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JR SX > Written Exam 2 - Fracture Fixation Methods 2 > Flashcards

Written Exam 2 - Fracture Fixation Methods 2 Flashcards

1
Q

what are the advantages & disadvantages of direct reduction?

A

advantages - precise reconstruction & limb shares load with the implant

disadvantages - dissection of soft tissues & disruption of healing & blood supply

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2
Q

what are the advantages & disadvantages of indirect reduction?

A

advantages - blood supply & soft tissues preserved, access to wounds around fx site, neutralizes load-bearing forces, can make post-op adjustments

disadvantages - implant sustains all of the load share & improper anatomic alignment, upsetting to owner, prematurely can loosen, associated infection, can get hung on objects, & maintenance

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3
Q

what is an external skeletal fixator?

A

series of transosseous (bicortical) pins or wires incorporated into an extracorporeal frame that can be used as primary or adjunctive stabilization

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4
Q

what kind of support does an external fixator provide?

A

bending - good to excellent

axial - excellent

rotational - good to excellent

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5
Q

what is the difference between unilateral & bilateral frame configurations?

A

all pins are bi-cortical!!!

unilateral - penetrates 1 skin surface

bilateral - penetrates 2 skin surfaces

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6
Q

why do you need to angle smooth pins?

A

they have weak pull-out strength & don’t grip the bone as well

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7
Q

T/F: moving the frame configuration closer to the bone increases the stiffness of construct

A

true

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8
Q

what is the stiffness of fixation pin related to?

A

the distance between the cis-cortex & the connecting clamps

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9
Q

what does a IM pin tie in do for a type Ia ESF?

A

increases bending support

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10
Q

what type of ESF is this?

A

type Ia - ESF is in one plant & pins only penetrate 1 skin surface (half pin)

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11
Q

what kind of ESF is this?

A

type Ib - biplanar type I configuration

stronger than uniplanar - fixator pins still only go through one skin surface

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12
Q

what type of ESF is this?

A

type II - pins penetrate 2 skin surfaces (full pins), can span joints, distal limbs

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13
Q

why can’t you use a type II ESF on a humerus or femur?

A

anatomical limitations of the animal

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14
Q

what type of ESF is this?

A

type II modified - utilizes both half & full pins, easier to apply with comparable stability

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15
Q

what type of ESF is this?

A

type III - strongest of the frame types, most expensive, usually used on the tibia & maybe radius

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16
Q

what are the advantages of using positive profile pins for ESF?

A

superior stiffness & axial extraction characteristics & effective centrally positioned pins

17
Q

which IMEX SK external fixation system is shown correctly?

A

A

18
Q

what is the strongest option of connecting bar?

A

titanium

19
Q

what is the size used for pins in ESF?

A

pin diameter should not exceed 30% of the bone diameter & the beveled tip of the pin should completely penetrate the far cortex

20
Q

how many pins should be used in ESF?

A

as many as possible - minimum 2 above & 2 below

21
Q

which clamps have been applied appropriately?

A

the ones on top - you want the clamps closest to the bone

22
Q

how should pins be applied?

A

drilling - high torque low speed drill

23
Q

why drill a pilot hole first?

A

theorized to decrease mechanical damage, heat generated during insertion, pull-out strength, & post-op morbidity

24
Q

what is the recommendation for predilling?

A

predill with a bit that has a core diameter 0.1 mm < core diameter of the corresponding fixation pin

25
Q

T/F: reduction of the fracture should be performed before placing the remainder of pins after the 1st two have been placed

A
26
Q

where should bars & clamps be placed in regards to an ESF?

A

as close to the limb as possible - use the clamp in configuration to shorten this distance

27
Q

what aftercare is needed for ESF?

A

pad heavily under the bars to reduce swelling, RJ bandage, cover open wounds with sterile dressing, remove bandages in 2-5 days, wrap bars to protect from injury, & keep clean

28
Q

when will frames of an ESF be removed?

A

minimum 8-16 weeks after in adult animals - under heavy sedation only

cut full pins short, clean, & pull with wire twisters or vice grips, clip/clean & bandage for a few days

rest 3-4 more weeks - must do radiographic assessment prior!!!!

29
Q

what can you do to increase axial stiffness for a type I ESF?

A

additional connecting bar to increase axial stiffness by 2.5X

30
Q

what are type Ia/Ib frames ideal for?

A

simple fractures

31
Q

what are type II/III ESF frames ideal for?

A

complex fractures

32
Q

T/F: positive profile pins & thread pins are better than smooth & negative profile pins

A

true

33
Q

what is the effect of a loose wire upon the healing & stability of a fracture?

A

damages bone blood supply, decreases stability, & negatively impacts bone healing

34
Q

how does the surgeon decide on the size of transosseous pins needed for an ESF? how is it performed?

A

should be approximately 25% of the fracture bone diameter - pre-op calibrated radiographs for measuring

35
Q

why are threaded pins applied in a perpendicular fashion?

A

threaded pins grip bone better than a smooth pin & have a higher pull-out strength

36
Q

why would you avoid using cerclage wire in a comminuted fracture?

A

smaller fracture pieces can collapse into the fracture when wires are tightened

37
Q

in younger patients, what should be considered when placing transosseous pins into a bone?

A

be aware of growth plates - want to avoid entering them, can cause probles

38
Q

how can you increase the strength of a modified type II ESF?

A

increase size & number of frame, increase number of pins used per bone fragment, & maximize pin diameter

39
Q

what post-op healing complications are associated with a modified type II ESF?

A

increased soft tissues swelling, superficial skin infections are expected, longer healing time due to the involvement of more soft tissue structures

JR SX (17 decks)

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