Lecture 16 2/20/25 Flashcards
What is a fracture patient assessment score?
sliding scale reflecting healing potential that takes into account mechanical, biological, and clinical factors
Which clinical aspects of fracture assessment contribute to little risk of healing complications?
-good client compliance
-good patient compliance
-stoic patient
-comfort level not being a consideration
Which clinical aspects of fracture assessment contribute to higher risk of healing complications?
-poor client compliance
-poor patient compliance
-wimpy patient
-high comfort level required
Why are more active dogs more difficult to treat?
they are likely to challenge the repair quicker/before adequate healing can take place
Why are bigger dogs more difficult to treat?
they apply a larger weight load onto the fracture repair
Which temperament is more difficult to treat with regards to fracture repair?
aggressive animals; more difficult to complete appropriate follow up care
What aspects of the owner must be evaluated when determining best approach to fracture repair?
-compliance/reliability
-willingness and ability to attend to post-op needs
-client expectations
-finances
Which biologic aspects of fracture assessment contribute to little risk of healing complications?
-juvenile
-excellent health
-good soft tissue envelope
-cancellous bone
-low velocity injury
-closed approach
Which biologic aspects of fracture assessment contribute to higher risk of healing complications?
-old patient
-poor health
-poor soft tissue envelope
-cortical bone
-high velocity injury
-extensive approach
Which biologic aspects of fracture assessment contribute to moderate risk of healing complications?
-middle age (moderate-high risk)
-young adult (low-moderate risk)
-mini approach (low-moderate risk)
What are the characteristics of low velocity injuries?
-simple fractures
-little to no fragment displacement
-low energy store before occurrence of fracture
What are the characteristics of high velocity injuries?
-comminuted fractures
-high energy dissipating on the soft tissue
Which mechanical aspects of fracture assessment contribute to little risk of healing complications?
-compression
-single limb
-toy breeds
Which mechanical aspects of fracture assessment contribute to high risk of healing complications?
-nonreducible fragments
-multiple limb injury
-giant breeds
Which mechanical aspects of fracture assessment contribute to moderate risk of healing complications?
-reducible fragments
-pre-existing clinical disease
-large breeds
What is the balance between stability and viability?
stability:
-must provide adequate stability to fracture zone
-no fixation can withstand repetitive loading forever; need viable tissue to heal
viability:
-nurture the tissues of the fracture zone
-speed up fracture healing to reduce requirement for fixation longevity
What are the characteristics of reconstructable fractures?
-great mechanical advantage
-less chance of implant failure
-decreased biological advantage
-iatrogenic damage of soft tissue
-longer healing times
What are the key features of reconstructable fracture repair?
-important to have very stable fixation for healing
-best implants are locking/conventional plates to provide compression or neutralization
-open approach recommended to allow for precise reduction and reconstruction
What are the characteristics of non-reconstructable fractures?
-poor mechanical advantage
-greater chance of implant failure
-less bone stock to work with
-poor biological advantage
-less vascular supply due to trauma
-longer gaps between bone fragments
-more biological requirement for bone gap bridging
What are the key features of non-reconstructable fracture repair?
-important to have strong implants, but can be less rigid
-best implants are locking plates, interlocking nails, and fixators
-want to use a minimally invasive approach to preserve as much soft tissue as possible
What are the characteristics of relative stability in non-reconstructable fracture repair?
-controlled movement at fracture site
-healing via callus formation
-acceptable reduction is maintained during loading of fractured bone
