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TOBIAS VETERINARY SURGERY > ORTO: 45, 46, 47, 48 > Flashcards

ORTO: 45, 46, 47, 48 Flashcards

1
Q

LIMITS OF FRACTURE GAPS

A

THOSE APPROACHING THE DIAMETER OF THE BONE SHOULD BE AVOIDED

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2
Q

STRAIN

A

DECREASE IN GAP WIDTH/TOTAL WIDTH

STRAIN IS GREATER IN SMALLER FRACTURE GAPS
ES: 1 MM FG, 1 MM MOTION=100% STRAIN

GRANULATION TISSUE CAN SUPPORT UP TO 100% STRAIN

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3
Q

STRESS PROTECTION

A

LIMITING STRAIN TO 1-2% SHOULD BE AVOIDED BECAUSE THERE IS NOT ENOUGH MECHANICAL SIGN TO CELLS OF THE CALLUS

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4
Q

BIOLOGIC FACTORS OF BONE HEALING

A

TISSUE GROWTH FACTORS + CELLS (MESENCHYMAL STEM CELL)

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5
Q

DELAYED UNION, DEFINITION

A

PROLONGATION IN TIME FOR FRACTURE HEALING

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6
Q

MECHANICAL CAUSES OF DELAYED UNION

A
  • EXCESSIVE FRACTURE GAPS
  • MOTION AT THE FRACTURE SITE
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7
Q

BIOLOGIC CAUSES OF DELAYED UNION

A
  • INTRINSIC (FACTOR OF PATIENT AND FRACTURE, MOST COMMON)
  • EXTRINSIC
  • BOTH
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8
Q

AVOID DELAYED UNION

A
  • PREEMPTIVE AUTOGENOUS CANCELLOUS BONE, BONO MORPHOGENETIC PROTEINS, DEMINERALIZED BONE MATRIX
  • AVOID LARGE FRACTURE GAPS
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9
Q

NONUNION

A
  • VIABLE NONUNIONS (HORSE’S FOOT)
  • NONVIABLE UNIONS (BIOLOGICALLY INACTIVE)
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10
Q

MALUNION

A
  • HEALING HAS OCCURRED
  • FAILURE OF MECHANICAL REESTABLISHMENT OF THE FORM AND FUNCTION OF THE FRACTURE
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11
Q

HOW TO DEFINE A DEFORMITY

A

IN RELATIONSHIP OF THE DISTAL SEGMENT TO THE PROXIMAL SEGMENT

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12
Q

MECHANICAL AXE BONE

A

LINE CONNECTING CENTER POINTS PROXIMAL AND DISTAL TO THE BONE IN FRONTAL OR SAGGITAL PLANE

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13
Q

ANATOMIC AXE

A

FOLLOWS GEOMETRY OF THE BONE: LINE THAT PASSES TROUGH THE CENTER OR MID DIAPHISIS

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14
Q

JOINT ORIENTATION ANGLE

A
  • FIRS LETTER: M or A, MECHANICAL OR ANATOMIC AXIS
  • SECON LETTER: CR or CD (angle on saggital images) ; M or L (angle on frontal planes)
  • THIRD LETTER: P or D: proximal or distal
  • FOURTH LETTER: letter for the bone
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15
Q

LABRADORS MEAN RADIUS ANGLE

A
  • FRONTAL

aMPRA 83 aLDRA 86

  • SAGGITAL

aCdPRA 85 aCdDRA 77 PROCURVATUM 27

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16
Q

FEMURAL ANGLE

A
  • ANATOMIC labradors

aLDFA 97 aLPFA 103

  • MECHANICAL

mLDFA 100 mLPFA 100

17
Q

FEMORAL ANTEVERSION ANGLE

A
  • Nunamaker AXIAL 27
  • montavon Oblique 31.3
  • dudley axial+CT 16 19.6
18
Q

PALEY’S RULE

A
  1. osteotomy and angulation correction axis (ACA) CORA based correct
  2. osteotomy non correct, ACA correct → appropriate realignment through angulation and TRANSLATION
  3. osteotomy and ACA non correct → traslation iatrogenic
19
Q

MOST COMMON BACTERIA ISOLATED OSTEOMYELITIS DOG

A
  • STAPHYLOCOCCUS SPP. (60%)
  • ESCHERICHIA COLI
  • STREPTOCOCCUS

STAPH. PSEUDOINTERMEDIUS, METHICILLYN RESISTANT UP 50% → MOST COMMON RECENT STUDIES

20
Q

BACTERIAL BIOFILM FUNCTIONS

A
  • ALTERED-QUIESCENT BACTERIAL GROWTH PATTERN (ANTIBACTERIALS RELY ON BACTERIAL GROWTH SO DIMINISHED EFFECT)
  • BARRIER
  • ANTIMICROBIAL ACTIVITY (HYDRATION LEVEL, LOW PO2, HIGH PCO2, LOW PH)
21
Q

RADIOGRAPHIC OSTEOMYELITIS

A

62.5% SENSIBILITY, 57% SENSITIVITY

22
Q

RADIOGRAPHIC OSTEOMYELITIS

A
  • SEQUESTRUM
  • LUCENCY AROUND IMPLANTS AND INVOLUCRUM (PERIOSTEAL PROLIFERATION9
  • CLOACA (DRAINING TRACT)
23
Q

SURGICAL TREATEMENT FOR OSTEOMYELITIS

A
  1. REMOVAL NECROTIC TISSUE, SEQUESTRA, FOREIGN MATERIAL
  2. METICOLOUS DEBRIDEMENT
  3. BIOFILM REMOVAL DISRUPTION
24
Q

PRATESI 2015, ORTHO POST-OP INFECTION

A
  • OVERALL 12,9%
  • 21.3% WITH POST-OP ANTIBIOTIC TREATEMENT
  • 4.3% WITHOUT POST-OP ANTIBIOTIC TREATEMENT
25
Q

FREY 2010, CCL POST-OP INFECTION

A

OVERALL 6.1%

  • ECLS surgeries 4.2%, TPLO surgeries 8.4%
  • suture material other (3,9%) than stainless-steel staples (7,7%) for skin closure
  • postoperative oral administration of antimicrobials (10,7 % VS 5,1%)
26
Q

surgical wound to become infected

A

critical amount of contamination (> 105 organisms/g of tissue) is required

27
Q

4 MECHANISM OF NEW BONE FORMATION

A
  • OSTEOGENESIS: SUPPLIES BONE-FORMING CELLS
  • OSTEOINDUCTION: MATERIALS THAT INDUCE BONE FORMATION (RECTUITS MESENCH. CELLS)
  • OSTEOCONDUCTION: SCAFFOLD TO MESENCHIMAL CELLS
  • OSTEOPROMOTION: ENHANCEMENT ON REGENERATING BONE; NO CELL (ES. PRP)
28
Q

GOLD STANDARD FOR BONE GRAFT

A

CANCELLOUS AUTOGENOUS BONE GRAFT

OSTEOGENESIS, OSTEOINDUCTIVE, OSTEOCONDUCTION AND OSTEOPROMOTIVE FUNCTION

29
Q

COMMON DONOR SITE FOR AUTOGENOUS CANCELLOUS BONE GRAFT

A
  • PROXIMAL REGION HUMERUS
  • ILIAC WING
  • PROXIMOMEDIAL TIBIA
  • SUBTROCANTERIC FEMUR
  • CONDYLES FEMUR
  • CAUDOVENTRAL PORTION MANDIBLE
30
Q

TIME TO REPEAT BONE GRAFTING

A

8 WEEKS HUMERUS, 12 WEEKS PROXIMAL TIBIA

31
Q

HOW TO HARVEST CANCELLOUS BONE AUTOGRAFT

A

CURETTAGE AFTER HOLE (KIRSCHNER) IN THE DESIRED LOCATION

32
Q

ALLOGRAFT-BASED BONE GRAFT: PROPERTIES?

A
  • OSTEOINDUCTIVE
  • OSTEOCONDUCTIVE
  • NO OSTEOGENIC CELLS PRESENT

MAY BE COMBINED WITH PRP OR OTHER GROWTH FACTORS TO HAVE OSTEOPROMOTIVE FEATURES

33
Q

CORTICAL ALLOGRAFT

A

ONLY STRUCTURAL SUPPORT. CREEPING SUBSTITUTION OCCURS AS THEY SLOWLY GET SUBSTITUTED WITH HOST BONE

34
Q

CALCIUM PERCENTAGE IN DEMINERALIZED BONE MATRIX TO ENHANCE OSSEOUS WOUND HEALING

A

LESS 2%. BECAUSE PROCESS OF OSTEOINDUCTION OCCURS IMMEDIATELY WITHOUT REABSORPTION PRIOR TO FORMATION OF NEW BONE

TOBIAS VETERINARY SURGERY (25 decks)

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