Long Bone Fractures III

Question 1

Best way to treat a complete transverse fracture of the femoral distal diaphysis with severe displacement?

Answer 1

stack pinning and cerclage wire

Question 2

T/F: Stall rest is unsuccessful for femoral fractures?

Answer 2

T

Question 3

What are some important factors to consider during fracture repairs of young ruminants?

1.
2.

Answer 3

1. Difficulties with plate/screw repair/loosening.

2. Cortical bone is thin and soft

Question 4

What is the recommended way of treating femoral fractures in young ruminants?

Answer 4

Open Reduction + Stack Pinning

Question 5

Three things you need for open reduction and stack pinning as a repair method for a femoral fracture in a young ruminant?

Answer 5

1. Retrograde 3 steinman pins
2. Cerclage wire
3. Active drain

Question 6

Open Reduction + Stack Pinning for Young Ruminants:

1. Drive pins (distally/proximally)
2. Try not to enter the _____
3. Use ____-end pins

Answer 6

1. distally as possible
2. stifle joint
3. threaded-end pins

Question 7

T/F: You should never use a external fixators to treat femoral fractures in calves.

Answer 7

F, you can use a type I external fixator in combination with stack pinning IF the calf is older/heavier

Question 8

IM pinning in calves as tx for femoral fracture repair:

1. Return to weight-bearing is a relatively (slow/quick) process?
   Why?

Answer 8

Slow,

IM pins cannot protect against axial and compressive forces at the fracture site

Question 9

Neonatal femoral fracture in calves with stacked pin fixation:

1. Success rate = ___%?
2. Three common complications?

Answer 9

1. 75%
2. Seroma
   Pin Migration
   Osteomyelitis

Question 10

Femoral fracture in the adult large animal:

1. Must use what repair method?
2. Prognosis is (poor/average/excellent)

Answer 10

1. double plating

2. Poor!

Question 11

Femoral fractures in foals:

1. What repair method?
2. Success rate - __%?

Answer 11

1. double plating on the cranial and lateral aspect of the cortex
2. 50%

Question 12

Long Bone Fracture Repair: Overall prognosis is dependent on what four factors:

1.
2.
3.
4.

Answer 12

1. Age
2. Weight
3. Fracture configuration
4. Open or closed fracture

Question 13

Closed fractures:

___x more likely to remain uninfected

___x more likely to be discharged from the hospital

Answer 13

4. 23

4. 59

Question 14

Treatment of Open Infected Fractures:

1.
2.
3.

Answer 14

1. Local debridement
2. Systemic and local antibiotics: RLP and Ab-impregnated PMMA beads
3. Cancellous bone grafts

Question 15

Tubing with acrylic PMMA and external frames may not be strong enough for open fractures in…

Answer 15

heavy patients

Question 16

Mandibular fractures:

common or rare?

Answer 16

common, caused by trauma

Question 17

Mandibular fractures:

Prognosis is (bad/good)? Why?

Answer 17

Good. It has an excellent vacular supply and is non-weight bearing

Question 18

Most common mandibular fractures?

Answer 18

avulsion fractures of incisors/mandible/pre-maxilla

Question 19

T/F: Loose teeth should never be removed until the fracture has healed

Answer 19

T

Question 20

Surgical techniques for treatment of mandibular fractures:

1.
2.
3.
4.

Answer 20

1. Intraoral wiring
2. tension band wiring to cheek teeth
3. External fixators
4. plates

Question 21

Two main indications for plating the mandible

1.
2.

Which kind of plates are best?
3.

Answer 21

1. Fracture of body and vertical ramus of mandible
2. Fracture of caudal aspect of horizontal ramus
3. LCPs best or 3.5 mm LC-DCP or reconstruction plates

Question 22

Disadvantages of mandibular plating:

2.

3.

4.

Answer 22

1. Can only place on compression side of the bone!!!
2. Screw placement is difficult d/t tooth roots
3. Exposure of caudal ventrolateral mandible difficult d/t parotid duct
4. most fractures of the mandible are open and can lead to infection or implant removal

Question 23

Aftercare of mandibular fracture repair

1. Diet?
3. Medication?
4. Remove implant when?

Answer 23

1. no diet modification for incisor fractures
2. Lavage mouth daily to remove feedstuffs
3. Bute 2.2 mg/kg BID or 4.4mg/kg PO SID for 7 days, +/- antibiotics
4. Upon healing, usually within 6-8 weeks

Question 24

Complications of mandibular fracture repair:

1.
2.
3.
4.
5.

Answer 24

1. Implant failure
2. Breakage of plates
3. Loosening/breakage of wires
4. Drainage
5. Sequestra