Introduction to Fracture Repair Flashcards
What signalment should be analysed which can influence the fracture type? (5)
Age
Sex
Breed
Size
Occpation
What are young animals prone to in terms of #?
Physeal #
Why are luxations rare in immature animals?
Physis is weaker than bone ligament attached
What should be suspected in older animals where a # has occured after minimal trauma?
Pathological #
What sex are more prone to # and why?
Male animals are more prone to traumatic fractures (e.g., road traffic accidents) than females due to their increased tendency to stray.
What # are springer spaniels prone to?
Humeral condylar #
What # are bull terriers prone to?
Avulsion of tibial tuberosity
What # are toy breeds prone to? (2)
distal, radial and ulna fractures after minimal trauma.
What # are greyhounds and lurchers prone to due to athletics? (3)
- Accessory carpal
- Radial carpal
- Central tarsal
What 4 questions need answering in consult when # suspected?
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?
When investigating a #, what 3 examinations need performing?
1 A full general clinical examination.
2 A full orthopaedic examination.
3 A basic neurological examination.
Is the following statement true or false: orthogonal views of the affected bone(s) are required.
True
True or false
Orthogonal views of the other bone(s) for comparison are not required.
False
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.
C) Typical fractures recommended to consider CT over radiographs are vertebral fractures, sacral fractures and articular fractures.
Why do we classify fractures?
= part of the management process
Consideration of all factors influencing the fracture
Necessary to design an appropriate fracture plan
What are the 10 points of # classifcation?
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.
What are the 2 causes of # during # classification?
Intrinsic vs Extrinsic
What are the 2 Extrinsic causes of #?
Direct trauma
Indirect trauma
What are the 3 intrinsic causes of #?
Muscular
Pathological
Stress.
Is a gunshot wound open or closed #?
A gunshot injury is per definition always an open fracture (there is communication with the environment along the path of the shot/bullet).
How can open # be identified on radiographs? (2)
Visible air bubbles
Defects of soft tissue
What are the 2 sub categories o f “extend of bony damage”
Complete
Incomplete
What are the 3 types of incomplete fractures?
Fissure
Greenstick
Depressed.
What is the correct term for 1 #?
Simple
What is the correct term for 2 #s?
Segmental
What is the correct term for 3 #s?
Comminuted
What are the 3 subcategories for the “direction of #”?
- Transverse
- Oblique
- Spiral
Which # is from a compressive force
Oblique #
Which # is from a tension/avulsion force
Transverse force
Which # is from a torque force
Spiral #
Which # is from a bending (tension + compression force)
Butterfly
How do forces effect decision making in # repair?
When considering how to repair a fracture you must consider the requirement to overcome forces acting on the fractur
What are the 5 subcategories of # location?
Diaphyseal (Proximal, Midshaft, Distal)
Metaphyseal
Epiphyseal
Condylar
Articular.
What are the 4 types of #/displacement?
Medial - Lateral
Cranial - Caudal
Overriding
Impacted-distracted.
Which fragment is described when with displacement?
Distal
What is #stability describing?
When subject to weight bearing force
When classifying a # what does the “degree of complexity” relate to?
Tissue involvement:
Muscle damage
Nerve damage
Blood vessel damage.
What are you looking for when ageing a #?
Recent - sharp lines and define
old - Callus
What is the ultimate “aim” of # fixation?
The aim of fracture fixation is to create an optimal environment for fracture healing and return the patient to normal.
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)
- 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.
What are the 3 # assessment scores?
- Mechanical
- Biological
- Clinical
What does the mechanical fracture assessment score indicate?
How strong the implant must be
What does the biological fracture assessment score?
The biological fracture assessment score indicates how long an implant must function.
Do younger or older animal heal quicker?
Younger
Do metaphyseal or diaphyseal # heal quicker?
Metaphyseal
What is clinical # assessment?
The clinical score indicates the level of postoperative care the owners can provide.
Active animals allowed excessive exercise must be treated with what implant?
Large and strong
Implants subjected to slow healing conditions must be…?
larger, stronger and able to remain in position for extended periods to minimise chances for cyclic fatigue of the implant.
Comminuted fractures are best treated with …
Implant. Comminuted fractures are best treated with biological techniques of major segment alignment and bridging osteosynthesis.
What FAS?:
Ideal – good healing expected, e.g. a reconstructable fracture and very attentive owners.
8-10
What FAS
For example, a young dog with a severely comminuted fracture which is not reconstructable.
6-7
What FAS
Usually indicates an animal with a reconstructable fracture but unfavourable biology.
4-5
What FAS
Expect slow healing with inattentive owners. Use strong fixation and biological support.
1-3
