Long Bone Fractures II Flashcards
Femoral Physeal Fractures:
Etiology:
1.
2.
- Dystocia
2. Group housed juvenile cattle
Femoral Physeal Fractures:
Treatments:
1.
2.
3.
- Stall rest
- FHO - not succesfull
- ORIF via pins/screws
Femoral Physeal Fractures:
IM Pin Repair:
1. Use how many pins? What size?
two pins
3/16th inch
Femoral Physeal Fractures:
IM Pin Repair:
Insert through ______ from the _____.
Penetrate the ____ with fracture reduction
through femoral neck from caudolateral femur
penetrate the femoral head
Femoral Physeal Fractures:
In a foal, you can use ______ as a treatment method.
Dynamic Hip Screw system (DHS)
Treatment methods for Tibial Fractures
1
2.
- External coaptation
2. Thomas Schroeder Splint/Cast combo
T/F: If a mostly healed fracture repair site becomes infected, you have to take everything out and treat the infection, than re-apply the fixators again.
F, take everything out and it’ll probably still result in a healed fracture without having to put it back in.
Potential complications of stall confinement as treatment for fractures:
1.
2.
3.
- Non union and mal union
- Breakdown or laminitis of the opposite limb
- Negative effect of the age and weight of the patient.
Treatment of Humeral Fracture via ORIF with plates:
Reasons it is challenging:
1.
2.
3.
4.
- Surgical approach is difficult
- Risk of injury to radial nerve
- Irregular contour of the humerus
- Economic concerns
Humeral Fracture: Describe the splint design you’d want for 1st aid and transportation?
should be on palmar aspect of elbow, with another splint at 90 degrees that will end up at the shoulder
T/F: You should splint a 140kg foal during transport before repair
F
ineffective to splint them and we’d just be adding extra weight which would exacerbate the problem
How would you treat a 140 kg foal with a closed short oblique fracture of the humerus with marked displacement and over-riding?
stabilize it with interlocking nail and two cerclage wires
Advantages of using interlocking nails to repair a humerus?
1.
2.
3.
4.
- Resists collapse at the fracture site
- Rotationally stable
- Prevents migration of the implant
- less invasive
Disadvantages of using interlocking nails as treatment for humerus fracture?
1.
2.
- Inadequate for adult large animals
2. Requires specialized equipment and techniques
External Fixators:
Transfixation pins can be supported by:
1.
2.
3.
- External frame
- Acrylic resins
- Cast material
When applying transfixation pins and casting:
- (does/does not) require antibiotics?
- (does/does not) require general anesthesia?
- What kind of recumbency most of the time?
- does
- does
- dorsal
External Fixators as treatment for mid-diaphyseal short oblique tibial fracture:
- _____ are placed as guides for pin placement?
- Minimum # of pins per fragment?*****
- Needles
2. 2 pins/fragment
Transfixation Pin Cast Placement:
- Incision on (medial/lateral) aspect of the limb?
- Pins inserted between the ____.
- _ mm drill bit.
- pin size?
- lateral
- muscles
- 4.5
- 6.35mm
During transfixation pin cast placement, you should constantly be doing what? Why?
Lavaging.
You can cause thermal damage to the bone and potentially lead to sequestrum
Two main types of large animal external fixators:
1.
2.
- Type 2
2. Type 3
LA External Fixators:
- Type 2’s are placed ____ to _____
- Type 3’s have ____ to ____ directed half-pins.
- laterally to medially
2. Cranially to caudally
How long to remove pins after fixation?
How much more additional stall rest after removal?
6-8 weeks
2 weeks
Advantages of TPC (transfixation pin casts) in farm animals:
1. 2. 3. 4. 5. 6.
- Maintenance of reduction (less motion than cast)
- Early weight bearing
- Flexibility in pin positioning
- Availability of pins and casting material
- Comparable to side bar/clamp and plates/screws
- Less expensive than plates and screws
Disadvantages of TPC in farm animals:
1.
2.
3.
- no adjustment after application
- restricted access to soft tissue
- requires GA
Number of pins/fragment in a larger animal (ie cattle)?
3-5
Plate luting:
Uses ____ to create _____
PMMA (bone cement) to create 100% bone-plate contact.
End result of plate luting?
increased strength of repair
Typically the rule for repairing a fracture of the radius AND ulna together is…..
What is the exception to this rule?
Repair the radius, and the ulna will follow.
If there is an olecranon injury!
Transfixation Pin Casting in Equine:
Used for ________ fractures of MTIII or MCIII
comminuted phalangeal fractures
Transfixation Pin Casting in Equine:
of pins?
__-__mm diameter pins?
2-3 pins,
4-6 mm in diameter
Transfixation Pin Casting for treatment of comminuted phalangeal fractures in Equine:
Pins placed in ____ bone
___ degree divergence of the pins in the frontal plane
use only ____ profile pins
- metaphyseal bone
- 30 degree divergence
- positive profile
