PELVIS, HIP: 56, 57, 58, 59 Flashcards

1
Q

How many fracture configuration can be seen in pelvic fractures?

A

160 total, with 19 repeatedly observed (in 52% of all cases)

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2
Q

anatomy of the lumbosacral trunk

A

it becomes the sciatic nerve after being joined by the 2° sacral nerve, and passing over the greater ischiatic notch and exit the greater ischiatic foramen

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3
Q

percentage of recovery of animal with peripheral nerve injury

A

15% had permanent loss of linb function

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4
Q

Pelvic canal ratio

A

hamilton 2009. A-B= cranial border sacrum
C-D= medial cortex acetabulum. 0.97 +- 0.025 in normal cats.

reduction of <10% mild, 10-30% moderate, >30% severe

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5
Q

typical pattern for ilium fractures

A

from cranioventral to caudodorsal, immediately caudal to the sacroiliac joint

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6
Q

position of the lumbosacral trunk in respect to the ilium body

A

medial and dorsal

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7
Q

in lateral plating of the ilium, where does screws tipically pull out?

A

cranial fracture segment

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8
Q

acetabular fractures classification

A

simple, transverse, oblique or comminuted

location: cranial, dorsal, caudal, central

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9
Q

prevalence of unilateral and bilateral SI luxation fracture

A

77% unilateral, 23% bilateral

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10
Q

do cats have a sacral notch?

A

only 34% of cats and 98% of dogs

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11
Q

screw loosening in SI luxation with screw >60% width sacrum

A

7%

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12
Q

classification of sacral fractures

A

1) alar
2) foraminal
3) transverse
4) avulsion
5) comminuted

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13
Q

most common pelvic fractures?

A

pelvic fractures

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14
Q

name the primary stabilizers of the hip joint

A

1) ligament of the head of the femur
2) joint capsule
3) dorsal acetabular rim

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15
Q

incidence of femural luxation on all luxation

A

90%

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16
Q

what percentage of femural luxation are craniodorsal?

A

75%

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17
Q

incidence of relaxation after closed reduction of COX-FEM luxation

A

more than 50%

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18
Q

name 5 techniques for augmentation of closed reduction

A

1) Ehmer sling: 10 to 14 days, relaxation 15-71%
2) Hobbles
3) Ischioilial pinning: 2-4 weeks
4) External skeletal fixators
5) transarticular pinning

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19
Q

median success rate after open reduction

A

+- 85%

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20
Q

Name 12 procedures for open reduction

A

1) capsulorraphy
2) prostethic capsule repair
3) transposition of the greater trochanter
4) transarticular pinning
5) toggle rod: 6% relaxation
6) fascia lat loop stabilization
7) transposition of the sacrotuberous ligament
8) extra-articular iliofemoral suture
9) surgical stabilization of ventral luxation
10) femoral head and neck excision
11) TPO/DPO
12) THR

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21
Q

caudal acetabular fractures should always be managed conservatively. T or F

A

F. caudal acetabulum has weightbearing load. without intervention faster progression to osteoarthritis

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22
Q

what is the main responsible to maintain hip joint stability during the first months of life?

A

ligament head of the femur

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23
Q

breifly describe the 2 biomechanic principles associated with funcional subluxation of the hip

A

1) forces crossing the joint increase
2) area over wich the forces are transmitted decreases

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24
Q

lower cutoff value for Distraction Index

A

0.3

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25
Q

Name all the proposed factors that can lead to hip joint laxity

A

1) joint fluid
2) pelvic muscle mass
3) hormonal factors
4) weight and growth
5) nutrition
6) environmental
7) other

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26
Q

pectineal myectomy or tenotomy reduces incidence of hip displasia. T or F

A

F

26
Q

progression of osteoarthritis lead to thightening of the capsule. T or F

A

False. greater osteoarthritis = greates laxity.

27
Q

all dogs with hip displasia have a wide based stance. T or F

A

F: initially wide stance to help with hip reduction. As it progresses, develop narrow-base to degrease discomfort caused by reduction and then subluxation.

28
Q

Negative Ortolani test is highly indicative of a sound hip. T or F

A

F: 50 % ortolani negative had hip joint laxity measured by DI

29
Q

what sign can be confused with a morgan’s line (caudolateral curvilinear osteophyte) ?

A

puppy line. same position, but shorter, more diffuse, more subtle. Younger than 18 MO, self limiting.

30
Q

distraction index always correlate with both ortolani sign. T or F

A

F: the presence of osteoarthritis weaken the correlation.

50% dogs with DI >0.3 had normal ortolani.

31
Q

ultrasonography of the hip has an high rate of false…….

A

positive. results in overtreatement in children.

32
Q

name 3 main cons of ultrasound for early diagnosisi of hip displasia

A

1) subjectivity/imprecision in repeated measurements
2) absence of reference ranges
3) variables at 16-49 days do not correlate with diagnosis of Hip displasya at 12 to 24 months.

33
Q

theorical characteristics of the ideal hip screening tool

A

1) accurately identify unwanted phenotype (es. hip extended, norberg do NOT correlate with OA progression)
2) interobserver reliability
3) continuous ratio scale; not intervals
4) early diagnosis
5) valuable tool for estimate breeding value (must have an hereditary component)
6) selection pressure: genetic change towards better hips.

34
Q

Mass selection (evaluate just the individual phenotype) is adequate for highly or lower geritable traits?

A

highly! (>0.5). as it decrease (<0.35), increasingly important to consider relative’s phenotype

35
Q

anatomic caracteristics of pelvic symphysis

A

is a synchondrosis that trasforms in synostosis

36
Q

time to ossification of pelvic symphysis

A

2-6 years (fibrocartilage replaced by bone)

37
Q

age at wich greatest changes in acetabular coverage is seen with JPS

A

12 W

38
Q

what muscles need to be retracted from pubic sympyhysis?

A

gracilis and adductor

39
Q

Gatineau correlation between reduction angle and development of OA: angle?

A

less than 15° less chances of developing OA

40
Q

surgical approach to the pubis

A

1) pectineus muscle
2) iliopectineal eminence palpable cranially, avoid deeper medial circumflex femural artery
3) elevate periosteum from cranial (IP eminence to caudal (obturator foramen)
4) osteotomy

41
Q

approach to ischium for ischial osteotomy

A

1) dorsal incision
2) elevation internal obturator dosally, avoid pudendal nerve
3) ventral elevation semim, semit, internal obturator (to evaluate complete cut

42
Q

the sacroiliac ligament may remain attacched to caudal iliac segment when….

A

osteotomy is performed perpendicular to iliac body. Better to perform osteotomy perpendicular to long axis pelvis

43
Q

rate of screw losening following DPO

A

3.2%

43
Q

rate of screw losening for Locking Pelvic osteotomies plates

A

0.4%

44
Q

what is stress shielding and what does it causes

A

a) implant stiffer than bone
b) bone resorption (result of disuse atrophy)

45
Q

what is the primary cause of aseptic losening?

A

wear debris

46
Q

How it’s called the science that studies bearing surfaces/friction lubrication articular surfaces?

A

Tribology

46
Q

name the various types of wear experienced by a prostethic component

A

1) adhesive wear
2) abrasive wear
3) Fatigue wear
4) erosive wear
5) impingement wear
6) corrosive wear

47
Q

Ceramic has a similar elastic modulus than bone T or F

A

F: almost 300 greater than cancellous bone. Backing with metal to prevent aseptic losening secondary to modulus mismatch

48
Q

Articulations combinations available in veterinary and lowest wear rates

A

1) vet only available metal on polyethylene
2) lower wear ceramic on ceramic.

49
Q

ideal micromotion to allow bone ingrowth (osseointegration)

A

below 20 um. (over 150 um fibrous interface will develop).

50
Q

benefit of hydroxiapatite

A

1) osteoconductive
2) calcium phosphate base
3) prevent migration of wear debris

51
Q

normal hip joint extension and flexion angles

A

148 ; 118 °

52
Q

the greater the jumping –>
lower is the resistance to luxation
lower production of wear debris

T or F

A

F: greater distance femural head must trave befor luxation occur –> higher resistance to luxation, increased production of wear debris

53
Q

name the 3 descriptors of acetabular component placement

A

1) version (15-20°)
2) angle of lateral opening
3) inclination

54
Q

what should happen in acetabulum of severe osteoarthritis hips

A

false medial acetabular wall

55
Q

forms of biological failure

A

A) aseptic loosening
B) septic loosening
C) stress protection

56
Q

Hayes found an higer rate of luxation in luxoid hips treated with THR. T or F

A

F. acetabular depth ratio associated.

57
Q

Vancouver classification of femur following THR

A

-Ag and Al: greater and lesser throcanter
-B1,2,3: fractures involving prosthesis (b1 stable, others unstable)
-C: distal to prosthesis

58
Q

pulmonary emboli has similar rates in press fit and Zurich THR. T or F

A

F. 82% cemented press fit (Liska); 0/11 Zurich

59
Q
A
60
Q
A