Long Bone Fractures 1: Cannon Bone And Ulnar Fractures Flashcards
(56 cards)
What is one of the biggest difference between orthopedic surgery in small animals and large animals (horse)?
A horse must be ambulatory and fully weight-bearing in the immdedate post op period after plating
-most fixation devices were not designed for horses
What are the challenges of Large animal fracture fixation?
1) large animals require large plates which need space —> Skin closure is challenging
2) implant failure—>cyclic fatigue
3) Post operative lameness
- contralateral limb lameness
4)orthopedic implants are not large animal specific
What are some post operative complications that can affect the contralateral lim?
1) Contralateral limb laminitis
2) angular limb/flexural limb deformities (due to consistent overloading of the limb)
What are the 5 types of Physeal fractures?
-what is important to know about these?
Salter Harris type 1-5
-decreased prognosis with articulate involvement
What does prognosis decrease with articulate involvement of Physeal fractures?
DJD subsequent to fracture.
Where do condylar fractures most often happen?
Metatarsus/metacarpus 3
Cannon bones
Condylar fractures can be lateral or medial, Which do we see most often?
Lateral
What special view needs to be taken to identify fractures in the articulate surface?
Tangential DP view
- bend the horses fetlock
- highlights palmer aspect of bone to fully evaluate the joint
Why is it important to see/assess comminution at the joint surface in an image (tangential view)
-Condylar fractures
To evaluate prognosis
What is the difference between TB and SB horses with condylar fractures?
TB: RACE HORSES
-forelimb (MC3) >2x more common than hind limb (MT3)
SB:
-Fore and hind limb Cannon bones are equally affected
What is the etiology of Lateral condylar fractures?
- high compressive load
- leads to Osseous adaption/sclerosis
- Microtrauma/ microfracture
= Condylar fracture
What is the CS of a non displaced incomplete condylar fracture
History of lameness with acute exacerbation
What are the CS of an Acute displaced fracture?
1) Acute onset of severe lameness after intense exercise
2) effusion of MCP/MTP joint (FETLOCK)
3) Pain on palpation
What will you do (in the field) if you suspect a lateral condylar fracture?
First aid:
1) compression bandage (stabilize, possible Robert Jones)
2) NSAIDs And SEDATIVE (xylazine) and OPIOID (butorphanol)
3)ABSOLUTE stall rest until definitive treatment undertaken
Possible Kimsey Splint
When would you use Phenylbutazone over flunixin Meglumine?
Bute:
-orthopedic pain
Banamine:
- visceral pain
- ocular pain
How would you surgically treat Lateral Condylar Fractures?
Internal Fixation with transcortical screws in LAG fashion
-compress across the joint
What does LAG screw repair involve?
- 4.5mm or 5.5mm cortical bone screws
- Place in lag fashion
- 2cm apart
- most only require 2 screws
Where do you place the first LAG screw during lateral condylar fracture fixation?
- CLOSE to the joint
- in the Epicondylar fossa of the cannon bone
When performing surgery for condylar fractures, What diagnostic tool should be used to aid placement of LAG screws?
- Fluoroscopy
- Radiographs
- arthroscopy
intraoperatively
Dont forget your bone reduction forceps! Know what these look like
How can you make sure you have realigned the articulations surface properly during internal fixation of a condylar fracture?
Arthroscopy
articulate alignment = no cartilage gap
What is the prognosis for RETURN to RACE for :
A) Non displaced and incomplete condylar fracture
B) Displaced condylar fracture
C) Joint comminution
A) 70-80%
B) 50%
C) <50% Not looking good bro
How are lateral condylar fractures different from Diaphyseal fractures of the Cannon bone?
??????
What is the MOST common LONG Bone fracture in horses?
Diaphyseal fractures of MC3 and MT3
Cannon bone
What is the prognosis of Diaphyseal fractures of MC3 and MT3?
Depends on:
- immediate 1st aid
- external coaptation
