A) 4-month-old kitten with a fracture of the distal femoral growth plate

Question 15

In which of the following procedures would it be useful to consider placing a bone graft?

Partial tarsal arthrodesis

Pancarpal arthrodesis

Internal fixation of a transverse radial fracture in a 3-year-old Labrador retriever

Internal fixation of a comminuted fracture of the distal tibia in a diabetic cat

Revision of a delayed union of a radial fracture in a miniature breed dog

External fixation of a comminuted femoral fracture in a cat

Answer 15

Partial tarsal arthrodesis

Pancarpal arthrodesis

Internal fixation of a comminuted fracture of the distal tibia in a diabetic cat

Revision of a delayed union of a radial fracture in a miniature breed dog

External fixation of a comminuted femoral fracture in a cat

Question 16

Treatment of a seroma after orthopaedic surgery should include..?

Answer 16

Application of a warm pack

Question 17

You plan to repeat a bone grafting procedure in a middle-aged dog and plan to collect an autogenous cancellous bone graft from the proximal humerus of the dog a second time. After what time would you expect to be able to repeat collection at the identical collection site of the same humerus?

Answer 17

3mo

Question 18

In the cat, the median nerve and a branch of the brachial artery pass:

Answer 18

through the supracondylar foramen.

Question 19

To have the optimal effect, a prophylactic antibiotic needs to be given:

Answer 19

30 minutes before the incision.

Question 20

Radial fractures in Toy breed dogs should be treated by:

Answer 20

Internal fixation

Question 21

A medially applied plate has the following effect for the stabilisation of radial fractures:
The flexor tendons may be irritated

The medial collateral ligament can be irritated by the plate

Longer screws can be placed

More screws per unit length can be placed

The extensor tendons are not in the risk of being irritated

Shorter screws can be placed

Less screws per unit length can be placed

Answer 21

Longer screws can be placed

More screws per unit length can be placed

The extensor tendons are not in the risk of being irritated

Question 22

In order to place an IM pin in the humerus of a cat, direct it:

Answer 22

into the central area of the distal part of the diaphysis

Question 23

The most common route of contamination leading to a surgical infection is:

Answer 23

During open surgery

Question 24

List possible treatment options for a cat with following #: (6)

Medio-lateral and cranio-caudal views of the tibia of a skeletally mature cat

Complete fracture of the distal third of the tibia diaphysis

Spiral

Minor comminution

Cranio-lateral displacement of the distal fragment

Fissure line in the middle of the distal fragment running distally

Fibula bent, no obvious fracture

Fracture closed, extrinsic trauma.

Answer 24

External coaptation (the fibula is intact but consider potential serious risk of cast and bandage sores)

Cerclage wire/lag screws for fissure and plate on medial aspect of tibia

Type II ESF

Hybrid ESF (linear frame proximally and circular distally)

IM pin + type Ia ESF

Orthogonal plating

Question 25

How to place the pins for a:
Hybrid ESF: type IIb frame proximally with one centrally threaded full pin and two end-threaded half pins (all pins positive profile).

Answer 25

Make little skin incision.

Dissect down to bone with a haemostat and periosteal elevator.

Hold skin retracted with little Gelpis.

Use tissue sleave and predrill the hole with a drill bit 0.1mm smaller than the pin using high speed.

Put a hypodermic needle or small K-wire into the hole to be able to find it again.

Place full pin low speed so that threaded part lies in the centre of the bone.

Question 26

List eight methods for increasing strength of a linear ESF

Answer 26

Frame configuration (bilateral biplanar>bilateral>unilateral).

Bar – using a double bar doubles the resistance to compression.

Bar as close to bone as possible increases resistance to compression.

Pins: maximum four pins per fragment is ideal.

Pins no bigger than 20% of the diameter of the bone to reduce risk of iatrogenic fracture.

Space pins out over the length of the bone.

Place the central pins as close to the fracture as possible.

Predrilling.

Question 27

How do you know if a # is recent? (3)

Answer 27

fracture lines sharp, no new bone, soft tissue swelling is still present.

Question 28

methods of repair of this fracture. List the repair system used and the bone to which it has been applied, i.e. plate applied to lateral femur.:

Intrinsic

Closed

Minor soft tissue swelling in the region of the fracture

Tibia complete, simple, distal diaphysis, spiral, minimally displaced, minor malalignment

Subtle radiolucent defect of the distal tibial with thinning of the cranial and lateral tibial cortex

Fibula – intact; no fracture.

Answer 28

Plate applied to (medial) tibia

Plate applied to (medial) tibia plus intramedullary pin

Linear or circular External Skeletal Fixator applied to tibia

External Skeletal Fixator plus intra-medullary pin

Interlocking nail

Intramedullary pin plus cerclage wires.

Orthogonal plating of the tibia

Question 29

A 5-month-old Staffordshire Bullterrier sustains a left tibial tuberosity avulsion. What fixation technique is most adequate?
a) Lag screw fixation
b) K-wire fixation
c) K-wire and tension band wire fixation
d) Positional screw and antirotational K-wire fixation

Answer 29

c) K-wire and tension band wire fixation

Question 30

A 6-year-old Cocker Spaniel had surgery 6-weeks ago to stabilise a transverse radial fracture with a compression plate. The fractured ulna was not stabilised. One day ago the dog has become acutely lame (4/5). The antebrachium is severely swollen. Radiographs reveal no implant related problems. What further work up is required to prove your suspected diagnosis?

Answer 30

FNA

Question 31

A 6-year-old domestic shorthair cat with a comminute distal diaphyseal tibial fracture is presented to you. What complication do you warn the owner about that is more frequently seen in tibial fractures of cats?

Answer 31

Delayed union

Question 32

You perform surgery to stabilize a fracture of the proximal third of the radial diaphysis in a 2-year-old Whippet. What nerve do you need to protect during your approach to the surgical site?

Answer 32

Radial nerve

Question 33

For a plate-rod construct, what size should the IM pin have in relation to the intramedullary canal?

Answer 33

30-40%