Lecture 25 4/3/25 Flashcards
What is the incidence of fractures in bovine?
-rare
-more common in young animals
-seen with external trauma or dystocia
What is the breakdown of fracture occurrence by bonre?
-metacarpus/metatarsus: 50%
-tibia: 12%
-radius/ulna: 7%
-humerus: 5%
-femur: rare
-phalanges: rare
Why are cattle good orthopedic patients?
-handle immobilization well
-used to being recumbent
-tremendous bone healing properties
-few complications for the contralateral limb
What are the characteristics of temporary immoblization?
-done in the field before transport to hospital
-goal is to keep a closed fracture from becoming an open fracture
-splint has to touch the ground to alleviate forces on fracture
-splint is placed lateral or palmar/plantar
How is splint length determined?
fractures that are more proximal to the body will require longer splints to ensure there are no unwanted forces acting on the fracture
What should be evaluated in patients presenting with fracture?
-TPR
non-weightbearing lameness/recumbency
How are fractures characterized?
-visual
-palpation
-x-ray
How many radiograph views are needed when assessing fractures?
2 orthogonal views
What are the different fracture configurations?
-simple or complex (comminuted, multiple)
-transverse, oblique, or spiral
-open or closed
-displaced or not
-portion of bone involved
How is short oblique distinguished from long oblique?
length of the fracture will be 2x the bone diameter in long oblique fractures
Which salter-harris physeal fractures are most common in cattle?
type 1 and type 2
What are the possible treatment options for fractures in cattle?
-external coaptation
-external fixators
-open reduction and internal fixators
What are the indications for external coaptation/casting?
-closed fracture
-simple fracture
-transverse or short oblique fracture
-fracture distal to carpus/tarsus
What are the advantages of external coaptation/casting?
easy and affordable
What are the rules regarding external coaptation/casting?
-must provide sedation +/- general anesthesia
-need adequate fracture reduction
-must immobilize the joints proximal and distal to the fracture
-must provide adequate protection of prominent bones
-must include the claws in the cast
Where must felt be placed to protect prominent bones when casting?
-between and under claws
-over palmar/plantar aspect of proximal sesamoid bones
-palmar/plantar aspect of carpus/tarsus
-elbow/stifle joint
Why is it recommended to place the proximal felt protection over the stockinette despite the other pieces being placed under the stockinette?
it helps to maintain the felt in place when the stockinette is rolled down
How many cast layers are required for different weights of cattle?
under 150 kg: 6 to 8 layers
greater than 150 kg/adults: 12 to 16 layers
What are the characteristics of fiberglass cast material?
-weak in compression
-strong in tension
Why is cast bulkiness needed?
-to provide appropriate protection to fracture and resist compression
-need especially bulky casts along palmar aspect of front leg and dorsal aspect of hind leg due to increased compression
How long does it take for clinical osseous healing to occur?
6 to 12 weeks
What are the characteristics of cast timing in calves?
-typically need casts for 5 to 6 weeks
-casts should be be changed every 3 weeks; calves grow out of them rapidly
What are the characteristics of cast timing in adults?
-time needed to heal is variable
-cast changes can occur after 4 weeks or longer
What should be monitored in a cow with a cast?
-comfort
-weight bearing
-gait
What are possible complications of casting?
-cast fracture
-cast sores
-gait alteration
-tendon laxity
-ruptured peroneus tertius
-angular limb deformity
What is the prognosis for fracture in cattle?
-excellent prognosis for closed fractures
-guarded to poor prognosis for open fractures; expensive and hard to heal
What is the adequate way to apply a calving chain?
loop above tha fetlock and do a half-hitch knot distal to it
What are the characteristics of calving chain injury treatment?
-closed reduction and external coaptation with fiberglass cast
-very difficult/impossible to assess vascular damage
What are the complications seen at cast changes with calving chain injuries?
-delayed opening of fracture site
-sloughing of skin
-necrosis of one or both digits
What are the characteristics of the modified thomas splint?
-complement to external coaptation
-principle is to bypass fracture site and maintain proximal joint in extension
-loading forces are applied at shoulder/hip
-applied after the cast
-does not fully immobilize the joint proximal to the fracture; suboptimal
What is the indication for a modified thomas splint?
closed fracture of the radius/ulna or tibia
What is the aftercare following placement of a cast and modified thomas splint?
-assess weight bearing daily
-assist animal and laying down, especially on first day
What are the complications associated with the modified thomas splint?
splint sores/wounds due to excessive pressure on skin
What are the expectations with modified thomas splints?
-secondary bone healing
-possibility for angular limb deformities due to leg being pushed away from body during healing
What are the characteristics of external fixation?
-can use type 2 fixators or fixators associated with a cast
-done for open and/or comminuted fractures
-requires general anesthesia
-longer hospitalization for animal
What are the characteristics of internal fixation?
-done for proximal fractures in the femur or humerus
-used in high value animals to get better reduction
-expensive
What is a type 1 Gustillo-Anderson fracture?
-small skin laceration less than 1 cm
-clean
What is a type 2 Gustilo-Anderson fracture?
-larger laceration greater than 1 cm
-mild soft tissue trauma
-no flaps or avulsions
What is a type 3a Gustilo-Anderson fracture?
-vast soft tissue laceration, flaps, and/or high-energy trauma
-soft tissue is available for wound coverage
What is a type 3b Gustilo-Anderson fracture?
-extensive soft tissue injury loss
-presence of bone exposure
-periosteum stripped away from bone
What is a type 3c Gustilo-Anderson fracture?
damage of the vascular supply of fracture and distal limb
