Fractures of the Pelvic Limb I

Question 1

how are femoral fractures usually caused?

Answer 1

trauma

Question 2

what is it called when femoral fractures occur secondary to preexisting bone pathologic condition?

Answer 2

pathologic fractures

Question 3

what is the most common cause of pathologic fractures?

Answer 3

primary or metastatic bone tumors

Question 4

when preexisting disease is present, what do radiographs show?

Answer 4

cortical lysis and new bone formation in area of fracture

Question 5

when is a lytic-proliferative lesion present?

Answer 5

primary bone tumor

Question 6

what are the most common traumatic femoral fractures?

Answer 6

high-velocity injuries - HBC

Question 7

what is used to help detect cardiac or airway abnormalities when traumatic femoral fx cases present?

Answer 7

thoracic auscultation and percussion

Question 8

what does an abnormal heart rhythm and pulse deficit suggest

Answer 8

traumatic myocarditis

Question 9

what does lack of normal air movement on auscultation indicate?

Answer 9

pulmonary contusion, pneumothorax, diaphragmatic hernia

Question 10

why may proprioception appear abnormal during PE for femoral fractures?

Answer 10

reluctant to move limb due to pain

Question 11

what is the purpose of radiographs of the contralateral limb?

Answer 11

assess normal bone length and shape, contour bone plate more precisely, select appropriate sized implants

Question 12

what are medical treatments for animals with femoral fractures?

Answer 12

analgesics for post traumatic pain, abx for open fx

Question 13

explain the use of casts or splints for femoral fractures

Answer 13

contraindicated because adequate stabilization is difficult

Question 14

what is the surgical treatment of choice for femoral fractures?

Answer 14

bone plates used for femoral diaphyseal fractures

Question 15

all affected animals with femoral fractures are examined for what?

Answer 15

concurrent injury

Question 16

why are femoral fractures not usually imobilized preoperatively?

Answer 16

difficulty in applying coaptation splints

Question 17

in rare cases, when can a spica splint be applied to a femoral fx?

Answer 17

preoperative only

Question 18

what dictates pin size used for femoral fx?

Answer 18

shape of femur

Question 19

which femur is straighter? cat or dog?

Answer 19

cat femur straighter - no cranial to caudal bend

Question 20

what is normograde placement of IM pins?

Answer 20

cutting pin at level of trochanter - pin end may injure sciatic n

Question 21

what is retrograde placement of IM pins

Answer 21

hold femur adducted and hip in extension driving IM pin thru trochanteric fossa - may injure sciatic nerve

Question 22

what are important forces for interlocking nails?

Answer 22

bending, rotational, axial

Question 23

why is external skeletal fixation application to femur challenging?

Answer 23

surrounding muscle mass and abdomen and motion of stifle

Question 24

what ESF is used for femur fx?

Answer 24

IM pin combined with type Ia fixator with pin ties to fixator

Question 25

what is ideal for complex or stable fx of femur when prolonged healing is anticipated?

Answer 25

bone plates

Question 26

what type of plate is this

Answer 26

compression plate

Question 27

what type of plate is this

Answer 27

neutralization plate

Question 28

what type of plate is this?

Answer 28

bridging plate +/- IM pin

Question 29

describe the movement of the plate and the bone with use of compression plates

Answer 29

plate shifts away from fx, bone shifts towards fx

Question 30

what are complications of femur fx repair

Answer 30

delayed union, nonunion, malunion, osteomyelitis, pin tract infection, fixation failure, sciatic n injury

Question 31

poor implant choice relative to fx assessment can lead to what?

Answer 31

premature loosesning and migration of IM pings, ESF pins, and cerclage wire

Question 32

if inappropriate implants or techniques are chosen, the implant and body connection are subjected to what?

Answer 32

subjected to excessive stress, promotes micromotion at implant- bone interface

Question 33

if stress is moderate over time, what is expected of the implant

Answer 33

implant expected to remain stable

Question 34

when does breakage of implants occur

Answer 34

occurs through fatigue

Question 35

what are common errors during femoral fx repair

Answer 35

failure to provide adequate rotational stability, single IM pin used, attempting to reconstruct nonreducible fx

Question 36

where do femoral neck fx occur?

Answer 36

base of neck where it joins metaphysis of proximal femur

Question 37

what do articular fx involve?

Answer 37

joint surface

Question 38

where do epiphyseal and metaphyseal fx occur?

Answer 38

trabecular bone at proximal or distal end of femur

Question 39

what is the angle of inclination?

Answer 39

femoral neck - femoral shaft junction in frontal plane

Question 40

what is the normal angle of inclination?

Answer 40

135 degrees

Question 41

what is anteversion?

Answer 41

external rotation of proximal femur relative to distal femur

Question 42

what is the normal angle of anteversion?

Answer 42

15 to 20 degrees

Question 43

which approach is most often used for femoral head and neck fx?

Answer 43

craniolateral approach to hip

Question 44

femoral head and neck fx are best stabilized with what?

Answer 44

lag screws

Question 45

describe this stabilization

Answer 45

stabilization of femoral unicondylar fx with lag screw

Question 46

describe this stabilization

Answer 46

bicondylar fracture stabilized with lag screw and dynamic cross pinning

Question 47

what does controlled limb use offer for femoral fx rehabilitation?

Answer 47

optimize limb function - important for fx affecting stifle

Question 48

how often are radiographs repeated after femoral fx repair?

Answer 48

6 week intervals until fx healed

Question 49

what is the most common implant error for femoral fx repair?

Answer 49

use k wires or small pins when fx indicates prolonged healing

Question 50

what is the most common problem reported with femoral neck fx?

Answer 50

inappropriate reduction and poor implant choice

Question 51

what does micromotion at pin bone interface cause?

Answer 51

pins to loosen early - avoided by lag screw

Question 52

femoral neck fx that fail to heal are usually treated how?

Answer 52

FHO

Question 53

who is most affected by femoral physeal fx?

Answer 53

<10 months - young male dogs more likely for trauma, young heavy male cats neutered before 6 months

Question 54

capital physis provides femoral neck length until how old?

Answer 54

8 months of age

Question 55

what provides most of the femoral length?

Answer 55

distal physis

Question 56

how do physeal fractures heal?

Answer 56

rapidly, but physis does not continue to function

Question 57

the younger the animal with a physeal fx...

Answer 57

the more dramatic effects of premature closure of physis

Question 58

why is surgery required for femoral physeal fx?

Answer 58

prevent severe DJD

Question 59

with greater trochanter separation, what must be done to the physis?

Answer 59

physis must be anatomically reduced and stabilized with tension band - counteract forces of gluteal m

Question 60

how do you stabilize proximal femoral physeal fx with lag screw?

Answer 60

2 k wires, drill glide hole between them, reduce fx advance wires, insert lag screw

Question 61

what is a frequent post op observation associated with proximal femoral physeal fx that doesnt have clinical significance?

Answer 61

apple coring

Question 62

what are complications if proximal physeal fx not appropriately reduced or if implants penetrate articular cartilage?

Answer 62

significant OA develops

Question 63

what is the EXCEPTION to stabilizing distal femoral fractures?

Answer 63

single IM pin