LA Management of Orthopedic Emergencies (29) Flashcards by Abbie Chase

Q

What are the primary causes of severe single limb lameness in horses?

A

foot abscess (subsolar abscess)
- fracture
cellulitis
- etc

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Q

What is this? How does it happen?

A

a subsolar abscess

localized infection = pus = compression = pain

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Q

Which parts of the lameness grading scale are obvious?

A

4 and 5

4: lameness obvious at a walk
5: lameness produces minimal weight bearing in motion and/or at rest or a complete inability to move

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Q

T or F: This is normal. Why or why not?

A

FALSE - in front limbs, so not normal (hind they can); they are resting the lame leg

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Q

How should you triage severe lameness?

A

assess patient’s level of pain
- history, PE

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Q

What should you do if you cannot determine the cause of lameness in equine?

A

treat as a fracture until proven otherwise

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Q

What may you observe on a lame limb?

A

digital pulses increased
swelling
wounds
crepitus
pain on palpation

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Q

What diagnostics should you do first?

A

hoof testers

nerve blocks for severe lameness - BUT do not block those with high likelihood of having a fracture!

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Q

When should you radiograph a limb?

A

once the limb is stable! - can take radiographs through PVC splints or wood

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Q

Why may incomplete fractures become more visible in 7-10 days?

A

osteoclastic activity - eats up fracture line, spreads it

osteoblasts create new callus and new bone

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Q

What is the #1 rule for fracture stabilization?

A

immobilize the joint above and below the fracture!

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Q

Which joints do you stabilize?

A

stifle and tarsus

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Q

Where can you use a Robert jones bandage?

A

knee and below the hock

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Q

What are characteristics of the Robert Jones bandage?

A

need splints to be stable

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Q

How do you apply splints?

A

apply in 2 planes (90 degrees from each other)

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Q

Where are kimzey splints used?

A

p1
p2
distal cannon (condylar)

p3 you use a foot cast

Q

What are characteristics of a bandage cast?

A

Q

Reference

A

Q

What is region 1? What do you use here?

A

fractures of the proximal and middle phalanx

dorsal and plantar flat surfaces

kimzey splint

Q

What is region 2? What do you use here?

A

fracture of 3rd metacarpal or metatarsal bones

full limb RBJ bandage

splints from the hoof to the elbow/stifle, caudal and lateral

Q

What is region 3A? What do you use here?

A

fractures of the tibia or radius

full limb RBJ

splint lateral - extends to proximal scapula or hip to prevent lateral displacement

Q

What is region 3B? What do you use here?

A

loss of triceps function, dropped elbow - olecranon fracture, radial nerve paralysis

full limb RBJ - caudal full length splint

Q

What is region 4? What do you use here?

A

fracture of the humerus, scapular, femur, or pelvis

no external coaptation

Q

What happens if there is an associated wound with the fracture?

A

basically euthanize

When should you give analgesia regarding fractures?

once the fracture is stabilized - do not provide too much pain relief before the fracture is stable

When do you use antibiotics for fractures?

open: use closed: wait until surgery

How should you transport horses for referral?

gooseneck trailer forelimb: face backwards hindlimb: face forwards

When do you apply a cast for a horse?

What are the types of casts?

What are guidelines for cast applications?

do not end a cast in the middle of a long bone! cast should fit snugly cast should be applied in the normal weight bearing angle

How do you prepare the cast?

How do you apply the cast?

- doubled stockinette and felt at pressure points - cast padding - casting tape: start small width and get wider

When and how should you remove the cast?

growing animal: every 2-3 weeks adult: every 6-8 weeks

What is a bandage cast?

cast over well-applied bandage

How do you care for casts?

- sparingly use NSAIDs - examine horse twice daily - change cast at first indication of problem

What are complications of cast with large animals?

cast sores

What are signs of cast sores?

- staining of cast - increased lameness - exudate coming out the top of the cast can be worse than the original injury!

Where are common locations of cast sores in horses?

- dorsal cannon at top of cast - palmar aspect of fetlock - coronet and heel bulbs