Small animal fracture workshop Flashcards
What is the mnemonic used when we first assess trauma cases?
A - airways
B - breathing
C - circulation
Describe the initial management of a trauma case
Establish airway (remove material from mouth, intubate)
Chest drainage or ultrasound if dyspnoeic
Supplement oxygen if required
Staunch any bleeding
Analgesia
Cage confinement (handle and stress cat as little as possible)
What is the first step of an orthopaedic exam?
Let the animal walk on the floor
What is crepitus?
popping, clicking or crackling sound in a joint
What things can you assess without touching an animal in a trauma case?
On which limbs is it unable to weight bear?
Of these limbs is there gross instability, abnormal posture or limb angulation?
Is there crepitus on manipulation of the limb.
Are there any skin wounds?
Can the bone be seen through any skin deficit?
What neurological exams should be done if neurological signs are suspected in a trauma case
Mentation/balance
Spinal reflexes and responses
Neurological deficits e.g. a paretic limb or one lacking cutaneous sensation
Palpable skull or visible jaw fractures
Unstable or painful spine
Schiff-Sherrington posture- this is indicative of severe spinal cord injury when the animal
shows flaccid hindlimbs and increased tone in the fore
Flaccid tail
Bladder size/ability to urinate?
What abnormalities can be seen here?
Pneumothorax (air escaped into thorax)
Can be seen as heart is not lying on sternum
Describe this fracture
simple oblique mid to distal-third diaphyseal fracture of the left humerus
What other structure may be damaged by this fracture?
radial nerve within the musculospiral groove
What other neurological abnormalities might you see in a cat with a
humeral fracture and significant chest pathology?
Brachial plexus avulsion => multiple neurological deficits e.g., loss of sensation to all aspects of the paw and Horner’s syndrome.
Horner’s syndrome occurs when there is damage to the sympathetic outflow from the
cranial thoracic spine. Signs include miosis, ptosis and pupillary constriction
What is Horner’s syndrome?
Horner’s syndrome occurs when there is damage to the sympathetic outflow from the
cranial thoracic spine. Signs include miosis (shrunken pupil), ptosis (droopy upper eyelid)
What can be used to stop shearing and rotation that IM pins do not protect against?
cerclage wire
What are the problems associated with cerclage wire
Tend to loosen as they are bent over so some surgeons leave them at right angles to the bone resulting in irritation to the soft tissue structures, possible irritation to adjacent nerves and seroma formation under the skin.
They may reduce the periosteal blood flow to the fracture
They tend to loosen with time
How should fracture repair cases be managed post-operatively
restrict to house
discuss complications including pin loosening and discharge
Frequent re-examinations, follow up radiographs and surgery to remove fixator
Describe the post-operative management once an external fixator has been removed
IM pin can be removed or left in permanently
Wounds close by second intention
Increased restriction as fracture is less well supported (bone has to take up strain the fixator was taking)
