Lecture 16 Short Notes Flashcards
What is the purpose of the fracture-assessment score?
to summarize preoperative data reflecting the mechanical, biologic, and clinical environment for implant function
What factors are included in the mechanical evaluation of a fracture?
-number of limbs injured
-patient size and activity
-ability to achieve load-sharing fixation
What are two types of fractures considered reducible?
-two-piece fractures
-fractures with large butterfly fragments
What is a nonreducible fracture?
fractures with multiple large fragments or multiple small fragments that cannot be secured with implants
What is the impact of mechanical factors on implant failure?
large or active patients subject fixations to greater loads, increasing the likelihood of premature loosening and failure
What does an accurate biologic evaluation indicate?
how fast callus may be formed, thus determining how long the implants need to function
What are the primary objectives in treating fractures?
bone union and the patient’s return to normal function
What is the significance of planning in fracture management?
detailed planning helps avoid prolonged operating times, excessive soft tissue trauma, and technical errors
What influences biologic assessment in fracture healing?
-age and general health of the patient
-whether the fracture is open or closed
-extent of soft tissue injury
What is the difference between closed and open reduction?
closed reduction is performed without surgical exposure, while open reduction involves exposing the fractured segments for reconstruction
What are the advantages of closed reduction?
-preserves soft tissue and blood supply
-decreases risk of infection
-reduces operating time
What does a high fracture-assessment score indicate?
minimal implant stress and enhanced healing potential
What is the impact of patient cooperation on fracture management?
very active or uncontrollable patients are not good candidates for external stabilization systems
What does a high fracture-assessment score indicate?
generally heals successfully with few complications
What does a low fracture-assessment score suggest?
potentially less successful healing and more complications
What is the role of mechanical assessment in fracture management?
estimates the strength of implant necessary
What does biologic assessment estimate?
length of time implants must be functional (time to bone union)
What is the significance of higher fracture-assessment scores?
less stress on the fixation system and less time required for bone healing
What type of fractures are typically associated with low scores?
nonreducible fractures in older animals
What are some suggested implants for low fracture-assessment scores?
-lengthening bone plates
-bone plate–intramedullary (IM) pin combinations
-interlocking nails
-type II external fixators
What is the goal for closed reduction of nondisplaced and nonreducible fractures?
achieve normal limb alignment
What types of fractures are managed with open reduction?
anatomically reconstructible fractures or those involving joint surfaces
