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Eq SX Musc Skel Exam > Principles of equine fx repair > Flashcards

Principles of equine fx repair Flashcards

1
Q

Classification of fractures

A
  1. complete/incomplete
  2. stable/unstable
  3. open/closed
  4. configuration
    - Greenstick/fissure
    - Transverse
    - Oblique
    - Spiral
    - Comminuted
    - Multiple
    - Impacted
    - Avul/Diaphy/Metaphy/Pyseal (salt-H)/Epiph/apophy/articular
    - Other
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2
Q

Stable fracture

A

Cortical continuity, positive prognosis

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3
Q

Open fracture classification

A

Type 1: < 1cm diameter skin perf, no loss soft tissue, no bone exp or gross contam
Type 2: Larger skin lac, little loss skin tis, minimal exp bone, min gross contam
Type 3: Extensive lac, massive skin defects, gross contam soft tis and fx bone

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4
Q

Main criteria for repair

A
  1. Minimal comminution
  2. 180 degress cortex (strut) for axial load
  3. Closed fx
  4. Sensible horse
  5. Pain control, well trained staff, well designed recovery system
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5
Q

Foals are less likely to suffer from

A

Support limb laminitis

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6
Q

Foals are more likely to develop

A

Angular limb deformity from abnormal load of physes

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7
Q

Foal implant removal may be indicated

A

When fracture has completely healed

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8
Q

Stall rest

A

-Splints (don’t require fixation)

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9
Q

Fractures that will heal w/ minimal intervention

A
  1. Deltoid tubercle of humerus
  2. Non-articular patellar fractures
  3. Fractures of scapular spine
  4. Some pelvic fractures
  5. Third trochanter of femur
  6. Stress fractures
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10
Q

Risk of conservative tx

A

catastrophic propagation of long bone fx

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11
Q

Splint coaptation

A

Tx incomplete fx tibia or radius

  • emergency support, not only means
  • prevent animals from lying down with head tie/sling
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12
Q

Casts

A 
Supplements internal fixation/P3 wing fx 
Can cause
-calus formation
-delayed/failed union
-breakdown opposite limb
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13
Q

Casting procedure

A
  • Palpate daily for heat/swelling/moisture
  • First cast changed after 3-4 days
  • Foal casts then changed q10-14d
  • Adult casts then changed q5-6 weeks
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14
Q

When casted watch for

A 
Lameness
Swelling
Odor
Moisture
Heat
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15
Q

Three types external fixation constructs in horses

A
  1. transfixation-pin casts
  2. external fixators
  3. external skeletal fixation devices
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16
Q

External fixation constructs indications

A
  1. Open fractures
  2. Severely comminuted fractures distal limb
    - when ORIF is not possible
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17
Q

External fixation constructs not used for

A

proximal limb fractures, not possible to apply

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18
Q

Transfixation pin casts indications

A
  1. Comminuted phalangeal fractures
  2. Distal MC/MT3 fx
  3. Breakdown injuries of the MCP joint
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19
Q

Transfixation pin cast procedure

A
  • 2-3 cross pins placed in metaphyseal region bone proximal to fracture
  • Pins incorporated into full/half-limb fiberglass cast
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20
Q

External skeletal fixators

A
  • Allow immediate sub-normal weight bearing
  • Allow access to open wounds for tx
  • Not enough axial support for most adults
  • Used in non-weight bearing fractures (mandibular)
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21
Q

External fixation complications

A
  1. Pin loosening, likely infection
    - removal and curettage
  2. Pin tract infection/fx
  3. Grade 1-3 minor infection can continue external fixation
  4. Grade 4-6 major infection must abandon external fixation
22
Q

Insufficient external fixation

A

Limb remains painful and increases risk of supporting limb laminitis

23
Q

Required cortex for successful repair

A

180 degrees of intact cortex

24
Q

Anatomic reconstruction joint surfaces required for

A

preventing development of Osteoarthritis

25
Q

Long bone fx repair

A

Screws and plates

26
Q

Intramedullary fixation with pins and orthopedic wiring

A

Can only be applied in a few, limited circumstances

27
Q

Orthopedic screws weakest in

A

Bending and shear

28
Q

Screw strength determined by

A

Core diameter

29
Q

Resistance of screw to bending related to

A

radius to the fourth power

30
Q

Cortical screws

A

Larger core diameter and small diameter threads

-preferred in adult equine bone

31
Q

Cancellous screws

A

Smaller core diameter with larger diameter threads

-reduces screw pull out

32
Q

Cortex screws can be

A
  1. Inserted as position screws
  2. Inserted as implant screws
  3. Placed in lag fashion
33
Q

Cortex screws expected to withstand weight-bearing loads should be placed

A

perpendicular to the long axis of the bone

34
Q

Screws may be used to

A

reconstruct fracture fragments

-then a plate is applied to withstand weightbearing forces

35
Q

Commonly used plates

A
  1. DCP (Dynamic compression plate)
  2. LC-DCP (limited contact dynamic compression plate)
  3. LCP (locking compression plate)
36
Q

Recommended rate of drilling

A

1mm/s

37
Q

Temp that causes bone necrosis and protein coagulation

A

54 degrees celsius

38
Q

Saline used as

A

lubricant

-not to cool drill or bone

39
Q

Temperature generation is inversely related to

A

Drilling rate

40
Q

Plate fixation procedure

A
  1. Minimum of 3 screws (6 cortices) should be engaged on each side of fracture frag
  2. Plate generally applied to entire length of the bone (prevents stress riser at plate termination)
  3. Screw placed into every plate hole when possible
41
Q

Plates strongest in

A

tension

-apply to tension side of fracture

42
Q

Plates weak in

A

torsion

43
Q

Plates weakest in

A

bending

44
Q

Persistent cyclic loading results in

A

implant failure

45
Q

Inability to transmit load across the fracture site will result in

A

implant deformation

46
Q

Load transmission across fracture line for anatomic reduction results in

A

stability

47
Q

plate applied in compression contoured to fit bone perfectly

A

compression of fracture only occurs on cis cortex

  • trans cortex remains decompressed
  • slight over-bending of plate at fx line results in compression across entire fracture line
48
Q

Locking compression plates

A

Two treatments in one

  1. compression plating
  2. internal fixation
49
Q

Equine fx repair complications

A
  1. Implant infection
  2. breakdown of implants/fracture repair
  3. Supporting limb laminitis
50
Q

Foal fx repair complications

A
  1. Supporting limb angular deformity
  2. Premature closure of affected physis in salter-Harris fracture
  3. flexural deformity
  4. OA
  5. Lameness

Eq SX Musc Skel Exam (20 decks)

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