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Flashcards in Final: Fractures Deck (62)
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1

8-month old M boxer 30kg. Hit by baseball 2 hours ago.

Classify and assess fracture, and give repair options

Salter Harris Type 2 

Fracture assesment score: 8-10

Repair: Diverging pin technique (K-wires)

2

4 month old canine, 10kg

HBC 24 hours ago

Classify and assess fracture, and give repair options

Long oblique fracture of the proximal femoral diaphysis

Fx score= 8-10

Repair: IM pin+ cerclage wire, ESF, bone plate 

3

4 month old mixed breed canine 

Acute lameness RHL

Classify and assess fracture, and give repair options

Transverse fracture of the diaphysis of the tibia

Fx score= 8-10

Repair: ESF, Interlocking nail, External coaptation

Bone plate may be overkill (young patient)

4

14 year old M mixed breed dog, 22kg

HBC yesterday

Classify and assess fracture, and give repair options

Spiral fracture of the distal to mid diaphyseal femur

Fx score= 0 (AGE!)

Repair: Type 2 ESF spanning the articular surface place in a CLOSED fashion

5

1 year old DSH, 4.5kg

HBC 24 hours ago.

Classify and assess fracture, and give repair options

Severely comminuted femoral fracture

and

Short oblique tibial fracture 

Fx score= 5

Repair: 2 ESFs (Type 1A), on femur + cerclage wire and IM pin

6

How can you prevent quadriceps contracture?

Early return to function

Physical therapy

No immobilization

Ice packs

NSAIDs

7

4 year old spayed female Dalmatian, 26kg

HBC 4 days ago

Concurrent ipsilateral tibial-tarsal luxation

Classify and assess fracture, and give repair options

Olecranon avulsion

Fx score WITHOUT luxation = 7-9 

Fx score = 5-7

Repair: Tension band

8

4 year old NM Burmese, 5kg

Unknown trauma yesterday 

Classify and assess fracture, and give repair options

Luxation of the radial head 

and 

Montaggia fracture of the ulna

Repair: ASAP - IM pin in ulna + Cerclage wire around radius

9

What does excessive local pain, fever, lethargy, lucency around the bone impant and a loose implant imply?

Osteomyelitis

10

4 year old F St.Bernard, 50kg

HBC 1 week ago

Classify and assess fracture, and give repair options

Transverse fractures of the radius and ulna

Fx score= 5 

Repair: 2 plates- one on radius and one on ulna (because of size, if had been smaller would not need ulnar plate)

11

What would you use to allow a scapular fracture to heal?

Velpau sling 

12

What causes ligamentous laxity when referring to fractures?

Disuse or immoilization, muscle atrophy, loose ligaments (due to atrophy), joint instability (due to muscle atrophy)

13

How deep does the first screw hole have to be when placing a lag screw into the long sacral body?

60% of the sarcal body width

14

2 year old GSD, 45kg

HBC 1 hour ago

Classify and assess fracture, and give repair options

Comminuted fracture of the mid-diaphysis of the femur

Fx score= 5 (large patient and comminuted, but young)

Repair: Bone plate + IM pin, Interlocking nails

15

What causes osteoporosis when referring to fractures? When can it be permanent?

Disuse (reduction of mechanical stress)

Will cause bone loss especially distally 

Can be permanent if >12 weeks

16

2 year old M Pharaoh hound, 18kg

HBC yesterday

Classify and assess fracture, and give repair options

Comminuted T or Y fracture 

Fx score= 3-5

Repair: Osteotomy of olecranon, bilateral plates or pins

17

4 year old mixed breed canine, 25kg

Found on side of road, NWB LHL with wound at level of the fracture

Classify and assess fracture, and give repair options

Open mid-diaphyseal tibial oblique fracture (possibly comminuted)

Fx score= 3-4 (open)

Repair: ESF, bone plate (Perl plate), interlocking nail

18

What are the 3 classifications of scapular fractures? When is surgery indicated?

SEA- Stable extra-articular

USEA- Unstable extra-articular

IA- Intraarticular

Sx if IA and some USEA

19

When does quadriceps contracture occur most often and in what type of patient?

After distal femoral fracture 

Young (<6mo) with poor limb use during healing and extensive muscle trauma

20

9 month old Mastiff, 75lbs

Ran over by owner 

Classify and assess fracture, and give repair options

Comminuted fracture of the distal humerus

Fx score= 3-5 (large patient, comminuted)

Repair: Bone plate (Perl) + IM pin

21

6 month old M mixed breed dog, 15kg

Playing w/larger dog, yelped and started running on 3 legs 2 hours ago

Classify and assess fracture, and give repair options

Avulsion fracture of the tibial tuberocity 

Fx score = 10 

Repair: Tension band

22

7 month old mixed breed dog, 13kg

Weight-baring lameness for 2 days, unknown cause

Classify and assess fracture, and give repair options

Single cortex greenstick fracture of the radius

Fx score= 10 (Potential problem= stunted growth/ limb shortening if physis closes prematurely)

Repair IF GROWTH AFFECTED: Radial osteotomy + Ulnar ostectomy (plus fat graft) and Ring fixator and Distraction Osteogenesis

23

What are the suggested implants in a situation where you have a small sized dog, with a simple greenstick fracture, and highly complant owner? What score range is this?

Type 1 ESF

IM pin + cerclage wire

External coaptation

Score: 8-10 (high)

24

18 month old M pitbull, 22kg

HBC 18 hous ago

Simple transverse fracture of the distal diaphysis of the femur

Fx score= 10

Repair= ESF + IM pin

IM pin + cerclage wire C/O'd on transverse fx

25

What are some proposed etiologies for fracture associated sarcomas?

Implant corrosion at fx site (Jonas pins, TPO plates)

Dissimilar metals

Hx of complications (inflammation, infection)

26

What are the options for repairing fractures of the ischial body?

2 or more IM pins (to resist forces of hamstrings) +lag or K-wires

Reconstruction plate

27

What are they keys for success for open fracture repairs?

Prompt debridement

BIgorous irrigation

Antibiotics

Soft tissue repair

28

When does fracture associated sarcoma occur?

In large breed dogs with comminuted/complicated femoral fractures >5 years after the facture has occured

29

What causes muscle atrophy when referring to fractures?

"Use it or lose it" (disuse, immobilization)

If occurs recovery takes 2-4 times longer to recover

30

What is the best approach when surgically repairing a sacroiliac fracture or luxation?

Dorsal 

Allows visualization of sacral wing

Use Ventral when have ipsilateral ilial fracture