Introduction to Fracture Repair (Betance 1) Flashcards by Meleah McMillen

Q

Complete or incomplete break in the continuity of bone or cartilage is defined as a_______

A

fracture

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

“The early return of the patient to full function of the limb” is defined as the ______ of fracture repair

A

goal

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

What are the methods of classification of fractures (6) Don’t Forget-Luers-RODS

A

Don’t Forget: DIRECTION of FRACTURE lines Lures: Location of the fracture on the bone R: Reducible or non O:Open or closed D: Displacement (of fracture segments) S: Specific (types of fractures)

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the direction of fracture lines: ?

A

Transverse

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the direction of fracture lines: ?

A

Oblique

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the direction of fracture lines: ?

A

Oblique

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the direction of fracture lines: ?

A

Spiral

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the direction of fracture lines: ?

A

Comminuted Reducible

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the direction of fracture lines: ?

A

Comminuted nonreducible

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Label

A

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Classify Harris classification

A

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Classify Harris classification

A

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

This is an example of ______?

A

Reducibility

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

This is an example of ______?

A

Displacement

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

This is an example of ______?

A

Specific fractures: tibial tuberosity being distracted

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

This is an example of ______? Dog presented with acute onset of lameness

A

Specific fracture: from pathological fracture due to osteosarcoma

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

This is an example of ______?

A

Transverse fracture and fissure fracture

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the type of fracture (open or closed)

no communication with the external environment

A

Closed fracture

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the type of fracture:

at some point developed communication with the external environment

A

Open fracture

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

State the open fracture classification?

Bone penetrating through skin
Laceration < 1 cm
Clean

A

Type 1

Q

State the type of open fracture?

External object penetrates soft tissue
Laceration > 1 cm
Mild soft tissue trauma

A

Type 2

Q

State the open fracture classification

Arterial supply damaged
Requires arterial repair for limb salvage

A

Type 3c

Q

State the open fracture classification

Vast soft tissue laceration
Soft tissue available for closure

A

Type 3a

Q

State the type of open fracture?

Extensive soft tissue injury and loss
Bone exposure and stripped periosteum

A

Type 3b

Classify the type of open fracture

Class 3c

State the type of fracture

Femoral bone Mid diaphysis 3 piece comminuted reduceable with medial butterfly segment

What are some causes of fractures? (4)

* Direct insult-Over 75% are HBC * Indirect Insult-Force transmitted through bone to distant point (femoral neck, tibial tuberosity) * Pathological-Causes weakening of bone (neoplasia, nutritional) * Repeated stress-Metacarpal and metatarsal bones in racing Greyhounds

State the types of forces?

State the method of fixation: reestablishing normal alignment of fracture fragments. Can ahve closed versus open \_\_\_\_\_\_\_\_\_\_

Reduction

State the method of fixation: securing fracture fragments to withstand forces acting on fracture following reduction

Fixation

What is the name of the method of fracture repair that is the best way if you can do it (yet very few classify with positive results to fix it this way)

External Coaptation

What type of reduction: ## Footnote \_\_\_\_\_\_ reduction: reducing a fracture without surgically exposing the fractured bones

Closed

What are the benefits of closed reduction? 4?

* Preserves soft tissue and blood supply * Decreased risk of infection * Decreased operating time * Difficult to obtain accurate reconstruction

What are the Indications for External Coaptation? (5)

* Closed fracture below elbow or stifle * Fractures in which bone will be stable after reduction * Fractures in which bone can be expected to heal quickly (no fracture disease) * Amendable small dogs and cats * Greenstick, Intact periosteal sleeve, Impaction fractures

What are advantage/indications for open reduction versus the the 3 disadvantages?

Advantage: * Direct visualization of fracture to facilitate reconstruction * Allows direct placement of implant * Allows load sharing * Bone grafts Disadvantages * Increased surgical time * Increased soft tissue trauma/blood supply * Increased risk of infection

\_\_\_\_ reduction: ## Footnote Surgical approach to expose fracture in order to reconstruct and stabilize

Open reduction

What types of fractures have indications for open reduction?

* Unstable fractures * Articular surfaces * Displaced fractures * Fractures anticipated to have delayed healing

What are the rules for open reduction? * Be gentle and efficient * Attain ______ \_\_\_\_\_\_ * Follow normal separations between muscles and fascial planes * If muscles need to be severed for exposure do near ____ or \_\_\_\_ * Know location of major vessels and nerves * Preserve ____ \_\_\_\_ and blood supply

* strict hemostasis * soft tissue * origin or insertion

How do you reduce a transverse fracture?

* Apply traction * Lift bone ends from incision * Place ends in contact * Apply force to place in normal position or * Use of a slim instrument * Apply as a lever * Reduce fracture

How do I reduce a oblique fracture? (3)

* Distract bone segments * Use two self retaining pointed reduction bone forceps * Position obliquely and reduce fracture

What are some things you need to think about with determining method of fixation?

* **Determine what type of bone is fractured** * Weight bearing vs. non weight bearing * **Where on bone is the fracture** * Articular vs. non articular * Some methods require more bone purchase * **Size, weight and activity of patient** * **Evaluate specific fracture** * Direction of fracture lines/loss of bone

When choosing a method of fixation, we need to look at the forces acting on the fracture in _____ \_\_\_\_ such as? (3)

weight bearing * compression * bending * torsion

Fixation method must _______ forces

counteract

When choosing a method for fixation patient needs to be comfortable enough for this?

load sharing

**Transverse fracture forces (fill in the blank)** * Stable in \_\_\_\_\_\_ * _____ in bending * Unstable in \_\_\_\_\_\_ * \*\*\*Ideal for \_\_\_\_\_ * Less stress on fixation

Stable in **compression** **Unstable** in bending Unstable in **rotation** Ideal for **load sharing** Less stress on fixation

**Forces Acting on an Oblique Fracture (fill in the blank)** * Unstable in \_\_\_\_\_\_\_ * Less unstable in _____ and _____ when compared to a _____ fracture

* Unstable in **compression** * Less unstable in **bending and rotation** when compared to a **transverse** fracture

This describes forces acting on a _______ fracture Unstable in * \_\_\_\_\_\_\_ * \_\_\_\_\_\_\_ * \_\_\_\_\_\_\_ Fracture will _____ or ______ when forces are applied No ______ \_\_\_\_\_\_\_

**Comminuted** fracture * Unstable in * compression * bending * torsion * Fracture will **displace or collapse** when forces are applied * No **load sharing**

_Forces acting on fractures (fill in the blank)_ * ____ method counteracts at least ___ force * Some counteract more than one force * Some counteract a force _____ than others * Ideally, the bone will take some of the load of _____ \_\_\_\_\_\_ * For optimal healing, the bone must be \_\_\_\_\_\_ * Impossible with severely _____ fracture

* **_ANY_** method counteracts at least **_ONE_** force * Some counteract more than one force * Some counteract a force **_better_** than others * Ideally, the bone will take some of the load of **_weight bearing_** * For optimal healing, the bone must be **stressed** * Impossible with severely **comminuted** fracture

Name some different methods of surgical fracture repair

* Intramedullary pin + cerclage wire * External fixator +/- cerclage wire or skewer pin * Tension band * Bone plate and screws * Lag screw * Interlocking nail