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Large Animal Surgery > Long Bone Fractures III Complications, Prosthetics, Madibular Fractures > Flashcards

Long Bone Fractures III Complications, Prosthetics, Madibular Fractures Flashcards

1
Q

What are open fractures at high risk of?

A

Infection

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2
Q

What are 3 clinical signs of infection?

A

Lameness
Heat
Fever

NOTE: You may also see drainage coming through a cast because the material is porous.

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3
Q

What are 3 treatment steps for an open/infected fracture?

A

Local debridement
Systemic and local Abx
Cancellous bone graft

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4
Q

If you have a long bone fracture in a heavier animal, what can you do to help create a stronger ex-fix?

A

Stick some tubing on the pins and fill with PMMA

NOTE: Leave 1/4 - 1/2” space between tube and skin to allow for swelling.

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5
Q

If you have a young animal come to you with a complete fracture of a long bone, what is a repair technique that you can use?

A

Stack pinning and cerclage wire

Note: Threaded-end pins are better because they are less likely to back out.

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6
Q

______ is unsuccessful for femoral fractures.

A

Stall rest. Because we see severe displacement of the fragments.

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7
Q

What is the difficulty with using plates and screws to repair long bone fractures in young ruminants?

A

Screws and plate loosen.

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8
Q

Why do you use stack pinning and cerclage wire to repair long bone fractures in young ruminants?

A

Because their cortical bone is thin and soft, so not great for plates and screws.

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9
Q

What is a downside to stack pinning and cerclage wire to repair long bone fractures in young ruminants?

A

You destroy the medullary vasculature so you slow healing.

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10
Q

What can intramedullary pinning not protect against?

A

Axial and compressive forces.

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11
Q

What are 3 possible complications with stacked pins in calves?

A

Seroma
Pin migration
Osteomyelitis

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12
Q

How would you repair a femoral fracture in a FOAL?

A

Double plating on the cranial and lateral aspect of the cortex.

NOTE: Stack pinning isn’t enough for foals.

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13
Q

How is a femoral fracture in an adult large animal repaired?

A

MUST use double plating.

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14
Q

What is the prognosis for an adult large animal fracture?

A

Poor. There is a significant risk of hemorrhage.

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15
Q

What 4 things does the overall prognosis of a long bone fracture depend on?

A

Age
Weight
Fracture configuration
Open or closed fracture

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16
Q

What part of the bone/fracture do you want to apply your plate when repairing a long bone fracture?

A

On the tension side.

17
Q

What is a common cause of mandibular fracture?

A

Trauma

18
Q

What sort of prognosis does a mandibular fracture have?

A

Good

19
Q

What is so great about unilateral fractures of the madible and maxilla?

A

They are partially supported by the other side.

20
Q

If you have loose teeth after a mandibular fracture, what should you do?

A

DO NOT extract them right away. Wait for them to declare themselves.

21
Q

What are 4 surgical techniques you can use to treat a mandibular fracture.

A

Intraoral wiring
Tension band wiring
External fixators
Plates

22
Q

When repairing maxillary fractures, what do you need to be careful to avoid?

A

The palatine artery.

23
Q

Often, when an incisor fracture presents to you, it cannot be reduced, why is that?

A

There’s a ton of crap in there that you need to debride out of the fracture line.

24
Q

What are 2 indications for plating a mandible?

A

Fx of the body and vertical ramus of the mandible

Fx of the caudal aspect of the horizontal ramus

25
Q

What 3 types of plate might you use with a mandible?

A

LCPs
LC-DCP
Reconstruction plates

26
Q

What are 4 major disadvantages of mandibular plating?

A

Can only place on the compression side of the bone (vs. the tension side)
Screw palcement is difficult
Exposure of the caudal ventrolateral mandible is difficult d/t parotid duct
Most mandibular fx are open (infection = implant removal)

27
Q

What sort of diet modification do you see with an incisor fracture?

A

None

28
Q

What must you do daily in aftercare with a mandibular fracture?

A

Lavage

29
Q

When are the implants removed from a mandibular fracture?

A

Upon healing (~6-8 weeks)

30
Q

What are 5 possible complications of mandibular fracture repairs?

A 
Implant failure
Breakage of plates
Loosening/breakage of wires
Drainage
Sequestra
31
Q

What is the most common reason for amputation in large animals?

A

Severe osteomyelitis

32
Q

What does amputation require from the owners?

A

Extreme dedication for extensive aftercare.

Prosthesis should be removed daily and the soft tissue should be inspected for sores etc.

33
Q

What are BIG risks with amputation in a large animal without a prosthesis?

A

Laminitis or angular limb deformity of the opposite limb

Large Animal Surgery (30 decks)

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