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VM733: SURGERY > Large Animal Fractures, Joints, Tendons > Flashcards

Large Animal Fractures, Joints, Tendons Flashcards

1
Q

How are fractures described?

A

Bone
Zone (epiphysis, physis, metaphysis, diaphysis)
Configuration (complete [simple/comminuted], incomplete)
Displacement
Open v closed
Articular or physeal involvement

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2
Q

Stabilization: Humerus

A

No immobilization necessary

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3
Q

Stabilization: Ulna

A

Robert Jones bandage with extended lateral splint

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4
Q

Stabilization: Carpus

A

Robert Jones bandage with caudal and lateral splint
Caudal splint to lock carpus in extension

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5
Q

Stabilization: Forelimb Phalanges

A

Dorsal splint
Includes tendon injuries

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6
Q

Stabilization: Femur

A

No immobilization necessary

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7
Q

Stabilization: Tibia/Fibula

A

Robert Jones bandage with extended lateral splint

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8
Q

Stabilization: Tarsus

A

Robert Jones bandage with plantar and lateral splint

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9
Q

Stabilization: Hindlimb Phalanges

A

Plantar splint
Includes tendon injuries

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10
Q

Emergency First Aid Management (6 Steps)

A

Sedation
Initial wound management
Fracture stabilization
Analgesia and NSAIDS
Antimicrobial prophylaxis (wounds, open fx)
IV fluids
Careful, safe transportation

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11
Q

How should fx pts be transported?

A

Lateral support to body wall
“Fracture in the back”
- Hindlimb fx = face forward
- Forelimb fx = face backward
Unload using sound limbs first (turn around)

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12
Q

Olecranon Fracture

A

Look at slides

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13
Q

Function: Articular Cartilage

A

Central structure constituting joint function
Provides frictionless movement of joint
Limited ability for shock absorption
Depends on diffusion for nutrients and waste removal

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14
Q

What does articular cartilage consist of?

A

Chondrocytes
Extracellular matrix (collagens, proteoglycans, water)

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15
Q

Zones of articular cartilage (5)

A

Superficial (tangential) zone
Intermediate (transitional) zone
Deep (radiate) zone
Calcified zone
Tidemark

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16
Q

Articular cartilage collagens

A

Primarily type II
Minor: type IX, VI, XII, XIV, III, X
Fibrocartilage at menisci, transition zone

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17
Q

Indications for arthroscopy

A

Diagnostic
Osteochondral fragments
Intra-articular fractures/fragments
Debride OCD/cystic lesions
Synovectomy/lavage for sepsis

18
Q

Benefits of arthroscopy

A

Less invasive
Visualize more articular surface

19
Q
A

Osteochondral fragmentation

20
Q
A

Osteochondral fragmentation

21
Q

Arthroscopic Closure: Skin Only

A

Simple interrupted or cruciate pattern

22
Q

Arthroscopic Closure: Synovial Layer

A

Small diameter absorbable suture
Simple continuous pattern
Reappose any major supporting structures, such as ligaments, that have been incised - large diameter absorbable or non-absorbable suture, simple interrupted or vertical mattress

23
Q

Tendon Composition

A

Cells (sparse tenocytes)
Extracellular matrix (type I collagen, ground substance [elastin, proteoglycans, glycosaminoglycans, glycoproteins])
Water

24
Q

Blood supply to tendons

A

Relatively avascular

25
Q

What affects blood supply to tendons?

A

Age: higher in foals, gradual decline
Exercise: training induced increased blood flow
Injury: elevated in affected and contralateral limbs

26
Q

Tendons vs ligaments

A

Tendons: more collagen (type I only), different cross-linking pattern, essentially a muscle-tendon-bone system
Ligaments: type III collagen, more numerous and larger cells, cross-linking similar to granulation tissue, increased proteoglycan for bone-bone attachment, essentially a bone-ligament-bone system

27
Q

Tendon speed of healing + result

A

Heals slowly due to low blood supply
Healed tendon lacks elasticity and strength compared to healthy tendon

28
Q

Why is there a high incidence of recurrence of tendon injuries?

A

Impaired elasticity/strength
Increased collagen type III (vs I) content
Reduced strength of scar tissue

29
Q

Contributing factors to tendon injury

A

Conformation
Shoeing
Fatigue-related incoordination during performance
Aging
Exercise

30
Q

Predispositions in tendon injury

A

Flexor tendons > extensors
SDFT > DDFT (more external, smaller CSA, less vascular mid-metacarpal region)
Forelimbs > hindlimbs

31
Q

What causes the different hyperextensions associated with tendon/ligament laceration?

A
32
Q
A

SDFT alone

33
Q
A

SDFT and DDFT

34
Q
A

SDFT, DDFT, suspensory ligament

35
Q

Suture patterns for flexor tendon lacerations

A

Three loop pulley (prevents distraction tendon ends)
Interlocking loop (not as strong, but recommended for intrathecal tendon repair within tendon sheath)

36
Q

Tx + prognosis flexor tendon lacerations

A

Debride wound +/- suture tendon closed
Distal limb cast for 6 to 8 weeks
55% return to athletic function

37
Q

Phalangeal Fx: Stabilization, Management, Prognosis

A
38
Q

3rd Metatarsal Fx: Stabilization, Management, Prognosis

A
39
Q

Olecranon Fx: Stabilization, Management, Prognosis

A
40
Q

Scapular Fx: Stabilization, Management, Prognosis

A

VM733: SURGERY (15 decks)

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