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Surgery III > Fractures of the pelvic limb II > Flashcards

Fractures of the pelvic limb II Flashcards

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1
Q

what may occur with tibial and fibular diaphyseal fx?

A

open fractures

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2
Q

how do tibial and fibular diaphyseal fx primarily occur?

A

trauma

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3
Q

while the fibula is usually fractured, is it stabilized?

A

not unless the stability of stifle or hock is threatened

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4
Q

what predisposes tib/fib diaphyseal fractures?

A

skeletal tumors

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5
Q

the paucity of soft tissue does what for tib/fib diaphyseal fx?

A

increases possibility of open fx, decreases extraosseous blood supply, advantageous for ESF

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6
Q

since tibial fx are mostly from trauma, what else must be evaluated?

A

the whole animal

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7
Q

concurrent injuries to the limb along with tib/fib diaphyseal fx may include what?

A

extensive soft tissue damage or loss

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8
Q

why may proprioceptive responses be abnormal for tib/fib fx?

A

reluctant to move due to pain

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9
Q

what do radiographs of the contralateral limb do?

A

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

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10
Q

animals sustaining fx secondary to trauma need what in terms of lab?

A

blood work done to determine anesthetic regimen and disease

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11
Q

animals with tib and fib fx should be evaluated to determine if fx are a result of trauma or what?

A

neoplasia or metabolic dz

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12
Q

what are conservative management methods for diaphyseal fx?

A

splits and casts for closed, nondisplaced, or greenstick fx

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13
Q

why are casts/splint fixation appropriate for tib fib fx?

A

joint above and below fx bone can be immobilized!

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14
Q

decision to perform open or closed reduction of tibial diaphyseal fx made on basis of?

A

fx configuration, fas, implant

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15
Q

if open reduction of fx tibia performed, what is an important question to ask?

A

will a bone graft be needed?

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16
Q

what is preoperative management of tib/fib fx?

A

analgesics, concurrent injuries, prophylactic abx

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17
Q

during a closed reduction or limited open reduction and ESF, how is the leg prepared? what else should be prepared?

A

leg is prepared from hip to hock, donor site should also be prepared if using bone graft

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18
Q

what other type of positioning is acceptable for tib/fib fx with the leg suspended?

A

open reduction and plate application

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19
Q

how is a cast bivalved for tib fib fx?

A

apply cast material over mx layers of padding and cut lateral and medial aspects

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20
Q

what do IM pins do to stabilize tib diaphyseal fx?

A

provides resistance to bending, additional implants used to provide rotational and axial support

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21
Q

what is used for spiral or oblique fx where the length of the fx line is 2-3 TIMES diaphyseal diameter?

A

IM pin and mx cerclage wires

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22
Q

how is this tib fib fx repaired?

A

IM pin and unilateral ESF for transverse fx

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23
Q

how is this tib fib fracture repaired?

A

spiral or oblique fx - IM pin with multiple cerclage wire

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24
Q

how is this tib fib fx repaired?

A

interlocking nails for non reducible fx

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25
what is critical to avoid with regards to placing IM pins for tib/fib fx
avoid interfering with stifle joint
26
should retrograde IM pinning be performed?
NO - risks damage to intra-articular stx in dogs and patellar lig in cats
27
to estimate appropriate pin penetration into distal bone segment:
2nd pin equal in length to one in marrow cavity for point of reference
28
how are IM pin sizes estimated?
estimate pin size from preop rads, smaller pin may be needed for curve of tib
29
how must pins be placed for tib fx?
normograde manner starting at proximal tibia - manipulate hock to ensure pin doesn't interfere
30
describe normograding an IM pin for tib fx
insert pin medial aspect of prox tibia and penetrate bone midway between tibial tubercle and medial tibial condyle
31
what type of ESF is this to tx tibial fx in patients with high and moderate FAS
type 1
32
what type of ESF is this to treat tibial fx in patients with high and moderate FAS
type Ib
33
what type of ESF is this to treat pt with LOW FAS
minimal type II
34
what plate is used for transverse fx?
compression plate
35
what plate is used to support long oblique fx
neutralization plate
36
what plate is used with or without IM pin to span non-reducible fx
bridging plate
37
what is the bridging plate called with IM pin
plate-rod construct
38
what is used to match normal configuration of the tibia
contouring plate
39
failure to reproduce normal curve of tibia results in...
valgus or varus angulation of limb
40
what are these methods used to stabilize?
transverse or short oblique tibial fx
41
which animals are going to require less rigid fixation?
younger animals - higher FAS score
42
which animals are going to require more rigid fixation?
older animals - lower FAS score
43
what are these methods of stabilization used for?
long oblique or reducible comminuted tibial fx
44
what are these methods of stabilization used for?
stabilizing nonreducible comminuted fractures
45
what are complications of tib fib fx?
osteomyelitis, implant migration, nonunion, malunion, delayed union
46
what are complications with ESF of tib
pin loosening and pin tract drainage
47
cats treated with rigid ESF may be at risk for what?
delayed healing or non union
48
what is the prognosis of tib fib fx?
good after tib fx repair
49
fxs of proximal tibial metaphysis and epiphysis are usually...
transverse or short oblique, may be comminuted
50
fractures of distal tibia in mature animals usually involve what?
malleoli
51
fx of malleoli and erosion injuries that remove malleoli result in loss of malleolar stability which results in
loss of collateral lig function and talocrural instability
52
simple single fractures of proximal tibial metaphysis in dogs with high fas are stabilized with
IM pin
53
what may be added to the IM pin to stabilize proximal tibial metaphyseal fx?
k wire and figure 8 wire or crossed K wires
54
what is the prognosis of tibial and fib metaphyseal fx
heal quickly due to large amounts of cancellous bone
55
in general, how does trabecular bone heal in regards to tib metaphyseal fx?
heals with minimal formation of callus
56
tib/fib physeal fx also called what?
epiphyseal plate fx or slipped physes
57
which physis is weaker than the surrounding bone and ligaments?
cartilaginous physis
58
how are salter harris fx classified?
basis of rads and histologic appearance
59
proximal tib physeal fx is usually which salter fx?
I or II fx
60
distal tibial physeal fx are usually which salter fx?
I or II
61
when are radiographs of opposite limb particularly beneficial regarding tib fib physeal fx?
with tibial tuberostiy avulsion
62
what do radiographs at time of injury do for tib/fib physeal fx?
do not provide info about crushing injuries to physis or damage to blood supply
63
what is the FAS of most physeal fx?
8 to 10 - young animals
64
what should be used when crossing physis in animals with potential growht?
smooth implants
65
displaced tibial open fx treated with open reduction and placement of
crossed k wires
66
what do fx through the physis of the tibial tuberosity result in?
results in proximal displacement of tuberosity, must be reduced and stabilized to restore quadriceps muscle function and stifle extension
67
when is figure 8 ortho wire added if the displacement of fragment occurs when stifle is flexed?
large breed dogs
68
what is the prognosis of tib fib physeal fx?
excellent for healing, prognosis depends on amount of damage
69
when is the prognosis for tib tib physeal fx good?
for fx that separates at zone of hypertrophied cells
70
when is prognosis for tib fib fx poor?
trauma that crushes physis
71
most trauma induced physeal fx sustain damage to growing cells and have what type of prognosis?
guarded prognosis for growth
72
premature closure of proximal or distal tib physis results in
short but straight limb, animal compensates by extending stifel
73
caudal malalignment of proximal tibial epiphysis may result in
increased tibial plateau angel

Surgery III (14 decks)

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