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Ortho > Specific Fractures > Flashcards

Specific Fractures Flashcards

1
Q

When to use tape muzzles?

A
  • Minimally displaced
  • Caudal fractures
  • Comminuted fractures
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2
Q

What can be an issue with caudal mandibular fractures?

A
  • No bone to implant

- Would want to use a tape muzzle

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3
Q

When to do dental bonding?

A
  • Minimally displaced maxillary or mandibular fractures
  • Caudal fractures
  • Comminuted fractures
  • Due to blood supply, many will heal quite well
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4
Q

Surgical options for maxillary fractures

A
  • Wires work well
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5
Q

Surgical options for mandibular fractures

A
  • Symphyseal wiring or bone cement
  • Also tape muzzle
  • In cats can use heavy PDS
  • People put lag screws in, but he likes to avoid drilling as it can damage the canine in small animals jaws
  • Can use an external fixator with bonding, but that’s unusual
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6
Q

What is the best way to diagnose mandibular fractures?

A
  • CT gives best view

- Radiographs are quite challenging to interpret when of the skull

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7
Q

Stroud wiring

A
  • Wiring and dental acrylic around the teeth

- Most people just etch and bond them now

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8
Q

Why do a majority of scapular fractures have concurrent injuries?

A
  • Common to have pulmonary contusions or broken ribs

- The type of force needed to break a scapula would often hit the thorax

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9
Q

Classification of scapula fractures

A
  • Stable extra-articular (body)
  • Unstable extra-articular (body, neck)
  • Intra-articular (glenoid)
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10
Q

What types of scapular fractures require fixation?

A
  • Unstable extra-articular and intra-articular classifications
  • Generally scapular neck fractures and articular fractures
  • Depends for the scapular body
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11
Q

What is typical treatment for unstable scapular body fractures?

A
  • Often can heal without surgery with conservative management
  • May benefit from repair if very painful
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12
Q

True false: Most scapula fractures will heal with conservative management

A

True

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13
Q

How to fix articular (glenoid) fractures?

A
  • Have to compress the fracture line first
  • Lag screw through the glenoid
  • Can do cross-pins
  • Difficult approach
  • Often have to do an osteotomy of the acromion or take the deltoid off an stick it back on
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14
Q

How many fractures are typically in pelvic fractures?

A
  • 3 of them!
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15
Q

What are indications for fixation of a pelvic fracture?

A
  • Weight bearing surface (acetabulum, ilium, sacroiliac joint)
  • Articular (acetabulum)
  • Pelvic inlet narrowing
  • Contralateral injury (polytrauma will change your thinking)
  • Uncontrollable pain!
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16
Q

What type of fracture do you worry about with uncontrollable pain and pelvic fracture?

A
  • Sacral wing fracture
17
Q

Where is the weight bearing axis (and where you would need to consider doing a fracture repair)?

A
  • Ilium
  • Acetabulum (cranial third)
  • Sacrum and sacroiliac joint
18
Q

Acetabular fracture repair

A
  • Articular
  • Weight bearing
  • Can do two cross pins with a wire around them, and cement over the top
19
Q

Ilial body fracture repair

A
  • Weight bearing
  • High cancellous to cortical and is encased in muscle, so heals well
  • Can heal with two lag screws if oblique enough
  • Can run two K wires and a hemicerclage
  • Plates work too
20
Q

Sacroiliac luxation repair

A
  • Weight bearing axis
  • Not all need to be repaired
  • Pain/Sacral fracture you would need to repair
  • Otherwise, cage rest might work
21
Q

When would you want to repair a sacroiliac luxation?

A
  • If they are painful or you suspect a sacral fracture
22
Q

When do you worry about with a pelvic fracture always?

A
  • Always warn about trauma to the urinary tract

- Ideally would do a urethrogram

23
Q

How far should the screw penetrate if doing an SI luxation repair?

A
  • Should penetrate at least 50% of the sacrum
24
Q

Repair for metatarsal/metacarpal fractures?

A
  • can coapt most of the them
  • Won’t really make a difference time wise if you externally coapt vs surgically repair
  • Minimal displacement
  • Consider age
  • Difficult to place implants in small patients
25
Q

What should you do with carpal/tarsal fractures?

A
  • REFER
26
Q

Which fractures should you consider coaptation/confinement?

A
  • Non-displaced maxillary fracture
  • Mandibular symphyseal fractures
  • Transverse fractures below the elbow and stifle (young animal)
  • Minimally displaced pelvic/scapular fractures
  • Most metacarpal/metatarsal fractures, unless very large dogs
27
Q

Humerus and femur fracture repair - when to refer?

A
  • REFER
  • Not amenable to external fixation
  • Diaphyseal and supracondylar fratcures
  • Articular fractures
  • Physeal fractures
  • Cannot easily coapt the humerus or the femur
28
Q

When to refer radius and tibia fractures?

A
  • Comminuted
  • Articular fractures
  • Physeal fractures
  • Distal radius
  • Geriatric patients

Ortho (10 decks)

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