Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Orthopedic Surgery > Midterm > Flashcards

Midterm Flashcards

1
Q

What are the five forces that cause fractures?

A
  1. Tension
  2. Compression
  3. Shear
  4. Bending
  5. Torsion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of fracture does the force of tension typically produce?

A

Avulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of fracture does the force of compression typically produce?

A

Short oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of fracture does the force of shear typically produce?

A

Lateral condylar fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of fracture does the force of bending typically produce?

A

Transverse or short oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of fracture does the force of torsion typically produce?

A

Spiral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When describing fractures, what does configuration generally refer to?

A

Incomplete or complete

Then orientation of the fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name and differentiate the two types of incomplete fractures.

A

Greenstick (two cortices)

Fissure (one cortex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Compare comminuted vs. segmental fracture

A 
Comminuted = 3+ seg, fx lines intersect
Segmental = 3+ segs, fx lines don't intersect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define type I open fracture

A

Clean soft tissue laceration <1 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define type II open fracture

A

Soft tissue laceration >1 cm; mild trauma, no flaps/avulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define type III open fracture

A

Vast laceration; contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is it important to recognize articular fractures?

A

They demand anatomic reduction and stabilization for healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define type I Saltar-Harris fracture

A

Physeal separation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define type II Saltar-Harris fracture

A

Involves metaphysis and physis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define type III Saltar-Harris fracture

A

Involves epiphysis and physis

= ARTICULAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define type IV Saltar-Harris fracture

A

Involves metaphysis, physis and epiphysis

= ARTICULAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define type V Saltar-Harris fracture

A

Physeal crush/compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the prognosis for any Saltar-Harris fracture?

A

Assume that the growth plate is going to close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 6 descriptors of a given fracture?

A 
Open/closed
Configuration (incomplete/complete + orientation)
Location (on bone)
Right or left
Bone
Displacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the purpose of the fracture assessment score and what factors is it based on?

A

Purpose: assist in selecting appropriate fracture repair, assess score based on risk
Factors: clinical, mechanical, biological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Fracture assessment score:
High scores signify __1__ healing with __2__ reliance on implants.
Low scores signify __3__ healing with __4__ reliance on implants.

A

1 - rapid
2 - less
3 - slow/complicated
4 - greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Primary goal of fracture repair

A

To promote an early ambulation and complete return to function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define reduction (verb vs noun) and the purpose

A

VERB: the process of re-apposing the fx fragments and/or segments (to their normal anatomic/functional position)
NOUN: describes apposition of the fx segments/fragments (anatomic, near anatomic or non-anatomic)
Purpose: anatomic reduction allows load sharing between bone and implants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define mechanical fixation

A

Anatomic reduction and rigid fixation; fixing a fracture at both ends by means of pins or screws, then using fixation units to reduce and immobilize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Define biological fixation

A

Closed or limited open reductions to preserve the local fracture environment (soft tissue = vascular supply)
“Bridging osteosynthesis”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Define alignment

A

Orientation of the joints proximal and distal to the fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Define fixation and the purpose

A

Means by which the fracture segments are maintained in functional position
Purpose: rigid fixation promotes weight bearing, fx healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which has a greater impact on function, reduction or alignment?

A

Alignment

Don’t necessarily need to reduce to achieve functional alignment (biological approach)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe primary vs. secondary bone healing

A

Primary bone healing involves osteoblasts directly laying down bone, requires anatomic reduction and rigid fixation, produces minimal callus, takes longer to heal, but rapid/complete return to function
Secondary bone healing occurs with spontaneously or with minimal fixation (no rigid stabilization); strength depends on callus
- Stages: hematoma, granulation tissue, fibrocartilage, cartilage, woven bone, lamellar bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Three indications for bone grafting

A

Enhance union
Replace bone loss
Arthrodesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What three sites can a bone graft be harvested from? How should it be stored?

A 
Greater tubercle
Iliac crest
Proximal tibia 
Storage: sterile container with lid
HARVESTED PRIOR TO FX REPAIR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Four possible functions of bone grafts

A
  1. Direct osteogenic effect (transfer osteoblasts) = fresh cancellous autografts
  2. Osteoinduction (recruitment) = allograft from euthanasized animal
  3. Osteoconduction (scaffold)
  4. Structural support (complications) = cortical (allo)grafts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Define coaptation and give examples

A

Extra-corporeal treatment modalities used to approximate fractures/other msk abnormalities
Ex: casts, splints, bandages
ONLY DONE FOLLOWING CLOSED REDUCTION, NEVER FOLLOWING OPEN REDUCTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the primary stability afforded with a splint or cast?

A

Stability against bending forces

Good for transverse fx!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Five indications for coaptation

A
  1. Temporary immobilization (msk injuries)
  2. Fractures in young animals
  3. Distal extremity fractures
  4. Simple, relatively stable fractures
  5. Ligament/tendon injuries (+/- post-sx)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Describe how a lateral coaptation splint would be applied.

A

Cast padding > cling > splint > vet wrap

  • joints in normal functional angles
  • make sure gauze is firm/tight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What 3 rules MUST be followed during any sort of coaptation?

A
  • Radiographs following application - two orthogonal views
  • Include the joint proximal and distal to injury (generally extended to the digits
  • Always leave toes exposed to assess digits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How does padding technique differ between rigid pre-formed splints and malleable splints?

A
  • Rigid pre-formed splints = pad depressions

- Malleable splints = pad protuberances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Spica splint/cast

A

For injuries proximal to elbow or stifle

Extends over midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Robert Jones bandage

A

For injuries distal to humeral/femoral condyles

Temporary immobilization to prevent swelling/further displacement until definitive treatment/sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Mason-Meta splint

A

For injuries distal to carpus/hock
Spoon splints
NOT for ulna/radius (won’t stabilize joint above/below)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Velpeau sling

A

Non-weight bearing sling for forelimb = scapular fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Figure of eight sling

A

For coxofemoral luxations
Flexes, abducts, internally rotates the hip
BUT basically, non-weight bearing sling; doesn’t hold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Ehmer sling

A

For coxofemoral luxations
Figure of eight sling + wraps over midline
Flexes, abducts, internally rotates the hip
Prevents weight bearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

90/90 flexion bandage

A

For prevention of quadriceps tie-down/contracture = femur fx
Stifle and hock at 90 degrees
Maintains quads in extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Five indications for external fixation

A
  1. Fractures that are comminuted, open, infected or non-union
  2. Arthrodesis
  3. Transarticular stabilization
  4. Limb deformities
  5. Traumatic wounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

List five advantageous properties of external fixators

A 
Applied open or closed
Can be adjunct to internal fixation
Can make post-op adjustments
Encourage early weight bearing
Versatile and economical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What forces does external fixation counteract?

What type of bone healing occurs with external fixation

A

Forces: axial, bending, rotational (some extend, shear)
Healing: secondary b/c not rigid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Type I external fixation

A

Half pin splintage (both cortices, but one skin surface)
Loaded in cantilever bending
Low morbidity, least stable
Only option for humerus and femur fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Type II external fixation

A

Full pin splintage (both cortices, two skin surfaces)
Loaded in four-point bending
More stability, more morbidity
Limited to disorders distal to elbow and stifle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Type II modified external fixation

A

Half + full pin splintage (in one plane)

Easier to apply, comparable stabilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Type III external fixation

A

Half + full pin splintage (biplanar, opposing planes)

MOST STABLE, time-consuming, difficult to see bone on rads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the weakest link in any external fixation construct?

A

Bone-pin interface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

The stiffness of the pin (resistance to bending) is proportional to ________

A

DIAMETER to the FOURTH power

Threaded positive profile pins conserve core diameter = superior stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Compare and contrast KE vs IMEX SK external fixation systems

A

KE:
- clamps only accept pins of limited diameter, no positive profile pins
- connecting rod weak and not radiolucent
- pilot holes difficult
IMEX SK:
- allows pilot holes, variability in pin diameter
- thick rod made of titanium or carbon fiber = simpler constructs
- better mechanics overall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Describe 11 proper external fixator application techniques (general)

A
  • drill pilot hole
  • place pins through small relief incisions
  • don’t place through traumatic/sx wounds or large muscle masses
  • low speed, high torque drill
  • place proximal and distal pins FIRST = length
  • then place near end of fx = finalize reduction
  • connecting rod as close to bone/fx as possible
  • fixation pin should not exceed 30% of bone diameter
  • beveled tips should completely penetrate trans cortex
  • min. 3-4 pins per fracture segment
  • additional pins distribute force
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q 
Where are external fixators best placed on the following bones:
Tibia
Radius
Ulna
Metacarpus/MT
Humerus
Femur
A 
Tibia = medial
Radius = lateral proximally, medial distally
Ulna usually NOT stabilized
Metacarpus/MT = lateral (no biplanar)
Humerus = craniolateral
Femur = lateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Four advantages of acrylic fixators

A

Pins can vary in diameter and don’t have to be placed in same plane
Most are radiolucent
Minimize distance b/t column and bone cortex
Lightweight, economical

60
Q

Four disadvantages of acrylic fixators

A

Difficult to maintain reduction if used as primary fixation
Polymerization of PMMA = exothermic
Generates noxious, toxic, teratogenic fumes
Hard to make adjustments

61
Q

Fixator pin should not exceed _________

A

30% of the diameter of the bone

62
Q

Name the four implants used for intramedullary fixation in small animals.

A

Steinmann pins
Kirschner wires
Rush pins
Interlocking nails

63
Q

3-point fixation

A
  1. Proximal epi/metaphyseal cancellous bone
  2. Endosteal surface of diaphysis
  3. Distal epi/metaphyseal cancellous bone
64
Q

What forces are counteracted by intramedullary fixation?

A

Bending, which is proportional to the diameter of the pin to the fourth power!
NO - compression, torsion, tension

65
Q

Name the three tip configurations of intramedullary pins and their attributes

A 
Trocar = cuts easily
Threaded = not used for IM pins, break where threading ends (good for ex fix)
Chisel = doesn't cut as well
66
Q

Are intramedullary pins suitable for stabilizing comminuted fractures?

A

Not alone - must be combined with ex fix or plate

67
Q

Normograde vs retrograde placement of IM pins

A

Normograde: pin inserted at one end of bone, driven across fx site
Retrograde: pin inserted through fx site, driven out of one end then reduce and driven across fx site

68
Q

Explain placing pins/wires in the manner of “rush pins”

A

Two pins/wires are inserted at an angle so that they cross proximal to fracture site and deflect of endosteal surface of both sides
Provides dynamic 3-point fixation “stress pinning”
K wires and Steinmann wires often used in this manner
For metaphyseal/physeal fx

69
Q

Advantages afforded by interlocking nails

A
  • controls bending, rotational, axial forces
  • in central mechanical axis
  • placed following closed/open reduction
  • fast/simple application
  • economical compared to plating
  • jigs to find holes for bolts
70
Q

Describe the process of interlocking nail application

A

Nail positioned within medullary cavity
Screws/bolts placement determined with a jig
Screws/bolts penetrate cortex to cortex, proximal and distal to the fracture

71
Q

Four key points for IM pin placement in the FEMUR

A

Normograde just medial to greater trochanter
AVOID sciatic nerve
Over-reduction helps avoid migration to stifle joint, but prevents anatomic reconstruction
Augmented with ex fix

72
Q

Three key points for IM pin placement in the TIBIA

A

Normograde through craniomedial aspect of tibial plateau
Medial to patellar tendon, on top of extra-articular fat pad
Cut off tip of pin so you don’t enter hock distally

73
Q

Key point for IM pin placement in the RADIUS

A

DO NOT DO IT unless stress pinning physeal fx

74
Q

Three key points for IM pin placement in the ULNA

A

Normograde or retrograde
Not a sole means of stabilization, but to supplement radial repairs
Incorporated with tension band technique

75
Q

Three key points for IM pin placement in the HUMERUS

A

Retrograde more common than normograde
Exits prox through greater tubercle
Seated distally in or prox to medial portion of condyle

76
Q

What is a cerclage wire and how does it function in stabilizing fractures?

A

Heavy gauge stainless steel wire placed circumferentially around bone to provide fragment apposition and ADJUNCTIVE fixation/stability

77
Q

10 rules of proper cerclage wire application

A
  1. sufficient diameter
  2. 360 degree anatomic reconstruction
  3. oblique (or spiral) fracture
  4. never use single wire
  5. wires 1cm apart
  6. 5mm from end of fx segments
  7. no interposition soft tissue
  8. perpendicular to long axis of bone (unless using k wire)
  9. prevent slippage in regions where diameter changes
  10. must be tight
78
Q

Why is a loose cerclage wire so detrimental for fracture healing?

A

A loose wire will shear the bone, disrupting vascular supply, thus impeding healing

79
Q

Advantages/disadvantages of twist wires

A

Advantages: more resistant to distractive forces, simple to apply, re-tighten if needed, economical
Disadvantages: less final tension, oblique to long axis of bone, twist protrudes to soft tissue

80
Q

Advantages/disadvantages of loop wires

A

Advantages: greater final tension, perpendicular to long axis of bone, does not protrude into soft tissues
Disadvantages: less resistance to distractive forces, cannot re-tighten, increased cost

81
Q

How can slippage of the cerclage wire be prevented in regions of varying bone diameter?

A

Hemicerclage wires or k wires
K wires:
- prox cerclage wire prox to k wire
- distal cerclage wire distal to k wire

82
Q

Tension band principle

A

Converts/redistributes distractive/tensile forces to compressive forces on the bony protuberances (where lig/tendons attach)
Used to stabilize osteotomies and fx at traction epiphyses

83
Q

Four principles of internal fixation

same for SA and equine

A

Anatomic reduction
Stable/rigid fixation
Atraumatic technique/preserve blood supply
Early pain-free return to function

84
Q

Properties of cortical screws

A

Thicker core = resistant to bending
Thinner threads = easier to pull out
Used in diaphyseal bone

85
Q

Properties of cancellous screws

A

Longer threads = harder to pull out
Used in metaphyseal bone
Can also be used to rescue/replace stripped cortical screw

86
Q

Properties of locking screws

A

Threads into plate and locks to it

Thicker core = better resistance to bending

87
Q

Implant screws (traditional vs locking) vs position screws

A

Implant screws just means it is being incorporated ito a plate = most common usage
- traditional compress plate to bone
- locking does not compress
Position screws hold bone fragment in reduction; threads engage both cortices so there is no compression

88
Q

Describe what is means to place a screw in lag fashion

A

Over-drill hole on near side, smaller hole on far side so that the threads only engage on the far cortex, pulling/compressing it to the near portion
(a true lag screw is partially threaded distally)

89
Q

Properties of dynamic compression plates (DCP)

A

Hole design allows compression across fracture
Full contact b/t plate and periosteum = reduced healing
Has a hill on one side of hole, if you place eccentrically place screw it will compress fx as it moves down incline

90
Q

Properties of limited contact dynamic compression plates (LC-DCP)

A

Reduced contact b/t plate and periosteum = increased blood supply immediately under plate
Reduces stress riser at holes

91
Q

Properties of locking compression plates (LCP)

A

Threaded = compression
Non-threaded = cortical screw, just presses plate to bone
PLACE CORTICAL SCREWS FIRST

92
Q

Plate functions:

Compare compression vs neutralization vs bridging plates

A

Compression: produces compression at fx site to provide absolute stability (consistent, but not faster healing)
Neutralization plate: protects primary repair mechanisms (ie: lag screw, cerclage, hemicerclage or wire) from bending, shear and torsional loading; DOES NOT COMPRESS
Bridging: acts as splint to maintain limb length and joint alignment to prevent axial deformity (bending, shear forces)

93
Q

Ideal fracture situation for internal fixation with plates and screws (four characteristics)

A

Closed
Diaphyseal (long bone)
Adequate soft tissue coverage
Can apply on tension side of bone/break

94
Q

Four basic goals for successful plate application (traditional plates)

A

Min. 6 cortices (3 screws on each side of fx)
Good plate/bone contact
Screw 30-40% bone diameter
Plate applied to tension side of bone

95
Q

Expected healing time for a union

A

3-6 m/o: 4-6 weeks

>1 y/o: 12 weeks

96
Q

Four causes of delayed union and whether they are biological or mechanical

A

Insufficient vascularity (b)
Infection (b)
Inadequate reduction and fixation (m)
Excessive post-operative activity (m)

97
Q

When is surgical intervention deemed necessary for a fracture?

A

When there is non-union or no further evidence of further progression

98
Q

Five causes of non-union and whether they are biological or mechanical

A 
Instability at fx site (m)
Poor vascularity (b)
Large gap b/t segments (b/m)
Soft tissue b/t segments (m)
Infection and sequestration (b)
99
Q

Five clinical signs of non-union

A 
Palpable instability at fx site
Muscle atrophy
Limb deformity
Impaired limb function/lameness
Variable pain
100
Q

Four radiographic signs of non-union

A

Distinct fracture margins
Pseudarthrosis
Sealed marrow cavity (sclerosis)
Arrest or regression of healing on serial rads

101
Q

What are the three sub-classifications of a viable non-union?

A

Hypertrophic
Slightly hypertrophic
Oligotrophic

102
Q

What are the four sub-classifications of a non-viable non-union

A

Dystrophic (partial healing on one side)
Necrotic
Defect (gap >1.5X diameter)
Atrophic (resorption of adjacent bone ends)

103
Q

Treatment of non-union

A

Find out what factors are contributing and address them

  • debride necrotic bone
  • open medullary canal
  • rigid internal fixation
  • autogenous cancellous bone graft
104
Q

What is the ONLY contraindication for an autogenous cancellous bone graft?

A

Infection

105
Q

Define malunion

A

Inadequate fracture reduction or stabilization leading to an non-anatomic bony union = deformity

106
Q

Clinical signs of malunion

A

Malalignment of limb
Fx site palpably stable and non-painful
Lameness/decreased ROM
DOESN’T ALWAYS CAUSE CLIN PROBLEMS

107
Q

What are the three components of malunion treatment and when is it indicated?

A

Corrective osteotomy
Realignment
Rigid fixation

Indicated when clinical signs are present!

108
Q

What two components does osteomyelitis require to occur?

A

vascular compromise

bacterial contamination

109
Q

What are five contributing factors to osteomyelitis?

A 
Tissue ischemia
Bacterial inoculation
Bone necrosis and sequestration
Fracture instability = vascular compromise
Foreign material implantation
110
Q

Radiographic signs of osteomyelitis

A

Soft tissue swelling
Irregular periosteal reaction
Lysis/bone resorption

111
Q

How is osteomyelitis specifically diagnosed?

A

Positive culture obtained by aseptic technique from deep aspirate of fx site, sequestra, local necrotic tissue or implants
NOT from draining tracts

112
Q

Osteomyelitis treatment

A

Long-term, culture guided antibiotics +/- beads
PLUS meticulous debridement
Establish drainage
Rigid stabilization

113
Q

What are some ways we can decrease the risk of osteomyelitis during fracture repair?

A

Prophylactic abx
Minimize duration of sx and anesthesia
Debridement
Irrigation

114
Q

Describe quadriceps contracture and why it occurs

A

When the quads contracted for long periods of time (hock extended) resulting in fibrosis of the muscles
Usually seen in young dogs following a femoral fx = infarcts quads
Can also be caused iatrogenically from surgical “repair” or prolonged immobilization/coaptation

115
Q

List five ways we can prevent quadriceps contracture

A 
Early fx management
Rigid fixation
Early return to function (PT!)
Only TEMP immobilization of femur
90/90 sling 
WANT QUADS EXTENDED, HOCK FLEXED
116
Q

Treatment for quadriceps contracture

A

Amputation

117
Q

EQ: What is classified as an orthopedic emergency?

A

ANY ACUTE-ONSET, SEVERE LAMENESS

118
Q

EQ: What is the primary goal for fx and catastrophic traumas?

A

Stabilize limb for transport

119
Q

EQ: Three main things to examine in equine patient with a fracture

A

CV status = MM, CRT
Affected limb/limbs
Evidence of trauma elsewhere

120
Q

EQ: Reliable sedatives for equine fractures

A

Xylazine or Detomidine (alpha-2 agonists) +/- butorphanol
May need higher/repeat doses
However, avoid excessive ataxia (tend to do repeat doses over increased doses)

121
Q

EQ: Which drug should be avoided for sedation and why?

A

Acepromazine = hypotension

122
Q

EQ: Goals of fracture stabilization

A

Reduce pain/anxiety
Minimize further trauma
Immobilize adjacent joints
ESSENTIAL FOR TRANSPORT

123
Q

EQ: Describe the method of fracture stabilization for distal MC/MT3, P1, P2, breakdown injury, or fetlock luxation for front and hindlimb (level 1)

A

FL: light bandage + dorsal splint
HL: light bandage + plantar splint

124
Q

EQ: Describe the method of fracture stabilization for proximal 2/3 metacarpus, carpus and distal radius (level 2)

A

RBJ (elbow to ground) + caudal + lateral splints

125
Q

EQ: Describe the method of fracture stabilization for mid/proximal metatarsus (level 2)

A

RBJ (hock to ground) + caudal + lateral splints

Uses calcaneal tuberosity to stabilize

126
Q

EQ: Describe the method of fracture stabilization for mid/proximal radius (level 3)

A

RBJ (elbow to ground) + caudal + lateral splints
C: elbow to ground
L: withers to ground (CRITICAL to prevent abduction)

127
Q

EQ: Describe the method of fracture stabilization for tarsus + tibia (level 3)

A

RBJ (stifle to ground) + lateral splint (tuber coxae to ground)
Width = resistant to rotation
Length = prevent abduction

128
Q

EQ: Describe the method of fracture stabilization for humerus, scapula and femur (level 4)

A

No coaptation

129
Q

EQ: Describe the method of fracture stabilization for olecranon. What is the classical clinical signs associated with this type of fracture?

A

Align bones, fix carpus in extension = allows wt bearing
Padded bandage + caudal splint (olecranon to fetlock/ground)
“CLASSIC DROPPED ELBOW” b/c triceps apparatus inserts here

130
Q

EQ: Five principles of treatment for any open fracture

A 
Clean
Keep moist
Bandage
BS antibiotics
Tetanus toxioid
131
Q

EQ: Three main further treatments for fractures, ONCE STABILIZED

A

Analgesia: NSAIDs (flunixin, bute)
Isotonic IV fluid bolus for hypotensive shock
Radiographs (better at referral facility)

132
Q

EQ: List a few factors that affect fracture prognosis(main ones)

A 
Fx type/location
Open/closed, degree of soft tissue damage 
Age, weight
Patient behavior
FIRST AID PRIOR TO REFERRAL
133
Q

EQ: Six bones that are more likely amenable to healing

A 
Phalanges
Sesamoids
MC/MT
Carpus/tarsus
Patella 
Ulna
134
Q

EQ: Seven bones that are more likely aversed to healing

A 
Radius
Humerus
Scapula
Calcaneous
Tibia
Femur
Pelvis
135
Q

EQ: List some differences in fractures in foals relative to adult horses

A
  • faster healing
  • angular limb deformities (growth plate)
  • SH fractures
  • more prone to cast sores
  • more prone to tendon laxity when splinting
136
Q

EQ: Which types of fractures can be treated by stall rest? What is the risk associated with this type of treatment?

A

Stress, splint bones, third trochanter, patellar, deltoid tubercle
Risk: catastrophic propagation, always

137
Q

EQ: How is external coaptation usually used with equine fractures?

A

To supplement internal fixation or emergency stabilization

138
Q

EQ: List three examples of external fixation in horses

A

Transfixation-pin casts, external skeletal fixators, ESFD

139
Q

EQ: Describe transfixation-pin casts and their indications

A

2-3 cross pins proximal to fracture, incorporated into cast to provide axial support and decrease rotation
Indications: comminuted phalangeal fx, distal MC/MT 3 fx, MCP breakdown

140
Q

EQ: Describe external skeletal fixators and their indications

A

Allow immediate wt bearing, access to wounds, but often do not provide enough axial support
Indications: foals, non-wt bearing fx (mandibular)

141
Q

EQ: What is the one key to a successful internal fixation fracture repair?

A

Intra-operative imaging, specifically CT

142
Q

EQ: Which type of screw is most commonly used in equine fracture repair and why?

A

Cortex because stronger and more rigid than cancellous

143
Q

EQ: What are the three ways/fashions a cortical screw can be placed and what is meant by each?

A 
Position = does not compress, holds in place
Implant = in a plate
Lag = compressing
144
Q

EQ: What is the purpose of tapping?

A

Creates thread holes in the drill holds to improve bone-screw interface

145
Q

EQ: two main principles of plate fixation

A

Min. 4 screws on each side of fracture

Apply to tension side

146
Q

EQ: four indications and two exceptions for implant removal

A

Indications: infection, loosening, lameness, return to exercise (if problem)
Exceptions: arthrodesis, screws (unless a problem)

staggered removal preferred!

147
Q

EQ: List 5 common complications of implants

A 
Implant infection
Catastrophic breakdown post sx/anesthesia 
Osteoarthritis 
Limb deformities in foals
Laminitis

Orthopedic Surgery (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions