General Knowledge Flashcards
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?
Countertraction
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?
Neutralisation
What is the name of the framework to help assess radiographs of treated bone fractures comprehensively?
The four A’s
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?
Functional malunion
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
Locking drill guide
Which method stimulates bone healing involves acoustic waves of high pressure?
:
Extracorporal Shock Wave Therapy
Which of the “four A’s” can be assessed on direct post-operative radiographs?
- Apposition
- Alignement
- Apparatus
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.
D) Well-developed callus which does not bridge the fracture gap, which contains cartilage and fibrous tissue.
Please select the three most common patterns of diaphyseal tibial fractures.
Comminuted
Spiral
Pblique
What anatomic structures cross the medial aspect of the tibia approximately at the level of the mid diaphysis?
Median saphenous a
Saphenous a
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
Kern bone holding forceps
Gelpi retractors
Pointed reduction forceps
Blunt Hohmann retractor
AO periosteal elevator
Freer periosteal elevator
How to you expect a dog’s lameness to develop after fixation of a transverse mid-diaphyseal fracture with a plate?
The dog is expected to start weightbearing 24-48 hours after surgery.
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
B) Blood-soaked swab
C) Sterile syringe case
A) Sterile metal pot
D) Saline-soaked swab
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
A) 4-month-old kitten with a fracture of the distal femoral growth plate
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
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
Treatment of a seroma after orthopaedic surgery should include..?
Application of a warm pack
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?
3mo
In the cat, the median nerve and a branch of the brachial artery pass:
through the supracondylar foramen.
To have the optimal effect, a prophylactic antibiotic needs to be given:
30 minutes before the incision.
Radial fractures in Toy breed dogs should be treated by:
Internal fixation
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
Longer screws can be placed
More screws per unit length can be placed
The extensor tendons are not in the risk of being irritated
In order to place an IM pin in the humerus of a cat, direct it:
into the central area of the distal part of the diaphysis
The most common route of contamination leading to a surgical infection is:
During open surgery
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.
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
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).
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.
List eight methods for increasing strength of a linear ESF
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.
How do you know if a # is recent? (3)
fracture lines sharp, no new bone, soft tissue swelling is still present.
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.
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
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
c) K-wire and tension band wire fixation
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?
FNA
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?
Delayed union
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?
Radial nerve
For a plate-rod construct, what size should the IM pin have in relation to the intramedullary canal?
30-40%
