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6th MELEAH Sur-Gur-RAYYY final lezzzz ace dis shit > Steinmann Pins, ESF's, and Orthopedic Wire (Betance 2) > Flashcards

Steinmann Pins, ESF's, and Orthopedic Wire (Betance 2) Flashcards

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1
Q

Steinmann pins are often referred to as _______ pins

A

intramedullary

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2
Q

What are steinmann pins made from?

A

round stainless steel rods

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3
Q

What are some different options for different types of steinmann pins?

A
  • Diameter from 1/16 to 1/4 inch (2-5 mm)
  • Double or single armed
  • Trochar or chisel point
  • Smooth or threaded
  • 230-300mm length
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4
Q

What is the name of the wire that uses small steinmann pins that are usually smooth with a trochar point

A

Kirschner wires

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5
Q

What are the disadvantages of steinmann pins? (3)

A

***Resists bending forces ONLY

cannot maintain bone length

pin migration

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6
Q

What are some advantages of steinmann pins besides the fact that they involve less surgical time (faster), are smaller to deal with in terms of inventory and inexpensive? (3)

A
  • Tech. easier
  • LESS TISSUE TRAUMA
  • Easy to place and remove
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7
Q

What are some different applic. of Steinmann Pins?

\_\_\_\_\_\_\_ placement
Stack pinning
\_\_\_\_\_\_ pinning
Rush pinning
\_\_\_\_\_\_\_ pins
Skewer pin
A 
Intramedullary placement
Stack pinning
Cross pinning
Rush pinning
Diverging pins
Skewer pin
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8
Q

What is the most common steinnman pin application and where is it placed in the bone?

A

Intramedullary placement; placed in the medullary cavity

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9
Q

For intramedullary pins, pin diameter is based on _____ _____

  • if used with just _____
  • If used with just _____
  • If used with just a _____
A

adjunct fixation

  • wires
  • ESF
  • plate
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10
Q

Intramedullary pin application only resists these forces only?

A

Resists bending forces only!

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11
Q

What bones can IM pins be used in to aid in fracture reduction? (6)

A

Thoracic limb: Humerus, Ulna, Metacarpal

Pelvic limb: Femur, Tibia, Metatarsal

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12
Q

What bone in the thoracic limb can we absolutely not use an IM pin in?

A

Radius!!!!

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13
Q

What devices are used to place an IM pin? (2)

A

Jacobs chuck or pin driver

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14
Q

When using IM pins we avoid _____ surfaces it almost always requires _____ ____ and can be placed _____ or ______

A

articular; adjunct fixation; normograde or retrograde

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15
Q

IM pins once again are contraindicated in this bone of the body

A

radius!!!

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16
Q

With IM pins, you either cut the end of the pin or leave it long to tie into this device?

A

External fixator

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17
Q

What size dogs and type of fracture do we use IM pins for, which size is it contraindicated in?

A

Indicated for: small breed dogs or cats with a simple stable fracture

Contraindicated for most fractures in medium and large dogs!!!!

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18
Q

If loretta’s vet recommended IM pins what am I going to do?

A

Go to a new fucking vet they’re obviously a dumbass who didn’t stay awake listening to Surgery!!!!!

IM pins are contraindicated for most fractures in medium and large breed dogs

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19
Q

What’s unique about IM pins that we always need todo when using these!!!

A

Always combine other fixation

  • Cerclage wire
  • External fixator
  • Bone plate
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20
Q

______ pinning is 2 or more pins to fill the medullary cavity

A

Stack

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21
Q

What are some disadvantages of stack pinning that lead to why its rarely praticed?

A
  • Clinical results show no advantage
  • Higher incidence of pin migration
  • Difficult cutting multiple pins
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22
Q

Cross pinning uses _____ diameter pins and used for these types of fractures

A

smaller; simple proximal/distal fractures/ physeal fractures

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23
Q

Describe the type of forces cross pinning uses and what it engages?

A

Counteracts rotational and bending forces; engaged both cortices

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24
Q

For cross pinning the pins cross in the _____ _____ segment

A

larger fracture

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25
Q

What type of pin is a medullary pin that does not have a cutting point

A

Rush pinning

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26
Q

How are rush pins placed and how many point of contact does it have?

A

Pins are placed in pins and each has 3 points of contact

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27
Q

State the type of pin:

The pin is forced to bend to provide dynamic forces on the bone

A

rush pinning

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28
Q

What type of pin technique is used to stabilize salter harris 1 fractures of proximal humerus and femur

A

Diverging Pin technique

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29
Q

What must be done when using the diverging pin technique?

A

must achieve anatomical reduction

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30
Q

Does the diverging pin technique penetrate the joint surface?

A

NO!

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31
Q

What pin technique uses 3 K wires placed in a triangular fashion

A

Diverging pin technique

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32
Q

What wire has the largest diameter and the higher tensile strength?

A

Orthopedic wire

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33
Q

This type of wire is never used as a sole method of fracture fixation except for this instance?

A

Orthopedic wire; only used solely with interfragmentary

34
Q

Orthopedic wire is used with ___pins, ____ ____, and plates

A

IM; external fiaxators

35
Q

What are the different orthopedic wire uses?

A 
Full cerclage
Hemicerclage
Skewer Pin
Tension Band
Interfragmentary Wire
36
Q

Cerclage means to ______

A

encircle

37
Q

Full cerclage wire can be used for a maximum of ___ fracture segments

A

3

38
Q

Full cerclage wire can only be if the fracture is ________ reduced

A

anatomically

39
Q

Full cerclage wire is used in ____ _____ or _____ fractures in which the fracture line is at least ___ times the diameter of the bone

A

long oblique; spiral; 2

40
Q

Orthopedic wire is often called _____ wire and is often used to hold fragments in position

A

cerclage

41
Q

What do we use in terms of size for full cerclage wire

A

use the largest diameter wire that seems appropriate to the size and strength of the bone

42
Q

When placing full cerclage wire place at least ____cm from the fracture ends and ___cm apart

A

at least (0.5)cm from the fracture ends and (1) cm apart

43
Q

What do we use to pass and tighten the full cerclage wire around the bone and how many do we have to always at least place?

A

wire passer; at least 2; wire tightner

44
Q

We place full cerclage wire ______ to the bone and twist the wire under _____ _____. When we cut the wire we leave __-__ twists or cut leaving ____ twist and then bend it over

A

perpendicular; tension preload; 2-3; 5

45
Q

This type of wire is used for short oblique diaphyseal fractures

A

Hemicerclage wire

46
Q

Hemicerclage wire ____ rotation in only __ direction

A

counteracts; 1

47
Q

State the type of wire where a hole is drilled in proximal and distal aspects of the fracture segment then the wire is passed through the holes and around the IM pin

A

Hemicerclage wire

48
Q

This pin us used in short oblique fractures and incorporates full cerclage wire and K-wire?

A

Skewer pin

49
Q

Where is the k wire placed in terms of the fracture with skewer pins?

A

placed on the line that bisects the perpendicular of the long axis of the bone and the fracture

50
Q

Where is the cerclage wire placed in terms of the fracture with skewer pins?

A

placed around the k wire and tightened

51
Q

With skewer pins, the k wire, skewer pin, and full cerclage wire together ultimately _____ the fracture

A

compresses

52
Q

What type of wire is indicated for avulsion fractures of tension physes and ______ of _______?

A

Tension Band wire; closure of osteotomy

53
Q

With tension band wire 2 ______ forces become _____ forces

A

2 distractive forces; compressive

54
Q

State what takes place with tension wire and where the k wire should penetrate?

A

reduce fragment and 1-2 K wires driven perpendicular to fracture line and parallel to each other

k wire should penetrate both cortices

55
Q

When placing a tension band wire a hole is drilled in the ____ of the bone around the same distance ____ the fracture line and the ___ are placed above.

Wire is passed through the hole and around the ends of the pin and back to the other end of the wire creating this shape.

Tighten both sides _____. Then bend and twist the ___ wire

A

cortex; below; pins;

figure 8

equally; K

56
Q

TENSION BAND WIRE INDICATIONS fill in the blank?

_____fracture or ______ of the greater ______

“__same as above___” fracture of _____ tuberosity

Fracture or osteotomy of the ____ _____

Fracture of tuber ______

Fracture of _____ process of the scapula

Fracture or osteotomy of the ______

A

Avulsion; osteotomy of the greater trochanter

Avulsion; tibial tuberosity

medial malleolus

calcanei

acromial

olecranon

57
Q

For interfragmentary wire it is placed like “______” holding bone fragments together

A

suture

58
Q

For interfragmentary wire, the hole are drilled in ______fragments and ______

A

apposing; tightened

59
Q

The fractures we use interfragmentary wire for are simple fractures of ____, non-_____ _____ bones that ______ well. Also in certain _____ and ______ fractures

A

flat, non weight bearing, interdigitate well; mandibular and maxillary

60
Q

State the method of fracture repair:

Smooth or threaded pins inserted through cis and trans cortex, pins secured with specialized clamps and connecting bars made of stainless steel, carbon composite, or titanium

A

External skeletal fixators

61
Q

This method of fracture repair is a less invasive fixation and has the ability to resist all forces and works well with infection

A

External Skeletal Fixation

62
Q

External Skeletal Fixation is not as stable as ____ fixation

A

plate

63
Q

Indications for External Skeletal Fixation:

Many ___ or ____ fractures

Limb ______

When _____ _____ is compromised

Need _______ and ______ access

When bone purchase is ______ for _____

_______

A

open; closed

Deformities

blood supply

need stabilization and wound access

insufficient for plate

arthrodesis

64
Q

State the pin diameter required for External Skeletal Fixation?

A

< than or = to 25% of the bone diameter

65
Q

State the pin angle required for External Skeletal Fixation for smooth pins versus threaded pins?

A

Smooth pins: 60-65 degrees

Threaded pin: 90 degree (to remember The letter T makes this angle)

66
Q

State the required numbered of pins for External Skeletal Fixation?

A

at least 2 PER segment

67
Q

State the required location for pins on the bone for External Skeletal Fixation?

A

> than or = to 2 pin diameter from the fracture

68
Q

How do we place the clamps and connecting rods for External Skeletal Fixation?

A

AS CLOSE to the skin AS POSSIBLE but AT LEAST 1 cm away

69
Q

SORRY LONG ASS RESPONSE REQUIRED BUT YA WON’T FUCK THIS UP ON THE FINAL SO YOU’LL THANK ME

State the bone location indicated for each type of external fixator and the official name combine with the type:

Type 1a?

Type 1b?

Type 2?

Type 3?

A

UNILATERAL-UNIPLANAR Type 1a

  • Radial fractures (cranial and medial)
  • Tibia (medial)
  • Femur and Humerus (Lateral)

UNILATERAL BIPLANAR Type 1b

  • Radius (craniomedial/craniolateral)
  • Tibia (craniomedial)
  • Femur and Humerus (lateral)
BILATERAL-UNIPLANAR Type 2 
(2 "TOO" good for femur and humerus)
-Radius (med-lateral)
-Tibia (med-lateral)
-CANNOT BE USED FOR FEMUR AND HUMERUS

BILATERAL BIPLANAR Type 3 (rarely used)

  • ONLY IN RADIUS ANS TIBIA
  • to remember type 3: ThRee has T and R in it for radius and tibia
70
Q

FOR UNILATERAL-UNIPLANAR Type 1a:

they are often combined with an ____ pin on the _____(bone) and _____(bone)?

A

IM pin on femur and humerus

71
Q

BILATERAL-UNIPLANAR Type 2

CANNOT BE USED on the _____ and ______

A

femur and humerus

72
Q

BILATERAL BIPLANAR Type 3 are ONLY USED in the ____ and _____ and connects 2 _____ together

A

radius and tibia; connect 2 frames together

73
Q

The femur and humerus cannot be used in this type of external fixator

A

BILATERAL-UNIPLANAR Type 2

74
Q

The radius and tibia can only be used in this type of external fixator

A

BILATERAL BIPLANAR Type 3

75
Q

IM pin on femur and humerus are often combined with this type of external fixator

A

UNILATERAL-UNIPLANAR Type 1a:

76
Q

Complex fractures with no other alternatives use this method of fracture repair, cane general practitioners do this?

A

Circular/Ring fixators

usually referred to an orthopedic specialist due to complexity of the repair

77
Q

Besides complex fractures with no other alternatives, state 2 other indications for circular/ring fixators (2)?

A

Limb shortening or lenghtening procedure

Angular deformities

78
Q

Circular/ring fixators have ___ rings on ____ side of the fracture. __ pairs of wires intersected at ____degrees. Tension by _____

A

Circular/ring fixators have (2) rings on (each) side of the fracture. (4) pairs of wires intersected at (90) degrees. Tension by (weight)

79
Q

External Skeletal fixators (fill in the blank)

what type of anesthesia?
Strict Surgical ______
Placed ____ or _____ (desirable) if fracture adequately ______
Limb often ______ to facilitate reduction and placement

____ ____ ____ accomplished with poly(methyl methacrylate)

A

(General anesthesia)
Strict Surgical ______(asepsis)
Placed ____(open) or __closed___ (desirable) if fracture adequately ______(reduced)
Limb often (suspended) to facilitate reduction and placement

free form fixators

80
Q

What kinds of things do you do for post op care for external skeletal fixation?

A

Radiographs immed. post op and at 4 and 8 weeks

Leash walks-to prevent joint stiffness, limb edema, disuse atrophy

Clean pin ports and bandage changes daily

81
Q

Complications of external skeletal fixation:

-Loosing ___ or ___
-Delayed or __-___ fractures
-______
-Loss of ____ ____
-____ or ____ damage
(do not place in _____ _____ blindly)

A

-Loosing pins or wires
-non union
-Osteomyelitis
-joint motion
-Nerve/vessel damage
do not place in (humeral diaphysis) blindly

6th MELEAH Sur-Gur-RAYYY final lezzzz ace dis shit (15 decks)

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