Long Bone Fractures 3: Stacking,complications, Mandibular Fractures Flashcards
Are femoral fracture in cattle common?
Not really
Why is stall rest alone, unsuccessful to treat FEMORAL fractures?
Diaphyseal fracture, different place
-this is different to the femoral head fracture (in which stall rest is indicated)
Why is the age of note in Young ruminant fracture repair?
1) difficulties with plate and screw repair
2) screw and plat loosening
3) Ruminants <4 months old have thin and soft cortical bone BUTTER BONES
T/F : When Ruminants are young (<4months old) they have very few options for fracture repair because they have soft bones
TRUE
How would you treat your young ruminant femur fracture?
- Cerclage wire
- IM pins (threaded)
- Drain (radio-opaque)
How would you treat Older/Heavier calf femur fracture?
Stack Pinning and type 1 external fixation
T/F: INTRAmedullary pinning (IM) Does NOT protect against axial and compressive forces at the fracture site
TRUE
T/F: IM pinning can cause a slow return to weight bearing.
TRUE
What is the prognosis for Neonatal calf femoral fracture repair with stacked pin fixation
-Complications?
75% Pretty good
-Seroma, pin migration, osteomyelitis
In order of commonality: what are the complications of Calf femoral fracture repair with stacked pin fixatures?
SEROMA>pin migration>osteomyelitis
How you you treat a femoral fracture in a FOAL?
-prognosis?
- Double plate application
- cranial and lateral aspects of the bone
Prognosis: 50%
How would you treat a femoral fracture in an adult LArge animal?
-prognosis?
MUST place DOULBE plates
Prognosis: POOR
What does the prognosis of Long Bone Fractures Repair depend on?
1) age
2) weight
3) Fracture configuration
4) open/closed
Etc…
What are the complications of fracture repair?
1) implant failure
2) infection
3) sequestration
4) delayed /non- union
5) Contralateral limb laminitis (equine)
6) contralateral angular limb deformity
- immature animals
What is more likely to occur in an open fracture compared to closed?
Closed:
- > 4x more likely to remain uninflected
- > 4.5x more likely to be discharged
Open :
-HIGH risk of infection
What are the clinical signs of infection Due to open fracture?
Lameness Heat Fever (even mild-often on NSAIDs)
How would you treat an OPEN/ INFECTED fracture?
1) local debridement
2) systemic and local antibiotics
- RLP
- Ab-impregnated PMMA beads
3) Cancellous Bone graft
Are tubing with acrylic (PMMA) and external frames strong enough for fixing OPEN fractures in Heavier patients?
NOOOOOO
Cause and prognosis of Mandibular fractures.
Commonly Trauma GOOd prognosis (cosmetic and functional) -excellent vascular supply -non-weight bearing -equipment cheap and readily available
T/F: loose teeth of a horse with a mandibular fracture should NEVER be removed until the fracture has healed.
TRUE
1) they will often do well and become solid later in the mouth
2) good anchor and space occupior
What are the surgical techniques for mandibular treatment?
1) intraoral wiring
2) tension band wiring to heel teeth
3) external fixators
4) plates
WHAT are the indications for mandibular plate application?
- Fx body and vertical ramus of mandible
- Fx of caudal aspect of horizontal ramus
- LCP, 3,5mm LC-DCP or reconstruction plates
What is the problem with plate fixation in mandibular fracture cases?
When plating, plate should be placed on the tension side of the fracture….but in mandibular fractures you can only place them on the ventrolateral edge (not tension)
What are the disadvantages of mandibular plate application?
- can only place on the compression surface of the bone (ventral, ventrolateral, lateral)
- screw placement tricky (due not engage tooth roots)
- exposure of caudal ventrolateral mandible difficult (parotid duct)
- most mandibular fractions are open
Why do you not want to modify the diet for incisor fractures?**
COLIC
What after care should be considered following mandibular fracture repair?
- no diet modification
- lavage mouth daily
- Bute 2.2mg/kg PO BID
4. 4mg/kg POD SID x 7 days - +/- antibiotics
- implant removal 6-8 weeks
