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Surgery 1 > Lecture 25: Principles of Orthopedic Surgery (Exam 3) > Flashcards

Lecture 25: Principles of Orthopedic Surgery (Exam 3) Flashcards

1
Q

Deine allograft

A

bone transplanted from one animal to another

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2
Q

Define apophyseal osteotomies

A

Procedures to enhance surgical exposure of a joint

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3
Q

Define Autograft

A

Bone transplanted from one site to another in the same animal

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4
Q

Define avulsion fracture

A

Insertion point of a tendon or ligament is fractured & distracted from the rest of the bone

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5
Q

Define bridging plates

A

Span comminuted fracture

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6
Q

Define Cerclage wire

A

Orthopedic wire placed around circumference of bone to compress an oblique fracture

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7
Q

Define closed reduction

A

Fractured bone alignment performed w/out surgical exposure

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8
Q

Define compression plates

A

Plates that act to compress the fracture

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9
Q

Define corrective osteotomies

A

Diaphysis or metaphysis of of a bone is cut realigned & stabilized until union occurs (elective proceduresO

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10
Q

Define cranial drawer

A

Abnorm movement of stifle joint elicited during PE caused by tibia sliding cranially in relationship to femur (cranial cruciate ligament deficient stifle)

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11
Q

Define crepitation

A

“grating feel” or sound w/ manipulating a fractured bone or arthritic joint

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12
Q

Define Delay unions

A

Fractures that heal more slowly than anticipated

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13
Q

Define direct bone union

A

Bone formed w/o evidence of callus

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14
Q

Define endochondral bone formation

A

Bone formed on cartilaginous precursor

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15
Q

Define external coaptation

A

Fracture fixation w/ casts or splints

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16
Q

Define external fixation

A

Fracture fixation in which pins penetrate bone & skin & connected externally

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17
Q

Define greenstick fracture

A

Incomplete fracture where portion of the cortex is intact

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18
Q

Define hemicerclage wire or interfragmentary wire

A

Wire placed through predrilled holes in bone

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19
Q

Define indirect reduction

A

Process of restoring fragment & limb alignment by distracting major bone segments (using animal’s weight)

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20
Q

Define internal fixation

A

Fracture fixation using internal implants to secure bone

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21
Q

Define intramedullary pins

A

Implants positioned in the medullary canal of long bones

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22
Q

Define intramembranous bone formation

A

Direct differentiation of mesenchymal stem cells into osteoblasts (bone forms w/out a cartilaginous precursor)

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23
Q

Define luxation

A

Complete dislocation of a joint

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24
Q

Define malunions

A

Healed fractures where anatomic bone alignment not achieved or maintained during healing

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25
Q

Define neutralization plates

A

Support a reconstructed fracture

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26
Q

Define nonunion

A

Fracture w/ an arrested repair process (requires surgical intervention to create environment conducive to bone healing)

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27
Q

Define normograde placement

A

Pin started @ on end of bone, driven to fracture area, then seated @ other end of bone

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28
Q

Define open fracture

A

Fracture is exposed to external atmosphere

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29
Q

define open (direct) reduction

A

Fracture repair performed after surgical approach to bone

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30
Q

Define ortolani maneuver

A

Manipulation used to subluxate a dysplatic hip

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31
Q

Define ostectomies

A

Removal of a segment of bone

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32
Q

Define osteomyelitis

A

Inflammatory condition of bone & medullary canal

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33
Q

Define osteotomies

A

Procedures where bone is cut into two segments

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34
Q

Define Procurvatum

A

Cranial bowing of a bone

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35
Q

Define subluxation

A

Partial dislocation of a joint

36
Q

Define valgus deformity

A

Angulation of distal portion of limb laterally

37
Q

Define varus deformity

A

Angulation of distal portion of limb medially

38
Q

What is the goal of treating fracture, nonounions, or bone deformities

A
  • Bone union
  • Px return to normal fxn
39
Q

What should be considered when planning a orthopedic surgical operation

A
  • Method of fracture reduction
  • Sequence of implant application
  • Possibilities for bone grafting
40
Q

What could happen if the is failure to plan the procedure

A
  • Prolonged operating times
  • Excessive soft tissue trauma
  • Technical errors
41
Q

What are the ultimate outcomes of improper planning

A
  • Implant failure
  • Delayed healing
  • Infection
  • Nonunion
42
Q

What does fracture classification allow for

A

Accurate communication w/ owners & colleagues to aid appropriate treatment planning

43
Q

What is evaluated to accurately classify fracture

A
  • Limb
  • Radiographs
44
Q

What is the basis of fracture classification

A
  1. Is fractures closed or open to external environment
  2. Degree of damage & displacement of fragment
  3. Type of fracture
  4. If fracture fragments can be reconstructed to provide load bearing (reducible or nonreducible)
  5. Loacation
45
Q

Describe a greenstick fracture

A
  • Occurs in immature animals
  • Incomplete fracture where portion of cortex is intact
  • Partially stabilizes bone
46
Q

Describe avulsion fractures

A
  • Occur when insertion point of tendon or ligament is fractured & distracted (pulled away) from the rest of the bone
  • May be nondisplaced or displaced
47
Q

Define a transverse fracture

A

Fracture line is perpendicular to the long axis of the bone

48
Q

Define a transverse fracture

A

Fracture line perpendicular to the long axis of the bone

49
Q

Define an oblique fracture

A

Lines run @ an angle to the line perpendicular to the long axis of the bone

50
Q

What is the difference btw/ a short & long oblique fracture

A
  • Short - fractures 45 degrees or less
  • Long - Fractures > 45 degrees to perpendicular to long axis of the bone
51
Q

Define a spiral fracture

A

Similar to long oblique fractures but wrap around long axis of the bone

52
Q

How many fracture lines are found in an single fracture

53
Q

Define a comminuted fractures

A
  • Have multiple fracture lines
  • Can range from 3-piece fractures w/ butterfly fragment to highly comminuted fractures w/ 5 or more pieces
54
Q

What is a butterfly fragment

A

Fragment w/ 2 oblique fracture lines resembling butterfly’s silhouette

55
Q

Label the following:

56
Q

Define a reducible fracture

A

Single fracture line or fractures w/ no more than 2 large fragment

57
Q

Define a nonreducible fracture

A

Fractures w/ multi small fragments

58
Q

What are the classifications of bone by location

A
  • Diaphyseal
  • Metaphyseal
  • Physeal
  • Articular
59
Q

What does velocity of forces dictate

A
  • # of fragments
  • Damage to surround soft tissues
60
Q

What happens if low-velocity forces create a fracture

A

Creates single fractures w/ little energy dissipated into soft tissue

61
Q

What happens if high-velocity forces create a fracture

A

Creates comminuted fractures w/ high energy dissipated through fracture propagation & surrounding soft tissue injury

62
Q

How are open fractures classified

A
  1. Mechanism of puncture
  2. Severity of soft tissue injury
    * Grade 1, 2, & 3
63
Q

Describe a Grade 1 open fracture

A
  • Small puncture hole located in the skin in proximity of fracture caused by bone penetrating to outside
  • Typically ~1cm in diameter
  • Bone may or may not be visible in wound
64
Q

Describe a grade II open fracture

A
  • Variably sized skin wound associated w/ fracture that resulted from external trauma
  • More damage to soft tissue w/ grade 2 thank w/ grade 1
  • Fracture is minimally or not comminuted
65
Q

Describe a grade III open fracture

A
  • Severe bone fragmentation w/ extensive soft tissue injury (w/ or w/o skin loss)
  • Usually high-velocity comminuted fractures like gunshot injuries or shearing type of injuries to the distal extremities
66
Q

label the following using the salter-harris classification of physeal fractures

67
Q

Describe a salter-harris type 1 fracture

A

Fracture runs through the physis

68
Q

Describe a salter-harris type 2 fracture

A

Fractures run through physis & portion of metaphysis

69
Q

Describe a salter-harris type 3 fracture

A
  • Fractures run through physis & epiphysis
  • Generally articular
70
Q

Describe a salter-harris type 4 fracture

A

Fractures are also articular running through the epiphysis, across the physis, & through metaphysis

71
Q

Describe a salter-harris type 5 fracture

A
  • Fractures are crushing injuries of physis
  • Not visible radiographically but become evident several weeks later when physeal function ceases
72
Q

Describe a salter-harris type 6 fracture

A
  • Classification used to describe partial physeal closures from damage to a portion of physis
  • Causes asymeetric physeal closure
73
Q

Label the following forces acting on fractured bones:

74
Q

What patient info should be collected for a fracture assessment score

A
  • Age
  • Weight
  • General health
  • Activity level
  • Presence of other ortho pathology
75
Q

What data should be gathered for a fracture assessment score

A
  • Px info
  • Radiographs of fractured & corresponding contralateral intact bones (including proximal & distal joints)
  • Client info (expectations & ability to perform postop care)
76
Q

What factors does the data fracture-assessment score reflect

A
  • Mechanical factors
  • Biologic factors
  • Clinical factors (clinical envi where implants must fxn)
77
Q

Why is a fracture assessment score important

A

Guides the types of implants chosen

78
Q

Describe conditions found on the left of the FAS scale (mechanical factors)

A
  • Nonreducible
  • Multi limb injury
  • Max stress on the implant
  • Req careful implant choice & application
79
Q

Describe conditions found on the right of the FAS scale (mechanical factors)

A
  • Less stress to implant
  • Reduced risk of complications
80
Q

Describe conditions found on the left of the FAS scale (biologic factors)

A
  • Do not favor rapid healing
  • Implant system must function for prolonged periods
81
Q

Describe conditions found on the right of the FAS scale (biologic factors)

A
  • Favor rapid healing
  • Implant only needs to fxn for a short time
82
Q

Describe conditions found on the left of the FAS scale (clinical factors factors)

A
  • Req comfortable implant sys
  • Req little postop maintenance
83
Q

Describe conditions found on the right of the FAS scale (clinical factors factors)

A
  • Can use any implant system
  • Regardless of postop maintenance
84
Q

How if the FAS interpreted

A
  • 1 to 10 scal
  • High (8-10)
  • Moderate (4 - 7)
  • Low (1-3)
85
Q

What does it mean when fractures have high FAS scores

A
  • Generally heal successfully w/ few complications
86
Q

What does it mean when fractures have low FAS scores

A

Healing is potentially less successful w/ more complications

Surgery 1 (25 decks)

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