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SAS kban RUSVM > Intro to Ortho and Fracture Fixation Methods - Betance > Flashcards

Intro to Ortho and Fracture Fixation Methods - Betance Flashcards

1
Q

Definition of a Fracture

A

complete or incomplete break in the continuity of bone or cartilage

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2
Q

Goal of fracture repair

A

the early return of the patient to full funciton of the limb

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3
Q

How many methods of fracture classification are there?

A

six

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4
Q

Methods of Classification:

A
  1. direction of the fracture on the bone
  2. location of the fracture on the bone
  3. reducible or non-reducible
  4. displacement of fracture segments
  5. open or closed fracture
  6. specific types of factures
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5
Q

What is a comminuted fracture?

A

More than 2 pieces of bone

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6
Q

What is a long oblique fracture

A

if length of oblique fracture is >2x diameter of the bone

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7
Q

Who/where does Salter Harris fractures commonly occur?

A

Young animals at the growth plate

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8
Q

SH Type I

A

Straight Across

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9
Q

SH Type II

A

Above

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10
Q

SH Type III

A

Lower or beLow

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11
Q

SH Type IV

A

Two or Through

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12
Q

SH Type V

A

ERasure of growth plate or

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13
Q

Basic definition of Open fracture

A

at some point developed communication with external environment

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14
Q

Basic definition of Closed fracture

A

No communication with the external environment

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15
Q

Open Fracture Type I

A
  • bone penetrating thru skin
  • laceration < 1cm
  • Clean
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16
Q

Open Fracture Type II

A
  • External object penetrates soft tissue
  • laceration > 1cm
  • mild soft tissue trauma
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17
Q

Open Fracture Type IIIa

A
  • vast soft tissue laceration

- soft tissue available for closure

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18
Q

Open Fracture Type IIIb

A
  • extensive soft tissue injury and loss

- bone exposure and stripped periosteum

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19
Q

Open Fracture Type IIIc

A
  • arterial supply damaged

- requires arterial repair for limb salvage

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20
Q

What is the number one cause of direct insult fractures

A

Over 75% are HBC

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21
Q

What is an indirect insult?

A

Force transmitted through bone to distant point (like the femoral neck, tibial tuberosity)

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22
Q

What does reduction mean?

A

reestablishing normal alignment of fracture fragments

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23
Q

Closed reduction:

A

reducing a fracture without surgically exposing the fractured bones

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24
Q

What does performing a closed reduction accomplish?

A
  • preserves soft tissue and blood supply

- decreases risk of infection and OR time

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25
What are some indications for performing a closed reduction?
- closed fracture below elbow or stifle - bone will be stable after reduction - quickly healing fracture - small dogs/cats - greenstick, intact periosteal sleeve, impaction fxs
26
What is an open reduction?
surgical approach to expose fracture in order to reconstruct and stabilize
27
What does an open reduction accomplish?
- direct visualization of fx to facilitate reconstruction | - allows direct placement of implant and load sharing
28
Indications for open reduction
- unstable and displaced fractures - articular surfaces - delayed healing - bone grafts
29
What are the Rules for Open Reduction
1. Halstead's principles 2. follow normal separations between muscles and fascial planes 3. if muscles need to be severed, do it near origins or insertions 4. preserve soft tissue and blood supply
30
Things about Transverse Fractures
- stable in compression - unstable in bending - unstable in rotation - ideal for load sharing
31
Things about Oblique fractures
- unstable in compression | - less unstable in bending and rotation when compared to a transverse fracture
32
Things about Comminuted fractures
- unstable in compression - unstable in bending - unstable in torsion - fracture will displace or collapse when forces are applied - no load sharing
33
Fixator: Steinmann Pins aka IM pins resist what?
bending forces ONLY
34
Indication for IM pins
- fractures of the humerus, femur, tibia, ulna, metatarsal, and metacarpal
35
Contraindication for IM pins
radius fractures, most fractures in medial and large dogs
36
IM pinning RETROGRADE
pin is inserted at FRACTURE SITE | - humerus, femur
37
IM pinning NORMOGRADE
pin is inserted at MOST PROXIMAL AREA OF BONE | - humerus, femur, tibia
38
Where is the IM pin placed
medullary cavity of bone
39
Does an IM pin require any adjunct fixation
Almost ALWAYS!!! | - cerclage wire, ESF, plate
40
Is stack pinning common?
Nope, rarely used. - 2+ pins to fill the medullary cavity - higher incidence of pin migration - difficult cutting multiple pins
41
When do you implement cross pinning?
with simple proximal/distal fractures - physeal fractures - smaller diameter smooth pins
42
What forces does cross pinning counteract
rotational and bending forces
43
What specific kind of fractures is cross pinning good for?
growth plate fractures, specifically Salter Harris II
44
What is rush pinning used for?
simple proximal and distal fractures
45
What kinds of forces does rush pinning resist?
bending and torsional forces
46
How many points of contact do rush pins have?
THREE! | - the pin is forced to bend to provide dynamic forces on the bone
47
What are diverging pins for?
stabilize Salter Harris I fractures of proximal humerus and femur
48
What don't you do with diverging pinning?
penetrate the joint surface
49
What must you achieve with diverging pinning?
anatomical reduction!!!!
50
What is orthopedic wire used for?
used with IM pins, ESFs, and plates
51
Larger diameter of orthopedic wire means what in relation to strength?
Higher tensile strength
52
When would you use full cerclage wire?
with long oblique or spiral fractures in which the fracture line is at least 2x the diameter of the bone - maximum of 3 fx segments - fx must be anatomically reduced - young/healthy patients combo w/ IM pin
53
When would you never use full cerclage wire?
a fully comminuted fracture
54
what would you use hemicerclage wire for?
short oblique diaphyseal fractures
55
What would you use skewer pins for?
short oblique fractures
56
What do skewer pins incorporate?
full cerclage wire and K-wire
57
Tension band wires are used for a lot of things. What are they?
- avulsion fractures or osteotomy of the greater trochanter - avulsion fracture of tibial tuberosity - fracture or osteotomy of the medial malleolus or olecranon - fracture of tuber calcanei or acromial process of scapula
58
What's the main theory behind tension band wires?
2 distractive forces become compressive forces
59
What are interfragmentary wires used for?
- simple fractures of flat, non-weight bearing bones that interdigitate well - certain mandibular and maxillary fractures - basically "suture" with wire
60
What are external skeletal fixators for?
- many open or closed fractures - limb deformities - when blood supply compromised - need stabilization and wound access - when bone purchase insufficient for plate - arthrodesis
61
Are external skeletal fixators invasive or non invasive?
They offer less invasive fixation
62
Which is more stable, external skeletal fixators or plate fixators?
Plate fixation is more stable!!
63
which is more desirable, open or closed placement?
Closed!!! but only if fracture is reduced
64
What type of fixator is a unilateral-uniplanar?
Type Ia
65
What fractures is a unilateral-uniplanar fixator used on?
- radial fractures - tibia-medial surface - femur and humerus - lateral surface - often used in combo with IM pin on femur and humerus
66
What type if fixator is a unilateral-biplanar?
Type Ib
67
What fractures is a unilateral-biplanar fixator used on?
- radius: craniomedial or craniolateral | - tibia: craniomedial
68
What kind of fixator is a bilateral-uniplanar?
Type II
69
What fractures is a bilateral-uniplanar fixator used on?
radius and tibia | - CANNOT USE ON THE FEMUR AND HUMERUS
70
What type of fixator is a bilateral-biplanar?
Type III
71
What fractures is a bilateral-biplanar used on?
ONLY the radius and tibia
72
What is the most common placement of a Type Ia fixator?
1 side of the bone in 1 plane
73
What is the most common placement of a Type Ib fixator?
1 side of the bone on 2 planes
74
What is the most common placement of a Type II fixator?
2 sides of the bone on 1 plane
75
What is the most common placement of a Type III fixator?
2 sides of the bone on 2 planes
76
Circular/Ring fixators are used when?
- complex fractures with no other alternatives - limb shortening or lengthening procedures - angular deformities - transport of bone segements
77
How does the circular/ring fixator place tension?
by weight

SAS kban RUSVM (2 decks)

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