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FCP - Surgery Week > Principles of Fracture Management > Flashcards

Principles of Fracture Management Flashcards

1
Q

Articular Fracture

A

Fracture within or around a joint

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2
Q

Non-articular Fracture

A

Away from a joint

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3
Q

Diaphyseal Fracture

A

Along shaft

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4
Q

Metaphyseal Fracture

A

At ‘neck’ of bone

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5
Q

Epiphyseal Fracture

A

At tip of bone

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6
Q

Transverse Fracture

A

Perpendicular to length

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7
Q

Oblique Fracture

A

At an angle to length

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8
Q

Butterfly Fracture

A

Two oblique lines leading to loss of fragment

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9
Q

Physeal fracture

A

At growth plate

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10
Q

Close fracture

A

Skin is intact

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11
Q

Open Fracture

A

Skin is ruptured - open wound

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12
Q

Simple Fracture

A

Only one site

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13
Q

Comminuted

A

Multiple locations

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14
Q

Avulsion Fracture

A

Small chink of bone attached to tendon or ligament pulled away

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15
Q

What are the steps in fracture repair?

A
  1. Assess and stabilise animal
  2. take two orthogonal radiographs
  3. Facture score
  4. Assess what forces will be applied
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16
Q

What are orthogonal radiographs and why do we do this?

A

Two radiographs taken at right angles
E.g. mediolateral and craniocaudal views

Using one view may not show a fracture - only visible in the other plane

17
Q

How do we describe radiograph orientation?

A

The direction the beam is going rather than position of animal
E.g. DV means beam is going from dorsal to ventral, animal would be lying in ventral recumbency

18
Q

What does a high fracture assessment score mean?

A

More complicated fracture
More difficulties in dealing with fracture may arise

19
Q

What factors should be considered when fracture scoring?

A

Patient Factors
* Weight of animal
* Age
* Boisterousness and ability to manage cage rest
* Concurrent illnesses
Fracture Factors
* Type of fracture
* Open or closed?
* Associated soft tissue injuries
* Single or one of several fractures
Owner Factors

20
Q

What factors should be considered when fracture scoring?

A

Patient Factors
* Weight of animal
* Age
* Boisterousness and ability to manage cage rest
* Concurrent illnesses
Fracture Factors
* Type of fracture
* Open or closed?
* Associated soft tissue injuries
* Single or one of several fractures
Owner Factors
* Finances
* Commitment to animal
Surgeon Factors
* Surgical expertise
* Equipment available

21
Q

What are the 4 physiologic forces?

A
  1. Axial Compression
  2. Tension
  3. Bending
  4. Torsion
22
Q

How does compression and tension affect long bones?

A

All long bones are asymmetrically loaded when weight barring
One side is compressed, the other undergoes tension

23
Q

Where should you apply plate on a long bone and why?

A

Side with tension
Plate would be broken by compression but not tension
* Femur
○ Lateral aspect
* Tibia
○ Medial aspect
* Radius
○ Craniomedial aspect
* Humerus
○ Latero-cranial aspect
* Mandible
○ Dorsal aspect

24
Q

What are the consequences of axial compression on fractures?

A

Good if the fracture is transverse
At right angles to the long bone
Good if the fracture interdigitates
Stops rotation
Not good if comminuted (i.e. multiple fragments)
Not good if oblique fracture
Causes collapse or shear

25
Q

What are the consequences of tension on fractures?

A

Produced by ligaments or tendons pulling on one of the bone fragments
Causes fracture to be distracted
Needs to be overcome with lag screwing or tension bands

26
Q

What are the consequences of torsion on fractures?

A

Results in rotation of the fracture site
Requires management with plates, external fixator or an interlocking nail

27
Q

What are the consequences of bending on fractures?

A

Occurs due to the asymmetrical nature of the bone loading
Counteract with a pin in the centre of the medullary cavity

28
Q

What is strain?

A

Changing in length / original length

29
Q

What tissue has the highest strain?

A

Granulation tissue - 100%

30
Q

How does strain change as a fracture repairs?

A

Strain slowly reduces
Bone has low strain - 2%

31
Q

Why are post-op radiographs taken?

A

To assess:
○ Alignment of fracture
○ Positioning of implant
○ Encroachment of implants into joints or soft tissues
○ Bridging of growth plates in young animals

FCP - Surgery Week (18 decks)

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