Long Bone Fx II

Question 1

Classify/describe the Fx…

Answer 1

Slipped femoral {capital} physeal Fx

• *Salter Harris I**
• often seen w.dystocia & group-housed juvenile cattle*

Tx:

• stall rest depending on extent of damage/value of animal
• ORIF {usu. pins & screws}

Question 2

How would we go about repairing a femoral physeal fx in our food animals {i.e. calves} w. IM pins?

Answer 2

*Stack-pinning technique*

• *{2 or 3}** ³/₁₆” pins → insert thru femoral neck
• from caudolateral* femur → engage femoral head
• don’t go thru femoral head bc it will disturb articular surface
• only penetrate fem.head & gain purchase -*

Question 3

How would we go about repairing a femoral physeal Fx in a foal?

Answer 3

DHS System
{Dynamic Hip Screw}

specialty plate w/system associated {guide pins, etc.}
to secure fragment & reduce Fx

*take advantage of using cool specialty plates like this in LA when you can!*

Question 4

A 3-month old calf presented acutely severely lame. Here is her radiograph…Classify the fracture.

Answer 4

Closed, displaced
proximal tibial physeal Fx
w.metaphyseal fragment laterally…

aka. Salter Harris Type II

Question 5

How would we treat a 3-month old calf with a proximal tibial {SH II} Fx?

Answer 5

external coaptation; Thomas Schroeder Splint/Cast

*caution w.straw in stall*

Question 6

2-month old foal presents for acute, severe lameness. Here’s her radiograph. Classify the Fx & what is the best repair?

Answer 6

Salter Harris Type II
Fx of the proximal tibial physis

Repair:

• *Plate & Screw** Fixation
  w. tension band wiring

Question 7

What are the potential complications of stall rest?

Answer 7

• Non/mal -union
• breakdown/laminitis of contralateral limb
• negative effect of age & weight of patient

Question 8

What’s the difference in how we would treat a humeral Fx in a heifer vs. a foal?

Answer 8

stall rest + nursing care for the heifer,
but foals don’t do well with this…

for foals, we want to perform ORIF w.plates

Question 9

How would we splint a radial Fx for transport?

Answer 9

Robert Jones bandage
{good compression, all the way up the limb}

2 splints:

1st: lateral from foot to withers {minimize ability to abduct limb}

2nd: palmar from ground to as high as you can {olecranon}

^prevents bending & abduction^

Question 10

How would we treat this Fx in a food animal?

Answer 10

Closed mid-diaphyseal short oblique tibial Fx

Transfixation Pin Placement
*minimum of 2 pins per fragmt*
incision on lateral aspect of limb → insert pins b/t mm.
→ 4.5mm drill bit {lavage to keep temp down}
→ positive profile centrally threaded ¹/₄” Steinnman pin

Question 11

In our food animals, what type of ESFs do we generally limit use to?

Answer 11

type 2: pins placed laterally to medially

type 3: cranially to caudally directed half-pins…
{in addition to the lateral—>med. pins}

Question 12

When do we typically use TPC {transfixation pin casting} in the equine patient?

Answer 12

Comminuted phalangeal Fx

2-3 centrally threaded, +profile pins 4-6mm diameter;
placed in metaphyseal bone;
30º divergence of pins in frontal plane

Question 13

T or F:

In the adult horse, because of the nature of the tibia, these fractures are usually “treated” w/euthanasia.

Answer 13

True.

But in the mini, we might be able to get away w/something…

• evaluate proximity of Fx to tarsocrural jt*
• *double plate fixation w/4.5mm broad DCP**

Question 14

What is plate lute?

Answer 14

a substance like cement
for packing a joint
or coating a porous surface

i.e. PMMA {bone cement}:
applied b/t plate & bone after plate/screw placemt
creates 100% plate-bone contact