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Intro to Surgery > Lecture 14 - Splinting & Casting > Flashcards

Lecture 14 - Splinting & Casting Flashcards

1
Q

What is a fracture?

A

Continuity of bone is broken

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2
Q

What is a simple fracture?

A

One line through bone - fracture of only the bone;

No penetration through the skin

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3
Q

What is a compound fracture?

A

Fracture in which a broken piece of bone pierces the skin

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4
Q

What is a comminuted fracture?

A

Breaking of bone into 2+ pieces

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5
Q

What is coaptation?

A

Joining or reuniting of 2 surfaces;

Often in terms of a splint designed to immobilize a fracture

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6
Q

What are some signs used to diagnose a fracture?

A
  1. Severe lameness
  2. Acute onset of clinical signs
  3. Swelling
  4. Pain on palpation
  5. History of trauma
  6. Visualize bone
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7
Q

How can shock be dealt with?

A

IVF and systemic support

(May have other life-threatening injuries such as a diaphragmatic hernia)

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8
Q

How should fractures be evaluated in small animals?

A

Using heavy sedation or anesthesia

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9
Q

Why should sedation to evaluate a fracture in horses be used with care?

A

Agitated horses override drug effects; may be ataxic (don’t want the horse to lay down)

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10
Q

What drug should not be used for front limb fracture in horses?

A

Butorphanol

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11
Q

What are the 5 goals of fracture stabilization?

A
  1. Prevent soft tissue damage
  2. Decrease patient’s anxiety
  3. Minimize eburnation
  4. Keep fracture closed
  5. Protect blood vessels and nerves from stretching
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12
Q

Why is minimizing eburnation important?

A

Eburnation occurs when jagged bone edges rub against each other and become smooth - makes it harder to put fractured edges back together if they are rounded

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13
Q

What are the 3 goals of first aid?

A
  1. Assessment of the animal
  2. Communication (diagnostics, prognosis)
  3. Create plan (hospital/farm management, referral)
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14
Q

Prognosis for equine fractures is _____ based on _____.

A

variable, location

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15
Q

How much does repair of long bone fractures in equines cost?

A

$5,000 to $10,000

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16
Q

When is prognosis of an equine fracture decreased?

A

With weight and compound fracture

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17
Q

How much does an adult horse weigh? Foal?

A

Adult = 1000-1500#

Foal/juvenile = 100-500#

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18
Q

What response do horses usually have when a fracture occurs?

A

Flight - will continue to try to use fractured limb

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19
Q

Small animal fracture prognosis can be _____ to _____.

A

good, excellent

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20
Q

What does small weight allow for with SA fractures?

A

Internal fixation, external fixation, casting, amputation

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21
Q

What 5 things should be considered when thinking about euthanizing an animal with a fracture?

A
  1. Responsibility to patient
  2. Responsibility to client
  3. Equine insurance
  4. AVMA guidelines
  5. AAEP guidelines
22
Q

How can equine fractures be stabilized?

A

External coaptation - bandage, splint, cast

23
Q

What is elastikon used for?

A

Helps seal top/bottom, holds bandages up

24
Q

What are the steps to splinting a fracture?

A
  1. Place RJ or modified RJ bandage (if open fracture start antimicrobials and wound treatment)
  2. Attach splint on outside of bandage (elastikon, vetrap)
  3. Make sure splint ends won’t abrade patient
25
Q

Where should a fracture be immobilized with a splint?

A

Joint above and below the fracture

26
Q

Why should there be lots of padding in a splint?

A

Splint needs to be tight to limit motion

27
Q

When would you use 2 splints together and at what orientation?

A

With a comminuted fracture; 90 degrees to each other

28
Q

What type of splints are used in SA?

A

Spoon, quick splint, casting tape

29
Q

What type of splints are used in equines?

A
  1. Homemade (PVC, wood, twitch/broom handle, casting material)
  2. Commercial (Kimzey)
30
Q

What materials are used in casts?

A
  1. Small bandage
  2. Stockinette
  3. Felt padding
  4. Fiberglass casting tape
  5. Technovit
31
Q

What is technovit used for?

A

Used to reinforce the bottoms of casts - thick epoxy that gives tou wear time

32
Q

How do you place a cast?

A
  1. Soak casting tape
  2. Shake out water (do not squeeze)
  3. Lay on casting material (no wrinkles, snug placement, overlap 50%)
33
Q

What is a complication of casting? What is a disadvantage to having a cast?

A

Complication = pressure sores

Disadvantage = cannot look at wounds

34
Q

How often must casts be changed?

A

Every 2-3 weeks

35
Q

What things should be monitored when a case is in place?

A

Heat, drainage, lameness, seal top of cast

36
Q

What are advantages to placing a bandage cast?

A

Increases immobilization, not as many complications as a normal cast, acts as a custom splint

37
Q

How can a cast be removed?

A

Cast saw, obstetric wire

38
Q

What is zone 1 for splinting?

A

Dorsal splint/plantar splint at the hoof level

39
Q

What is zone 2 for splinting?

A

RJ bandage with caudal/plantar and lateral splint at the level of the metatarsal bones

40
Q

What is zone 3 for splinting?

A

RJ bandage with extended lateral splint at the level of the radius/ulna

41
Q

What is zone 4 for splinting?

A

Caudal splint to lock carpus in extension

(at level of shoulder only, not needed in the hip area)

42
Q

What type of fractures are involved in zone 1 and what direction should the splint be done?

A

Phalanx fractures;

Splint from ground to proximal MC3/MT3 (want toe facing down)

43
Q

What type of fractures are involved in zone 2 and in what direction should the splint be placed?

A

MC3/MT3 fracture;

Splint from ground to elbow/stifle

44
Q

What type of fracture is involved in zone 3 (front limb)? What direction should the bandage be? What direction should the splint be?

A

Radial fracture;

RJ bandage ground to elbow;

Splint ground to shoulder

45
Q

Why is a long splint important in zone 3?

A

Muscles are all on the lateral side of the leg; when they contract they will push the bone out on the medial aspect of the leg causing an open fracture; long splint keeps muscles from contracting/pushing bones out the medial leg

46
Q

What type of fracture is involved in zone 3 (back limb)?

A

Tibial fracture

47
Q

What fracture is involved with zone 3a/b? What does it cause? Where do you splint?

A

Olecranon or ulna; locks the carpus in extension; splint back of leg and give them something to stand on - makes them panic less

48
Q

What fractures are involved in zone 4 and what in animal could you splint this?

A

Humerus/femur;

May be able to support with high bandage and splint in SA

49
Q

How should you transport a horse with a front limb fracture? Rear limb?

A

Front = face backwards

Rear = face forwards

50
Q

Casts are not a good option for fracture treatment in _____.

A

equines

51
Q

What is used for internal fixation of fractures?

A

plates, screws

(LA usually left with this option)

Intro to Surgery (36 decks)

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