Introduction to Fracture Repair

Question 1

What signalment should be analysed which can influence the fracture type? (5)

Answer 1

Age
Sex
Breed
Size
Occpation

Question 2

What are young animals prone to in terms of #?

Answer 2

Physeal #

Question 3

Why are luxations rare in immature animals?

Answer 3

Physis is weaker than bone ligament attached

Question 4

What should be suspected in older animals where a # has occured after minimal trauma?

Answer 4

Pathological #

Question 5

What sex are more prone to # and why?

Answer 5

Male animals are more prone to traumatic fractures (e.g., road traffic accidents) than females due to their increased tendency to stray.

Question 6

What # are springer spaniels prone to?

Answer 6

Humeral condylar #

Question 7

What # are bull terriers prone to?

Answer 7

Avulsion of tibial tuberosity

Question 8

What # are toy breeds prone to? (2)

Answer 8

distal, radial and ulna fractures after minimal trauma.

Question 9

What # are greyhounds and lurchers prone to due to athletics? (3)

Answer 9

• Accessory carpal
• Radial carpal
• Central tarsal

Question 10

What 4 questions need answering in consult when # suspected?

Answer 10

Has there been a major or minor trauma?

Was there any prior history of lameness?

Has the animal any concurrent disease?

Do they take any medication?

Question 11

When investigating a #, what 3 examinations need performing?

Answer 11

1 A full general clinical examination.

2 A full orthopaedic examination.

3 A basic neurological examination.

Question 12

Is the following statement true or false: orthogonal views of the affected bone(s) are required.

Answer 12

True

Question 13

True or false
Orthogonal views of the other bone(s) for comparison are not required.

Answer 13

False

Question 14

What considerations are correct concerning diagnostic imaging in dogs and cats with a fracture?

A) CT provides more detailed information compared to radiography and decision making will therefore be improved in all cases.

B) Decision making in long bone fractures will likely profit from taking a CT rather than radiographs.

C) Typical fractures recommended to consider CT over radiographs are vertebral fractures, sacral fractures and articular fractures.

Answer 14

C) Typical fractures recommended to consider CT over radiographs are vertebral fractures, sacral fractures and articular fractures.

Question 15

Why do we classify fractures?

Answer 15

= part of the management process
Consideration of all factors influencing the fracture
Necessary to design an appropriate fracture plan

Question 16

What are the 10 points of # classifcation?

Answer 16

1 Cause of fracture

2 Communication with external environment

3 Extent of bony damage

4 Number and position of fragments

5 Direction of fracture lines

6 Location of fracture

7 Displacement

8 Stability

9 Degree of complexity and involvement of other tissues

10 Age of fracture.

Question 17

What are the 2 causes of # during # classification?

Answer 17

Intrinsic vs Extrinsic

Question 18

What are the 2 Extrinsic causes of #?

Answer 18

Direct trauma
Indirect trauma

Question 19

What are the 3 intrinsic causes of #?

Answer 19

Muscular

Pathological

Stress.

Question 20

Is a gunshot wound open or closed #?

Answer 20

A gunshot injury is per definition always an open fracture (there is communication with the environment along the path of the shot/bullet).

Question 21

How can open # be identified on radiographs? (2)

Answer 21

Visible air bubbles
Defects of soft tissue

Question 22

What are the 2 sub categories o f “extend of bony damage”

Answer 22

Complete
Incomplete

Question 23

What are the 3 types of incomplete fractures?

Answer 23

Fissure
Greenstick
Depressed.

Question 24

What is the correct term for 1 #?

Answer 24

Simple

Question 25

What is the correct term for 2 #s?

Answer 25

Segmental

Question 26

What is the correct term for 3 #s?

Answer 26

Comminuted

Question 27

What are the 3 subcategories for the "direction of #"?

Answer 27

- Transverse - Oblique - Spiral

Question 28

Which # is from a compressive force

Answer 28

Oblique #

Question 29

Which # is from a tension/avulsion force

Answer 29

Transverse force

Question 30

Which # is from a torque force

Answer 30

Spiral #

Question 31

Which # is from a bending (tension + compression force)

Answer 31

Butterfly

Question 32

How do forces effect decision making in # repair?

Answer 32

When considering how to repair a fracture you must consider the requirement to overcome forces acting on the fractur

Question 33

What are the 5 subcategories of # location?

Answer 33

Diaphyseal (Proximal, Midshaft, Distal) Metaphyseal Epiphyseal Condylar Articular.

Question 34

What are the 4 types of #/displacement?

Answer 34

Medial - Lateral Cranial - Caudal Overriding Impacted-distracted.

Question 35

Which fragment is described when with displacement?

Answer 35

Distal

Question 36

What is #stability describing?

Answer 36

When subject to weight bearing force

Question 37

When classifying a # what does the "degree of complexity" relate to?

Answer 37

Tissue involvement: Muscle damage Nerve damage Blood vessel damage.

Question 38

What are you looking for when ageing a #?

Answer 38

Recent - sharp lines and define old - Callus

Question 39

What is the ultimate "aim" of # fixation?

Answer 39

The aim of fracture fixation is to create an optimal environment for fracture healing and return the patient to normal.

Question 40

After the patient has been thoroughly examined and any life-threatening problems corrected, the planning of the fracture treatment is performed. What needs to be considered? (4)

Answer 40

* assessing preoperative patient data such as age, weight, general health, activity level, presence of other orthopaedic pathology and/or neurologic pathology; * examination of diagnostic images of the fractured and corresponding contralateral intact bones, including the joints proximal and distal to the fracture; * considering all the mechanical and biological factors relevant to the fracture; * considering client information such as their expectations and ability to perform postoperative care.

Question 41

What are the 3 # assessment scores?

Answer 41

- Mechanical - Biological - Clinical

Question 42

What does the mechanical fracture assessment score indicate?

Answer 42

How strong the implant must be

Question 43

What does the biological fracture assessment score?

Answer 43

The biological fracture assessment score indicates how long an implant must function.

Question 44

Do younger or older animal heal quicker?

Answer 44

Younger

Question 45

Do metaphyseal or diaphyseal # heal quicker?

Answer 45

Metaphyseal

Question 46

What is clinical # assessment?

Answer 46

The clinical score indicates the level of postoperative care the owners can provide.

Question 47

Active animals allowed excessive exercise must be treated with what implant?

Answer 47

Large and strong

Question 48

Implants subjected to slow healing conditions must be...?

Answer 48

larger, stronger and able to remain in position for extended periods to minimise chances for cyclic fatigue of the implant.

Question 49

Comminuted fractures are best treated with ...

Answer 49

Implant. Comminuted fractures are best treated with biological techniques of major segment alignment and bridging osteosynthesis.

Question 50

What FAS?: Ideal – good healing expected, e.g. a reconstructable fracture and very attentive owners.

Answer 50

8-10

Question 51

What FAS For example, a young dog with a severely comminuted fracture which is not reconstructable.

Answer 51

6-7

Question 52

What FAS Usually indicates an animal with a reconstructable fracture but unfavourable biology.

Answer 52

4-5

Question 53

What FAS Expect slow healing with inattentive owners. Use strong fixation and biological support.

Answer 53

1-3