Pins And Wires

Question 1

Steinmann pins are AKA?>

Answer 1

Intramedullary pins

Question 2

T/F: steinmann pins can be smooth or threaded

Answer 2

True

Question 3

Small steinmann pins are AKA?

Answer 3

Kirschner (k) wires

Question 4

Advantages of steinmann pins?

Answer 4

Inexpensive 
Small inventory 
Less tissue trauma 
Less surgical time 
Easy to remove

Question 5

Can are disadvantages of steinmann pins?

Answer 5

Cannot maintain bone length
ONLY resists bending forces
Pin migration

Question 6

What are all the possible applications of steinmann pin applications?

Answer 6

Intramedullary placement 
Stack pinning 
Cross pinning 
Rush pinning 
Diverging pins 
Skewer pin

Question 7

T/F: intramedullary pins are an adequate fixation method on their own

Answer 7

False

Always need adjunct

Eg cerclage wire, ESF, or plate

Question 8

How can you place a intramedullary pin ?

Answer 8

With Jacobs chuck or pin driver

Normograde or retrograde

Question 9

IM pin placement is contraindicated in what bone?

Answer 9

Radius

Question 10

Indications for IM pins?

Answer 10

Small dog or cat with stable/simple fracture

Question 11

When is IM pin contraindicated?

Answer 11

Most fractures in medium and large dogs— too much force

Question 12

T/F: stack pinning (2 or more pins to fill the medullary cavity) provides more fracture fixation

Answer 12

False

Clinically has shown no advantage and has higher incidence of pin migration

Question 13

When cross pinning, the pins should cross on which side of the fracture

Answer 13

Larger side

Question 14

Cross pinning is able to counteract which forces?

Answer 14

Rotational and bending forces

Question 15

When is cross pinning used?

Answer 15

Physeal fractures

Question 16

What type of IM pinning is used for very distal or proximal fractures and provides 3 points of contact ?

Answer 16

Rush pinning

Question 17

What type of pinning method is used to stabilize salter harris 1 fractures of proximal humerus and femur?

Answer 17

Diverging pin

3 K wires are placed in triangular fashion (do NOT penetrate joint surface)

Question 18

What are the uses of orthopedic wire?

Answer 18

Full cerclage 
Hemicerclage 
Skewer pin 
Tension band 
Interfragmentary wire

Question 19

When if full cerclage wire used?

Answer 19

Long oblique or spiral fractures in which the fracture line is at least 2x the diameter of the bone

Question 20

What is the maximum number of fracture segments that you can use full cerclage wire with?

Answer 20

3

Question 21

When is hemicerclage wire indicated?

Answer 21

Short oblique diaphyseal fractures

Hole drilled in proximal and distal fracture segment

Question 22

T/F: hemicerclage wire only counteracts rotation in one direction

Answer 22

True

Question 23

What fracture fixation method uses a full cerclage wire that is placed around a K-wire that bisects a fracture at a perpendicular axis

Answer 23

Skewer pin

Question 24

When is the skewer pin method indicated

Answer 24

Short oblique fractures

Question 25

What type of fixation method is indicated for avulsion fractures?

Answer 25

Tension band wires

Question 26

When can interfragmentary wires be used?

Answer 26

Simple fractures of flat, non weight bearing bones that interdigitate well

Eg certain mandibular and maxillary fractures

Question 27

T/F: external skeletal fixators resist all forces?

Answer 27

True

Question 28

When placing external fixator, you need at least _____ pins per fracture segment

Answer 28

2

Question 29

When placing a type Ia fixator on the tibia, which side of the limb is it placed on?

Answer 29

Medial

Question 30

When placing a type 1a fixator in a radius, which side of limb is it placed on?

Answer 30

Cranial and medial

Question 31

When placing a type 1a fixator on the femur or humerus, which side of the limb is it placed on/

Answer 31

Lateral

Question 32

What is a type1b external fixator?

Answer 32

Unilateral -biplanar

Question 33

When placing a type 2 fixator on the humerus, what side is it placed?

Answer 33

None.. cannot place type 2 fixators on the humerus or the femur

Only on tibia and radius - these will be placed medial to lateral

Question 34

What are the indications for a circular/ring fixator?

Answer 34

Complex fractures

Limb shortening/lengthening procedure

Angular deformities

Transport of bone segments

Question 35

Complications to external skeletal fixation?

Answer 35

Loosing pins or wires

Delayed or non union fractures

Osteomyelitis

Loss of joint motion

Nerve or vessel damage