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Large Animal Surgery > Long Bone Fractures I (Cannon Bone and Ulnar) > Flashcards

Long Bone Fractures I (Cannon Bone and Ulnar) Flashcards

1
Q

What are the two most common locations of condylar fractures?

A
  • Metacarpus 3

- Metatarsus 3

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2
Q

Do condylar fractures occur in the lateral condyle, medial condyle or both?

A

Both

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3
Q

What type of view is necessary to highlight the palmar aspect of bone and fully evaluate the joint?

A

Tangential view

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4
Q

If there is a comminution at the joint surface of a condylar feature, what should be done?

A

The fragment should be removed.

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5
Q

Condylar fractures are seen predominantly in what type of horses?

A

Young racehorses

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6
Q

Are the majority of condylar fractures lateral or medial?

What percentage?

A
  • Lateral

- 85%

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7
Q

What do medial fractures tend to do?

A

Spiral up the leg.

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8
Q

Which are more common in TBs, MC3 or MT3 condylar fractures?

A

MC3

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9
Q

Which are more common in SBs, MC3 or MT3 condylar fractures?

A

Both are about equal.

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10
Q

What are 3 possible causes of condylar fractures?

A
  • High compressive load
  • Asynchronous longitudinal rotation of the cannon bone
  • Young racehorses during fast work or race
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11
Q

A history of lameness with acute exacerbation can be seen with what type of condylar fracture?

A

Non-displaced incomplete condylar fractures

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12
Q

An acute onset of severe lameness after intense exercise can be seen with what type of condylar fracture?

A

Acute displaced condylar fracture

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13
Q

Effusion of the MCP/MTP joint can be seen with what type of condylar fracture?

A

Acute displaced condylar fracture

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14
Q

Can on palpation can be seen with what type of condylar fracture?

A

Acute displaced condylar fracture

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15
Q

What is the most common treatment used for the majority of condylar fractures?

A

Internal fixation with transcortical screws in lag fashion

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16
Q

What are 3 first aid components involved with a lateral condylar fracture of the cannon bone?

A
  • Compression bandage
  • NSAIDs
  • Absolute stall rest until definitive tX is undertaken
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17
Q

What should be placed on patient with a fracture if trailering is necessary?

A

Kimzey splint

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18
Q

What type of alignment is important with condylar fracture repair?
What should there not be?

A
  • Articular alignment

- No cartilage gap

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19
Q

What should be used during surgery in order to evaluate the reduction and alignment of the articular surface?

A

Arthroscope

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20
Q

Where should the first screw be placed with a condylar fracture?
What is a good target for this?

A
  • Close to the joint

- Epicondylar fossa

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21
Q

What kind of screws should be used with lag screw repair?

A

4.5 or 5.5 mm cortical bone screws

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22
Q

Placing screws in a lag fashion across a fracture causes what?

A

Compression of the fragment together.

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23
Q

How far apart should lag screws be placed when used for condylar fracture repair?

A

20 mm apart

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24
Q

Most condylar fractures only require how many lag screws?

A

2 screws

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25
Q

What type of condylar fractures have a 70-80% favorable prognosis?

A

Non-displaced and incomplete

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26
Q

Prognosis for condylar fractures is not as good if what 2 conditions occur?

A
  • Displaced

- Joint communication

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27
Q

What are the most common long bone fractures in horses?

A

Diaphysial fractures of MC3 and MT3

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28
Q

What does the prognosis depend on with diaphysial fractures of MC3 and MT3 in horses?

A

Dependent on immediate management of fracture - how fracture was treated in the field.

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29
Q

What type of compression is important with diaphysial fracture repair?
What is the goal of this?

A
  • Inter-fragmentary compression

- Transform comminuted fracture into 2 fragments

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30
Q

How should be plates be placed for a diaphysial fracture of the cannon bone?
Why?

A
  • Plates should be staggered

- Allows screws to intersect each other and not hit

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31
Q

What needs to be done to a diaphysial fracture before plates can be put on?

A

Fracture needs to be reduced.

32
Q

What is the optimal treatment for a simple transverse fracture of the diaphysis of a cannon bone?

A

Double plate fixation

33
Q

Which side of a bone is a plate usually placed on?

A

Tension side

34
Q

What is a tool that can be used to compress a fracture with a broad DCP plate?

A

Load drill guide

35
Q

What are 4 types of plates that can be used for fracture repair?

A
  • Dynamic compression (DCP)
  • Limited contact-dynamic compression (LC-DCP)
  • Locking compression (LCP)
  • Anatomic/specialty
36
Q

What does DCP stand for?

A

Dynamic compression plate

37
Q

What does LC-DCP stand for?

A

Limited contact-dynamic compression plate

38
Q

What does LCP stand for?

A

Locking compression plate

39
Q

What is a type of plate that has continuity of bending stiffness and improved blood supply under the plate?

A

Limited contact-dynamic compression plate (LC-DCP)

40
Q

What are 4 types of plate functions?

A
  • Compression
  • Neutralization
  • Tension band
  • Buttressing
41
Q

2 screws on either side of a fracture are placed under load with what type of plate function?

A

Compression

42
Q

What type of functioning plate is placed after anatomic reconstruction with screws inserted in a neutral position?

A

Neutralization

43
Q

What type of functioning plate transforms tensile forces into compressive forces?

A

Tension band

44
Q

What type of functioning plate is placed to bridge the area of bone defect?

A

Buttressing

45
Q

A self-compressing plate where screws can be angled in many directions and can be adapted to different internal fixation needs is what?

A

Dynamic compression plate (DCP)

46
Q

Screws used in a dynamic compression plate (DCP) can be placed up to what angle?

A

25 degree angle

47
Q

Does a dynamic compression plate (DCP) have uniforms bending stiffness?

A

No

48
Q

What is a type of plate that is adaptable for different internal fixation needs with limited contact due to a grooved undersurface?

A

Limited contact-dynamic compression plate (LC-DCP)

49
Q

What type of plate has uniform bending stiffness?

A

Limited contact-dynamic compression plate (LC-DCP)

50
Q

Screws used in a limited contact-dynamic compression plate (LC-DCP) can be placed up to what angle?

A

40 degree angle

51
Q

What type of plate provides dynamic compression with atraumatic and minimally invasive application and has limited contact with a grooved undersurface?

A

Locking compression plate (LCP)

52
Q

“Combi Holes” found in locking compression plates (LCP) can permit what?

A

Permit combined use of conventional and locking screws.

53
Q

Locking screws used with locking compression plates are what size?
Cortex screws are what size?

A
  • 4.0/5.0 mm

- 4.5/5.5 mm

54
Q

What type of plate can be placed using standard screws or locking screws?

A

Locking compression plates (LCP)

55
Q

What do locking screws increase?

A

Stability and fixation strength of the plate/screw construct.

56
Q

T/F: The goal for horses is to be ambulatory and fully weight-bearing in the immediate post-op period after plating for diaphysial fracture repair.

A

True

57
Q

What is the major problem with using fixation devices in large animals?

A

Most fixation devices were not designed for horses so may have implant failure.

58
Q

Since large plates occupy more space, this makes what more difficult?

A

Skin closure

59
Q

Most fractures of the ulna involve which part?

A

Olecranon

60
Q

What group of muscles inserts on the olecranon?

A

Triceps

61
Q

What is a common etiology of ulnar fractures?

What are 2 examples of this?

A
  • Direct trauma

- Kick, injury during halter training of weanlings

62
Q

What is a common presentation of an olecranon ulnar fracture?

A

Dropped elbow with carpus in flexion

63
Q

What are 4 differentials for a horse with a dropped elbow with the carpus held in flexion?

A
  • Humeral fracture
  • Radial nerve paralysis
  • Olecranon fracture
  • Neuro disease
64
Q

Ulnar fractures can result in disruption of what?

A

Disruption of the stay apparatus.

65
Q

Ulnar fractures require what type of external coaptation?

A

Splint to fix carpus in extension

66
Q

Where should a splint be placed when being used for an ulnar fracture?

A

Apply splint palmarly extending from the fetlock to the level of the elbow.

67
Q

What is an important consideration when placing a splint for an ulnar fracture?

A

Use adequate padding

68
Q

What is a good material to use for a splint when doing a full limb bandage?

A

Schedule 40 PVC

69
Q

A Salter-Harris type 1 fracture with minimal displacement needs what type of fixation?

A

Needs internal fixation

70
Q

If a foal weighing less than 250 kg has a Salter-Harris type 1 with minimal displacement, what is a fixation option?
If the horse is larger, what must be used?

A
  • Tension band technique using screws and wires.

- Must use a plate

71
Q

With a displaced Salter-Harris type 1b fracture with comminution of the anneal process, what is an important thing to remember to do?
Why?

A
  • Remove fragments

- If fragments were left, more likely to develop OA

72
Q

What is the treatment of choice for an olecranon fracture?

A

ORIF

73
Q

What is a special type of plate that can be used for a foal less than 250 kg?

A

Hook plate

74
Q

What has to be done with the bone plate for an olecranon fracture?

A

Contoured to fit over the top of the olecranon tuberosity.

75
Q

Where can screws be added with an adult horse to help ensure rigidity of the fixation?

A

Distal screws can be inserted int eh caudal cortex of the radius.

76
Q

What should not be done with screws used in ulnar fracture repair in horses less than a year old?
Why?

A
  • Distal screws should not engage the radius.

- May lead to subluxation of the elbow.

77
Q

What is the prognosis for ulnar fractures when internal fixation is used?

A

Good (68-87%)

Large Animal Surgery (30 decks)

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