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6th MELEAH Sur-Gur-RAYYY final lezzzz ace dis shit > Introduction to Fracture Repair (Betance 1) > Flashcards

Introduction to Fracture Repair (Betance 1) Flashcards

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1
Q

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

A

fracture

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2
Q

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

A

goal

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3
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)

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4
Q

State the direction of fracture lines: ?

A

Transverse

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5
Q

State the direction of fracture lines: ?

A

Oblique

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6
Q

State the direction of fracture lines: ?

A

Oblique

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7
Q

State the direction of fracture lines: ?

A

Spiral

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8
Q

State the direction of fracture lines: ?

A

Comminuted Reducible

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9
Q

State the direction of fracture lines: ?

A

Comminuted nonreducible

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10
Q

Label

A
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11
Q

Classify Harris classification

A
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12
Q

Classify Harris classification

A
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13
Q

This is an example of ______?

A

Reducibility

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14
Q

This is an example of ______?

A

Displacement

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15
Q

This is an example of ______?

A

Specific fractures: tibial tuberosity being distracted

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16
Q

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

A

Specific fracture: from pathological fracture due to osteosarcoma

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17
Q

This is an example of ______?

A

Transverse fracture and fissure fracture

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18
Q

State the type of fracture (open or closed)

no communication with the external environment

A

Closed fracture

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19
Q

State the type of fracture:

at some point developed communication with the external environment

A

Open fracture

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20
Q

State the open fracture classification?

  • Bone penetrating through skin
  • Laceration < 1 cm
  • Clean
A

Type 1

21
Q

State the type of open fracture?

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

Type 2

22
Q

State the open fracture classification

  • Arterial supply damaged
  • Requires arterial repair for limb salvage
A

Type 3c

23
Q

State the open fracture classification

  • Vast soft tissue laceration
  • Soft tissue available for closure
A

Type 3a

24
Q

State the type of open fracture?

  • Extensive soft tissue injury and loss
  • Bone exposure and stripped periosteum
A

Type 3b

25
Q

Classify the type of open fracture

A

Class 3c

26
Q

State the type of fracture

A

Femoral bone

Mid diaphysis

3 piece comminuted reduceable with medial butterfly segment

27
Q

What are some causes of fractures? (4)

A
  • 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
28
Q

State the types of forces?

A
29
Q

State the method of fixation:

reestablishing normal alignment of fracture fragments. Can ahve closed versus open __________

A

Reduction

30
Q

State the method of fixation:

securing fracture fragments to withstand forces acting on fracture following reduction

A

Fixation

31
Q

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)

A

External Coaptation

32
Q

What type of reduction:

______ reduction: reducing a fracture without surgically exposing the fractured bones

A

Closed

33
Q

What are the benefits of closed reduction? 4?

A
  • Preserves soft tissue and blood supply
  • Decreased risk of infection
  • Decreased operating time
  • Difficult to obtain accurate reconstruction
34
Q

What are the Indications for External Coaptation? (5)

A
  • 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
35
Q

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

A

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
36
Q

____ reduction:

Surgical approach to expose fracture in order to reconstruct and stabilize

A

Open reduction

37
Q

What types of fractures have indications for open reduction?

A
  • Unstable fractures
  • Articular surfaces
  • Displaced fractures
  • Fractures anticipated to have delayed healing
38
Q

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
A
  • strict hemostasis
  • soft tissue
  • origin or insertion
39
Q

How do you reduce a transverse fracture?

A
  • 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
40
Q

How do I reduce a oblique fracture? (3)

A
  • Distract bone segments
  • Use two self retaining pointed reduction bone forceps
  • Position obliquely and reduce fracture
41
Q

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

A
  • 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
42
Q

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

A

weight bearing

  • compression
  • bending
  • torsion
43
Q

Fixation method must _______ forces

A

counteract

44
Q

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

A

load sharing

45
Q

Transverse fracture forces (fill in the blank)

  • Stable in ______
  • _____ in bending
  • Unstable in ______
  • ***Ideal for _____
    • Less stress on fixation
A

Stable in compression

Unstable in bending

Unstable in rotation

Ideal for load sharing

Less stress on fixation

46
Q

Forces Acting on an Oblique Fracture (fill in the blank)

  • Unstable in _______
  • Less unstable in _____ and _____ when compared to a _____ fracture
A
  • Unstable in compression
  • Less unstable in bending and rotation when compared to a transverse fracture
47
Q

This describes forces acting on a _______ fracture

Unstable in

  • _______
  • _______
  • _______

Fracture will _____ or ______ when forces are applied

No ______ _______

A

Comminuted fracture

  • Unstable in
    • compression
    • bending
    • torsion
  • Fracture will displace or collapse when forces are applied
  • No load sharing
48
Q

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
A
  • 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
49
Q

Name some different methods of surgical fracture repair

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

6th MELEAH Sur-Gur-RAYYY final lezzzz ace dis shit (15 decks)

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