Musculoskeletal

Question 1

What is the Gustilo-Anderson open fracture classification?
What is another open fracture classification system?

Answer 1

Type I: wound <1cm, mild-moderate soft tissue bruising

Type II: wound >1cm without extensive soft tissue damage

Type III: extensive soft tissue damage
IIIa: adequate tissue covering remaining
IIIb: soft tissue loss, periosteal stripping, bone exposure
IIIc: arterial blood supply injury

Other system: S1-3, M1-3, A1-2, B1-3, C1-3
-> grades mild to severe injury for skin, muscle, arteries, bone, and contamination

Question 2

What is the recommended treatment for a penetrating joint injury

Answer 2

Joint exploration, drainage, collection fo culture samples, broad spectrum antibiotics until culture results.
If there is minimal soft tissue damage, primary closure is possible after exploration and drainage. Otherwise, it should be kept open.

Question 3

What are indications for open reduction after traumatic joint luxation?

Answer 3

• Unsuccessful attempts at closed reduction
• Joint reluxation
• Chronic luxation (closed reduction ideally performed within 12-48h of injury)
• Concurrent intra-articular fractures
• Internal stabilization is necessary fr adjacent long bone fractures
• Neurologica injury suspected and exploration warranted

Question 4

What bandages are recommended after closed reduction of a craniodorsal hip luxation / a lateral elbow luxation

Answer 4

• Ehmer sling for hip lux
• Spica splint for elbow lux

Question 5

What is the indication for surgical repair of skull fractures

Answer 5

Compromise of cerebral blood flow or injury to brain parenchyma

Question 6

What is the recommended antimicrobial plan for open fractures

Answer 6

• Second generation cephalosporin for type I and type II open fractures
• Second generation cephalosporin + fluoroquinolone for type III open fractures

Then based on post-surgical debridement cultures

Question 7

What are the type of inflammatory arthritis

Answer 7

• Immune-mediated: erosive (rheumatoid) or non-erosive (Type I: idiopathic / Type II: reactive associated with infection / Type III: associated with GI disease / Type IV: associated with neoplasia / drug reaction / breed-related: Sharpei)
• Infective: bacterial, Lyme, fungal, mycoplasmal, mycobacterial
• Crystal-induced (gout, pseudogout)

Question 8

What are bacteria commonly causing infective arthritis in dogs and cats

Answer 8

Dogs: Staphylococcus intermedius, Staphylococcus aureus, beta-hemolytic Streptococcus spp.

Cats: Pasteurella multocida, Bacteroides spp.

Question 9

Name 2 differentials of lameness in young dogs without a history of trauma (including one relevant to critical care)

Answer 9

• Panosteitis (affects diaphysis of long bones)
• Hypertrophic osteodystrophy (affects metaphysis of long bones and can be associated with SIRS)

Question 10

For how long should antibiotic therapy be continued for ostemoyelitis

Answer 10

At least 28 days