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LAS - RUSS > Long Bone Fractures 1 > Flashcards

Long Bone Fractures 1 Flashcards

1
Q

85% of long bone fractures in young racehorses are….

A

lateral condylar fractures

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2
Q

In a thoroughbred horse, which is a more common fracture location, MCIII or MTIII?

What about in a standardbred?

A

in TB, its 2x more likely to be MCIII

in SB, they are about equal

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3
Q

T/F: Long bone fracture etiology is usually NOT due to a single event injury

A

T

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4
Q

What is the most common etiologic pathway for a long bone fracture in equine?

  2. leads to ______
  3. causes ____/____
  4. end result is ___ fracture
A
  1. High compressive load
  2. Leads to osseus adaption/sclerosis
  3. microtrauma/microfracture
  4. condylar fracture
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5
Q

What is the most common clinical presentation for a non-displaced incomplete fracture in equine?

A

history of lameness with acute exacerbation

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6
Q

What are the three signs of the clinical presentation that would suggest an acute displaced fracture in an equine?

A
  1. acute onset of severe lameness after intense exercise
  2. effusion of MCP/MTP joint
  3. Pain on palpation
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7
Q

Condylar fracture treatment:

A

Internal fixation with transcortical screws in lag fashion

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8
Q

First aid components for a lateral condylar fracture include:

1.
2.
3.

A
  1. Compression bandage
  2. NSAIDs
  3. ABSOLUTE stall rest until definitive tx is undertaken
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9
Q

During the articular alignment stage during the treatment of a lateral condylar fracture, it is very important that there is no…..

A

cartilage gap

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10
Q

In a lateral condylar fracture repair, the first screw is placed (close to / far from) the joint?

Ideal location?

A
  1. close to

2. Epicondylar fossa

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11
Q

Lag screw repair of condylar fracture:

  1. Screw size?
  2. Place screws how far apart?
  3. Most require how many screws?
A
  1. 4.5 mm or 5.5 mm cortical bone screws
  2. 20 mm
  3. only 2
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12
Q

Prognosis for RTR for condylar fracture if:

  1. non-displaced or incomplete?
  2. displaced?
  3. worst prognosis if ____
A
  1. 70-80%
  2. 50%
  3. joint comminution exists
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13
Q

Most common long bone fracture in horses?

A

Diaphyseal fractures of the cannon bone (MCIII and MTIII)

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14
Q

Prognosis for diaphyseal fractures of MCIII and MTIII are dependent on _______.

Best treatment method?

A

immediate 1st aid.

External coaptation via Double Plate Fixation.

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15
Q

Cannon Bone Fracture Repair:

Plates are placed on the (tension/non-tension) side of the bone.

_____ compression is EXTREMELY IMPORTANT

A

tension.

Inter-fragmentary

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16
Q

Fracture compression during treatment of Cannon Bone fractures:

  1. ______ is used to compress a fracture with a plate.
  2. Max __mm compression using plate holes.
A
  1. load drill guide.

2. 4 mm

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17
Q

Types of plates used for repair of cannon bone fractures?

1.

2.

3.

4.

A
  1. Dynamic Compression (DCP)
  2. Limited Contact - Dynamic Compression (LC-DCP)
  3. Locking Compression (LCP)
  4. Anatomic / Specialty
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18
Q

Plates for Cannon Bone Fracture Repair:

Which one is preferred? Why?

A

LCP - it’s specifically designed for equine fracture repair.

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19
Q

What are the two benefits of a LC-DCP?

A
  1. Continuity of bending stiffness

2. Improved blood supply under plate

20
Q

4 main functions of plates during cannon bone fracture repair

1.
2.
3.
4.

A
  1. Compression
  2. Neutralization - placed after anatomic reconstruction so the screws are inserted in a neutral position
  3. Tension band - transforms tensile forces into compressive forces
  4. Buttressing - placed to bridge the area of bone defect
21
Q

Cannon bone fracture repair:

Maximum # of screws placed on either side or fracture?

Placed when fracture (is/is not) under load?

A
  1. 2

2. when it is under load

22
Q

Name the type of Plate:

It’s self-compressing, the screws can be angled in many direction, it can be adapted to different internal fixation needs, and the screws can be placed orthogonally or up to a 25 degree angle.

A

DCP

23
Q

Name the type of plate:

It has a limited contact with a grooved undersurface, it has a uniform stiffness, and it has a DCU hole that allows screws to be placed at a 40 degree angle.

A

LC-DCP

24
Q

T/F: LC-DCP plates are adaptable for different internal fixation needs?

A

T

25
Q

Name the type of plate:

It can undergo dynamic compression, it has limited contact and a grooved undersurface, It has combi-holes that permit the combination of conventional or locking screw, and it can be applied with minimal invasiveness.

A

5.5mm LCP

26
Q

Screws used with LCP plates:

What are the two kinds? What size are they in mm? What are their functions?

A

Locking and Cortex

Locking is 4.0/5.0 mm
Cortex is 4.5/5.5 mm

Locking screw provides angular stability, cortex screw provides compression/neutralization

27
Q

LCP can be placed using ____ screws or _____ screws.

A

standard screws or locking screws

28
Q

What are the two main benefits of using locking screws to place an LCP?

A
  1. increased stability

2. increased fixation strength

29
Q

Horses must be _____ and ______ in the IMMEDIATE post-op period after plating

A

ambulatory and fully weight-bearing

30
Q

Challenges for large animal fracture fixation:

1.
2.
3.
4.

A
  1. large plates occupy space making skin closure difficult
  2. Implant failure
  3. Post-op lameness (contralateral limb lamenesses)
  4. Large animal specific orthopedic implants would facilitate equine fracture repair
31
Q

Ulnar Fracture etiology:

1.

A
  1. Direct trauma via external trauma ie injury during halter training
32
Q

Most common presentation of ulnar fracture?

A

Dropped elbow with carpus in flexion

33
Q

DDx for Ulnar Fracture:

1.
2.
3.
4.

A
  1. Humeral fracture
  2. Radial nerve paralysis
  3. Olecranon fracture
  4. Neuro dx (rare)
34
Q

Ulnar Fracture:

Results in disruption to the ______

A

Stay aparratus

35
Q

Do/do not use a splint for an ulnar fracture?

A

Do

36
Q

Why splint an ulnar fracture?

A

to fix the carpus in extension

37
Q

Splints for ulnar fractures should be applied to the (dorsal/palmar) side, extending from the ____ to the _____

A

palmar,

fetlock to the level of the elbow

38
Q

If an ulnar fracture is in an animal less than 250 kg, you can repair it via…..

if larger?

A

tension band technique (screws and wires)

you must apply a plate

39
Q

Olecranon fracture repair: Treatment of choice?

A

ORIF

40
Q

Olecranon fracture repair:

Use _____ principle

A

Olecranon fracture repair:

tension-band

41
Q

Olecranon fracture repair:

Plate applied to (caudal/cranial) ulna?

What plates can you use?

A

caudal ulna

Narrow DCP, LC-DCP, LCP

42
Q

Describe how you’d apply a bone plate for an olecranon fracture repair?

A

contour the plate to fit over the top of the olecranon tuberosity

43
Q

Olecranon fracture repair:

In an adult horse, distal screws can be inserted in the _______. Why do this?

A

caudal cortex of the radius

ensure a rigid fixation

44
Q

Olecranon fracture repair:

Why would you not insert distal screws into the radius in a young horse?

A

it may lead to subluxation of the elbow

45
Q

Olecranon fracture repair:

Prognosis?

A

Good with ORIF - 68-87%

LAS - RUSS (32 decks)

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