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Equine Medicine and Surgery > Lecture 18: Principles of Equine Fracture Management > Flashcards

Lecture 18: Principles of Equine Fracture Management Flashcards

1
Q

T or F: horses have to stand immediately after surgery

A

True

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2
Q

What are complications from fracture repair

A
  1. Prolonged recovery- myopathy and neuropathy
  2. Implant infections and subsequent osteomyelitis
  3. Support limb laminitis
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3
Q

What are the AO-ASIF principles

A
  1. Precise anatomic reconstruction- accurate alignment, perfect reconstruction of joint surfaces, sx approaches that allow visualization
  2. Stable fixation
  3. Soft tissue considerations
  4. Successful internal fixation
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4
Q

What does successful internal fixation mean

A

Anatomic reconstruction of bones and joint surfaces that allow sharing of loads between reconstructed bone and implants

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5
Q

What are the simple types of fractures

A
  1. Splint bone fractures
  2. MC stress fractures
  3. Condylar fractures
  4. Coffin bone fractures
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6
Q

What are major types of fractures

A

Long bone fractures
1. Radius
2. MC/MT 3
4. Tibia

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7
Q

Where are splint fractures most common

A

Distal 1/3 of bone

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8
Q

Are forelimbs or hind limbs most commonly affected with splint bone fractures

A

Forelimbs

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9
Q

What can cause splint bone fractures

A

External trauma- kick

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10
Q

Split bone fractures from trauma are often open or closed

A

Open

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11
Q

what wrong

A

Open splint bone fracture

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12
Q

Fractures of the mid and proximal 1/3 splint bone are complicated by ___, __, and __

A

Comminution, joint involvement and bone sequestration

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13
Q

Proximal fragments of splint bone fractures must be secured to ___ to prevent excessive motion and subsequent ___

A

MC/MT 3, subsequent OA

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14
Q

Proximal fragments of ___especially must be secured to MC/MT II because they make up significant portion of articular surface of carpometacarpal joint

A

MC II

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15
Q

Splint bones can heal without internal fixation but often result in __ which can impinge on ___ necessitating removal

A

Callous, suspensory ligament

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16
Q

What is dorsal metacarpal disease

A

Periostitis and stress fracture of dorsal surface of MC3

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17
Q

What this

A

Dorsal metacarpal disease- stress fracture of dorsal surface of MC3

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18
Q

Who is likely to get dorsal metacarpal disease

A

Young thoroughbreds in race training

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19
Q

What are signs of dorsal metacarpal disease

A

Acute onset after intense exercise, dorsal cortex of M3 painful on palpation

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20
Q

Dorsal metacarpal disease is also called

A

Bucked shins, shin splints

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21
Q

What is the early phase of dorsal metacarpal disease and what do radiographs show

A

Bucked shins
Painful on palpation, heat, swelling
Rads show subperiosteal callous, endosteal thickening but NO FRACTURE LINE

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22
Q

What is the late phase of dorsal metacarpal disease

A

Dorsal cortical fracture, typically 60-70% through dorsal cortex

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23
Q

What is this

A

Late phase of dorsal metacarpal disease—dorsal cortical fracture

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24
Q

What is tx for dorsal metacarpal disease- early phase

A

Gradually increase stress to dorsal surface of M3, controlled exercise (reduce galloping by 50%), if speed increased, decrease distance, run on softer surface

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25
What is tx for late phase dorsal metacarpal disease- dorsal cortical fracture
Surgery- place unicortical lag screw
26
What are clinical signs of MC/MT III condylar fractures
Lameness after work/race Fetlock joint effusion
27
What wrong
MC/MT 3 condylar fracture
28
__condylar fractures more common in thoroughbreds
MC III
29
__condyle is more commonly affected than ___ in MC/MT III condylar fractures
Lateral condyle
30
Horses with medial or complete displaced MC/MT 3 condylar fractures should be transported in __ or __
Cast or Kimzey splint
31
Identify the different types of MC/MT III condylar fractures left to right
Left: incomplete- starts at joint surface and goes up cannon bone a little Complete/nondisplaced: start at joint surface and out to cortex Complete displaced- through cortex and out Medial propagating- allow the way up cannon bone
32
What typically causes coffin bone fractures
Acute trauma- kicking wall
33
How do you tx non-articular coffin bone fractures
1. Shoeing with bar shoe so foot can’t expand 2. Unilateral palmar digital neurectomy
34
What causes a joint luxation
Rupture of collateral ligaments
35
For joint luxation take ___radiographs
Stressed view
36
What wrong
joint luxated
37
T or F: long bone fractures are true emergencies
True
38
What is first thing you do when arriving to suspected long bone fracture
Sedate horse
39
T or F: it is a good idea to do a nerve block on long bone fracture patient
False
40
___should be suspected with acute onset of severe non-weightbearing lameness
Fracture
41
Long bone fractures have good prognosis with optimal emergency treatment which includes what
1. Sedation +/- anesthesia 2. Wound management 3. Stabilization 4. Infection prophylaxis 5. Safe and proper transport
42
What sedatives and analgesics should you give for long bone fracture
1. Alpha 2 agonists- xylazine and detomidine 2. Butorphanol
43
What is appropriate wound management for open fracture
1. Cover wound with water soluble ointment 2. Clip hair around 3. Clean skin around wound 4. Clean/lavage wound itself 5. Cover with sterile dressing and bandage
44
What is the principle of fracture stabilization
Regional immobilization- immobilize joint proximal and distal
45
What are the goals of stabilization
1. Reduce stress and anxiety 2. Assist with weight bearing 3. Prevent soft tissue damage 4. Prevent complications (closed becoming open, damage to tissue, increased fragment displaced)
46
What materials are in Robert jones bandage
1. Practical/rolled cotton 2. Brown gauze (tight) 3. Vet wrap or elastic on
47
What bio mechanical forces need to be opposed when placing splint
1. Extensors- abduct limbs 2. Suspensory apparatus- applies bending forces at fetlock and we need fetlock straight 3. Reciprocal apparatus- fractures at tibia and tarsus can be displaced by flexion of stifle
48
Splinting is based on the ability to counteract___
Bio mechanical forces imparted on fracture
49
How should splint be placed for forelimb phalange fracture
Dorsal
50
How should splint be placed for metacarpal fracture
Palmar and lateral
51
How should splint be placed with radial fracture
Lateral up to withers
52
How should splint be placed with humeral fracture
Caudal up to olceranon
53
How should splint be placed with scapular fracture
None
54
How should splint be placed with fracture of hind limb phalanges
Plantar
55
How should splint be placed with metatarsal fracture
Plantar and lateral
56
How should splint be placed with tibial fracture
Lateral and up to tuber coxae
57
How should splint be placed with stifle, femur or pelvic fracture
None
58
Splint was placed like this for fracture of what bone
radius
59
If there is forelimb fracture how should they be positioned in trailer
Face horse backwards
60
If there is hindlimb fracture how should horse be positioned in trailer
Forward/normal
61
Pelvic fractures are more common in who
Foals and yearlings
62
What is the cause of pelvic fractures in foals and yearlings
Distinct traumatic event
63
How do you tx pelvic fractures in foals and yearlings
Internal fixation
64
How do pelvic fractures occur in adults
During intense exercise without obvious trauma
65
What is tx for pelvic fracture in adults
Conservative treatment- stall rest
66
What is a major concern with pelvic fractures
Internal iliac artery can be lacerated resulting in severe hemorrhage, shock and death

Equine Medicine and Surgery (27 decks)

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