Emergency fracture management and casting

Question 1

Why is soft tissue damage important?

Answer 1

supply to limb (blood etc)

Question 2

Is hemorrhage usually a problem?

Answer 2

no

Question 3

What is bad about an open fracture?

Answer 3

can get infected

Question 4

What should you do with an open fracture?

Answer 4

lavage
topical/systemic antibiotic
careful what put on wound
careful about clipping
sterile wrap

Question 5

What are the benefits of immobilization?

Answer 5

1. decrease bone damage (eburnation)
2. decrease soft tissue damage
3. slight weight bearing–lower stress
4. safer transport

Question 6

What are the types of immobilization?

Answer 6

1. cast
2. cast material over modified robert jones bandage/splint
3. modified robert jones bandage/splint
4. robert jones bandage–poor
5. plain stable wrap–useless

Question 7

What is a modified robert jones bandage?

Answer 7

multiple tight layers. Do one layer at a time and get nice and tight

Question 8

What allows best immobilization for lower limb?

Answer 8

cast (but usually do it when horse recumbent and that is easier to put cast on properly)

Question 9

What is the best choice for long transport and severe comminution?

Answer 9

cast

Question 10

What are the four areas of the leg?

Answer 10

area 1: fetlock and below
area 2: canon bone
area 3: hock in back and above carpus and below elbow in front? (or including elbow?
area 4: shoulder, hip/pelvis

Question 11

What should you do for area 1 front leg?

Answer 11

light wrap
NON elastic tape (not too tight!)
dorsal splint

Question 12

What should you do for area 1 beack leg?

Answer 12

light bandage
fetlock flexes so hard to apply cranial splint
can apply caudal or cranial splint
non elastic tape

Question 13

What should you do for an area two (cannon bone)

Answer 13

modified robert jones bandage–snug, not too much pressure

2 splints: lateral and caudal

Question 14

What do you do for area 3 front leg?

Answer 14

1. modified robert jones bandage
2. lateral splint with padding–incorporate
3. deceases abduction and medial compounding

Question 15

What tends to happen in the front leg fracture in area 3 is not immobilized?

Answer 15

it tends to go medially and proximally (the proximal end)

as the distal end of leg abducts

Question 16

What do you do for area 3 back leg?

Answer 16

modified robert jones wrap

lateral thigh suport, padded top

Question 17

Why should you travel with the fractured leg caudally?

Answer 17

because if have to stop, then horse’s weight will be loaded on the cranial facing legs so want two good legs cranially

Question 18

Why is it better t have dividiers, chest and rump ropes when travelling with horse?

Answer 18

less work for horse, can lean against things, something to support if stop quickly

Question 19

Why should you call the referral center?

Answer 19

because they should be prepared and to ask what they want–how you should send the horse (feed, antibiotics, analgesics?)

Question 20

What are the types of casts?

Answer 20

1. ? foot casts–below fetlock
2. 1/2 leg cast–below hock/carpus
3. full leg cast–elbow/stifle
4. tube cast–no bottom, not for fracture repair, can cause rubsores

Question 21

How can you apply casts

Answer 21

standing or recumbent

Question 22

How do you put a cast on?

Answer 22

put a LIGHT wrap on if wound, NOT a lot of material!!!!

stockingette, felt at top

Question 23

Why do you want stockinette the appropriate diameter for casting?

Answer 23

so there aren’t wrinkles so dont get a sore

Question 24

What is a walking bar?

Answer 24

bar for horse to walk on. can incorporate into cast
make so no part of leg touches ground? Put in the middle between heel and toe and make the bar the lowest point so it contacts the ground.

Question 25

What is a wedge up (casting)?

Answer 25

put it on foot and wrap with casting material so that they have a flat surface to walk on