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Animal Diseases 2 > Fractures > Flashcards

Fractures Flashcards

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1
Q

What are the 5 forces that act on fractures/can cause fractures

A

Bending
Torsion
Compression
Shearing
Tension

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2
Q

What is the most common force that acts on fractures

A

Bending

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3
Q

What type of fracture results from bending

A

Angulation

Breaks opposite to where the force is applied

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4
Q

What type of fracture does torsion result in, what bones are they most common in?

A

Rotation

Tends to cause spiral fractures

Most common in long bones

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5
Q

What type of fractures does compression usually result in

A

Oblique/comminuted fractures as well as shearing fractures

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6
Q

What type of fracture does tension result in

A

Avulsion

Distraction (pulling apart)

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7
Q

True or false
Fractures normally only involve one force

A

False
They normally involve a combination of forces

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8
Q

Why is it important to understand the forces that caused a fracture

A

Because the same forces will prevent it from healing

Neutralizing the forces is key in healing

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9
Q

Bone is Viscoelastic, what does this mean

A

Can take a certain amount of force/load/bending before it breaks

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10
Q

What does it mean when you see translucent lines on the ends of bones on a radiograph

A

These are the growth plates and it indicates the animal is still growing

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11
Q

What is a closed fracture

A

When the fracture has no connection to the outside world (the skin is intact)

The way to tell is with physical manipulation and observation

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12
Q

What is an open fracture AKA compound fractures

A

The wound connects the bone to the outside world (skin is open) often bone is sticking out

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13
Q

Which type of fracture often need antibiotics? Why?

A

Open fractures

Because of the open wounds, and because there is often an infection present

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14
Q

What is a fissure fracture?

A

Cracks or incomplete fractures

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15
Q

Why do you need multiple views on radiographs with fissure fractures

A

Because it can be hidden depending on how you look at it

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16
Q

What is a green stick fracture

A

Young animal fractures

These are incomplete due to elasticity of young bones (bending a green stick from a tree)

These heal very rapidly and have a good prognosis

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17
Q

How do you often need to treat fissure and green stick fractures

A

Often just need a splint

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18
Q

What defines a “complete” fracture

A

When both cortexes of the bone are affected (goes all the way through)

Can be displaced or not

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19
Q

What does it mean when a fracture causes the bones to be “displaced”

A

Being moved from their correct/original position

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20
Q

What is a comminuted fracture? What force often causes it? How is it corrected?

A

When the fracture results in more than 2 fragments

These require surgical fixation

Often from compression

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21
Q

What are physeal/growth plate fractures (AKA Salter Harris Fractures)? What does it result in?

A

These are fracture that in some way affect the growth plates of young animals

Often results in abnormal growth and formation of the bones or early closure of the growth plates

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22
Q

What is a transverse fracture versus an oblique fracture

A

Transverse: across the bone

Oblique: at an angle through the bone

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23
Q

What is a long versus short oblique fracture

A

Long: the fracture is at least twice the diameter of the bone

Short: the fracture is less than twice the diameter of the bone

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24
Q

Spiral fractures are often caused by ___ forces

A

Twisting / torsion

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25
What is a concern when the edges of a fracture are flat versus jagged
Torsion or sliding is an issue with flat edge fractures because the bones will slide on one another which prevent healing Jagged edge fractures fit together like puzzle pieces and sliding does not occur
26
What are the factors that affect fracture geometry
The energy applied The type and direction of the force applied Which bone is fractured Age of the animal (viscosity)
27
Knowing the type of fracture and what types of forces to avoid and which forces work in your favour comes in hand when you ___
Reapply a splint Restrain Take radiographs Provide nursing care
28
What is the fracture considered if it happens to a healthy bone
Traumatic fracture
29
What is the fracture considered when it happens to a diseased bone, why?
Pathological fracture Diseased bones cannot withstand normal amounts of force like healthy bones can and can break easier
30
What does fracture healing rely on the most
The formation of new bone
31
What are the 5 steps in fracture healing
1: fracture is reduced and immobilized 2: gap must be made small enough for blood vessels to grow across it because blood vessels bring in cells and healing factors 3: fibroblasts and chondrocytes enter the gap and fill in with fibrocartilagenous tissue scaffolding 4: osteoblasts enter and fill the gap in with new bone 5: get rid of infections (infected bone will not heal)
32
Why is it normal to see a wider gap a little while after a fracture was reduced on x ray?
Osteoclasts come in and eat away dead and damaged bone tissue, this makes the gap wider but also promotes new bone growth This is why 2 week X-rays are need in check ups
33
What forms around the fracture but will go down with time
Bone calluses (this is where the bone is healing)
34
Fractures must be ___ and ___ in order to heal
Reduced and stable
35
What are the healing times of fractures in healthy adults versus young animals
Adults: 8-12 weeks Young: 4-6 weeks
36
What are the 3 ways fractures are repaired
External coaptation External fixation Internal fixation
37
What forces are external coaptation good at correcting
Bending (best) Torsion (fair)
38
What are the advantages of external coaptation
Non invasive (no disruption of blood supply or growth plates and no surgery) Moderate expense Can be done anywhere and with anything Good temporary measure (prevents further damage)
39
What are the limitations to external coaptation
Poor control of tensile and compressive forces Less rigid stabilization Alignment and reduction can be difficult or impossible to attain
40
What are the disadvantages of external coaptation
Rub sources and dermatitis is common (mostly in skinny limbs) Constrictive coaptation can lead to swelling and necrosis
41
What are the rules of external coaptation
Go at least 1 joint above and below the fracture Don’t put on too tight or too loose (rubbing) Add padding on pressure points Include the foot but leave the 2nd and 3rd digits exposed Splint in normal position but slightly flexed Splint changes regularly and require many people for restraint Take X-rays BEFORE removing the splint
42
What is internal fixation
When hardware is placed inside the limb or bone These are sometimes left in for life
43
What are the different options for internal fixation
Intramedullary pins (left in for life) (only neutralizes bending) Interlocking nails with or without a bone plate Cerclage wiring (only works on long oblique fractures)
44
What is external fixation
Hardware being place internally that are connected to hardware externally
45
What are some examples of external fixation
Intramedullary pin with ESF tie in Screws and bone plates
46
What forces do screws and bone plates control
ALL OF THEM
47
What is locking vs non-locking plating
Locking: fracture fixation devices with threaded screw holes. This threads the screws to the plate and acts as a fixed angle device. The screws and the plate work as a unit Non locking: these systems require the plate to be directly on the bone in close contact to prevent the bones from being displaced. Force is transferred from bone to plate via friction at each screw site
48
What are the advantages of internal AND external coaptation
Most rigid support (external > internal > coaptation) Animal can use the limb sooner Allows skin to be exposed to air and wounds can be exposed Better fragment reduction which results in faster healing
49
What are some disadvantages and possible complications of internal and external coaptation
Risks with GA very expensive More specialized surgeries Risk of iatrogenic fractures and disrupted blood supply External requires second procedure for hardware removal Hardware causes discomfort in cold temps Pins can shift over time and cause pain Higher risks of infection due to foreign material in the body
50
What are the limitations to internal and external fixation
Need to monitor for infections (harder to treat, may result in hardware removal, impedes bone healing) Still need post operative care (bandage changes, analgesia, physical therapy)
51
True or false Infections are not always an emergency
FALSE they are always an emergency
52
How often must you recheck external coaptation fixture versus surgical repairs
Coaptation: every 2-3 days Initially then weekly Surgical: at 2 weeks and then every 2-4 weeks
53
When must rechecks happen sooner
If the splints or hardware slips If they aren’t using the limb Infections Pain
54
What are some possible complications associated with fracture healing
Rub sores Tendon contracture Quadriceps contraction or tie down Osteomyelitis (bone infection) Malunion Nonunion
55
What are the 5 categories of physical therapy used after fractures heal
Warm packs Passive range of motion Active motion (recumbent) Active motion (mobile) Cool packs
56
Describe the use of warm packs in physical therapy
Used on tight muscles to loosen/relax them Used before exercise Avoid on joint/inflamed tissue/incisions (increases swelling) 40-45 degrees Celsius for 15-20 minutes Works well with massaging
57
Describe passive range of motion (PROM) in physical therapy
Movement of the muscles while the patient is not moving via physical manipulation Prevents contracture of muscles, ligaments, tendons and scar tissue Prevents muscle atrophy And increases blood flow and Strengthens innervation Must support either side of the joint 20x 1-3 reps minimum 3x a day
58
Describe active motion for recumbent patients in physical therapy
Used for animals that can’t walk on their own Maintains muscle mass, encourages nerve memory Includes standing, rocking, balancing Must keep the patient supported at all time
59
How often should you flip recumbent patients, why do we do this?
Every 2-3 hours Prevents sores and necrosis
60
Describe active motion for mobile patients in physical therapy
Includes slow walks, underwater treadmills and swimming Start on flat, non slippery surfaces for 2-4 weeks for 5-10 minutes And gradually increase duration/frequency/ incline Must keep patient supported
61
What are slings used for in physical therapy
For support Remember to not carry the patient, only support
62
How are cool packs used in physical therapy
Decreases inflammation, swelling and bleeding (vasoconstriction) 10-15 minutes 3x a day Watch shaved areas Use after any active motion or PROM
63
When talking about displacement what portion of the bone do you refer to?
The distal portion If it is moved caudally, it’s considered a caudal displacement

Animal Diseases 2 (4 decks)

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