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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
Q

What is tx for late phase dorsal metacarpal disease- dorsal cortical fracture

A

Surgery- place unicortical lag screw

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26
Q

What are clinical signs of MC/MT III condylar fractures

A

Lameness after work/race
Fetlock joint effusion

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27
Q

What wrong

A

MC/MT 3 condylar fracture

28
Q

__condylar fractures more common in thoroughbreds

A

MC III

29
Q

__condyle is more commonly affected than ___ in MC/MT III condylar fractures

A

Lateral condyle

30
Q

Horses with medial or complete displaced MC/MT 3 condylar fractures should be transported in __ or __

A

Cast or Kimzey splint

31
Q

Identify the different types of MC/MT III condylar fractures left to right

A

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
Q

What typically causes coffin bone fractures

A

Acute trauma- kicking wall

33
Q

How do you tx non-articular coffin bone fractures

A
  1. Shoeing with bar shoe so foot can’t expand
  2. Unilateral palmar digital neurectomy
34
Q

What causes a joint luxation

A

Rupture of collateral ligaments

35
Q

For joint luxation take ___radiographs

A

Stressed view

36
Q

What wrong

A

joint luxated

37
Q

T or F: long bone fractures are true emergencies

A

True

38
Q

What is first thing you do when arriving to suspected long bone fracture

A

Sedate horse

39
Q

T or F: it is a good idea to do a nerve block on long bone fracture patient

A

False

40
Q

___should be suspected with acute onset of severe non-weightbearing lameness

A

Fracture

41
Q

Long bone fractures have good prognosis with optimal emergency treatment which includes what

A
  1. Sedation +/- anesthesia
  2. Wound management
  3. Stabilization
  4. Infection prophylaxis
  5. Safe and proper transport
42
Q

What sedatives and analgesics should you give for long bone fracture

A
  1. Alpha 2 agonists- xylazine and detomidine
  2. Butorphanol
43
Q

What is appropriate wound management for open fracture

A
  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
Q

What is the principle of fracture stabilization

A

Regional immobilization- immobilize joint proximal and distal

45
Q

What are the goals of stabilization

A
  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
Q

What materials are in Robert jones bandage

A
  1. Practical/rolled cotton
  2. Brown gauze (tight)
  3. Vet wrap or elastic on
47
Q

What bio mechanical forces need to be opposed when placing splint

A
  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
Q

Splinting is based on the ability to counteract___

A

Bio mechanical forces imparted on fracture

49
Q

How should splint be placed for forelimb phalange fracture

A

Dorsal

50
Q

How should splint be placed for metacarpal fracture

A

Palmar and lateral

51
Q

How should splint be placed with radial fracture

A

Lateral up to withers

52
Q

How should splint be placed with humeral fracture

A

Caudal up to olceranon

53
Q

How should splint be placed with scapular fracture

A

None

54
Q

How should splint be placed with fracture of hind limb phalanges

A

Plantar

55
Q

How should splint be placed with metatarsal fracture

A

Plantar and lateral

56
Q

How should splint be placed with tibial fracture

A

Lateral and up to tuber coxae

57
Q

How should splint be placed with stifle, femur or pelvic fracture

A

None

58
Q

Splint was placed like this for fracture of what bone

A

radius

59
Q

If there is forelimb fracture how should they be positioned in trailer

A

Face horse backwards

60
Q

If there is hindlimb fracture how should horse be positioned in trailer

A

Forward/normal

61
Q

Pelvic fractures are more common in who

A

Foals and yearlings

62
Q

What is the cause of pelvic fractures in foals and yearlings

A

Distinct traumatic event

63
Q

How do you tx pelvic fractures in foals and yearlings

A

Internal fixation

64
Q

How do pelvic fractures occur in adults

A

During intense exercise without obvious trauma

65
Q

What is tx for pelvic fracture in adults

A

Conservative treatment- stall rest

66
Q

What is a major concern with pelvic fractures

A

Internal iliac artery can be lacerated resulting in severe hemorrhage, shock and death

Equine Medicine and Surgery (27 decks)

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