Specific Fractures Flashcards
When to use tape muzzles?
- Minimally displaced
- Caudal fractures
- Comminuted fractures
What can be an issue with caudal mandibular fractures?
- No bone to implant
- Would want to use a tape muzzle
When to do dental bonding?
- Minimally displaced maxillary or mandibular fractures
- Caudal fractures
- Comminuted fractures
- Due to blood supply, many will heal quite well
Surgical options for maxillary fractures
- Wires work well
Surgical options for mandibular fractures
- 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
What is the best way to diagnose mandibular fractures?
- CT gives best view
- Radiographs are quite challenging to interpret when of the skull
Stroud wiring
- Wiring and dental acrylic around the teeth
- Most people just etch and bond them now
Why do a majority of scapular fractures have concurrent injuries?
- Common to have pulmonary contusions or broken ribs
- The type of force needed to break a scapula would often hit the thorax
Classification of scapula fractures
- Stable extra-articular (body)
- Unstable extra-articular (body, neck)
- Intra-articular (glenoid)
What types of scapular fractures require fixation?
- Unstable extra-articular and intra-articular classifications
- Generally scapular neck fractures and articular fractures
- Depends for the scapular body
What is typical treatment for unstable scapular body fractures?
- Often can heal without surgery with conservative management
- May benefit from repair if very painful
True false: Most scapula fractures will heal with conservative management
True
How to fix articular (glenoid) fractures?
- 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
How many fractures are typically in pelvic fractures?
- 3 of them!
What are indications for fixation of a pelvic fracture?
- Weight bearing surface (acetabulum, ilium, sacroiliac joint)
- Articular (acetabulum)
- Pelvic inlet narrowing
- Contralateral injury (polytrauma will change your thinking)
- Uncontrollable pain!
What type of fracture do you worry about with uncontrollable pain and pelvic fracture?
- Sacral wing fracture
Where is the weight bearing axis (and where you would need to consider doing a fracture repair)?
- Ilium
- Acetabulum (cranial third)
- Sacrum and sacroiliac joint
Acetabular fracture repair
- Articular
- Weight bearing
- Can do two cross pins with a wire around them, and cement over the top
Ilial body fracture repair
- 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
Sacroiliac luxation repair
- Weight bearing axis
- Not all need to be repaired
- Pain/Sacral fracture you would need to repair
- Otherwise, cage rest might work
When would you want to repair a sacroiliac luxation?
- If they are painful or you suspect a sacral fracture
When do you worry about with a pelvic fracture always?
- Always warn about trauma to the urinary tract
- Ideally would do a urethrogram
How far should the screw penetrate if doing an SI luxation repair?
- Should penetrate at least 50% of the sacrum
Repair for metatarsal/metacarpal fractures?
- 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
