Long Bone Fractures I (Cannon Bone and Ulnar) Flashcards Preview

Large Animal Surgery > Long Bone Fractures I (Cannon Bone and Ulnar) > Flashcards

Flashcards in Long Bone Fractures I (Cannon Bone and Ulnar) Deck (77):
1

What are the two most common locations of condylar fractures?

- Metacarpus 3
- Metatarsus 3

2

Do condylar fractures occur in the lateral condyle, medial condyle or both?

Both

3

What type of view is necessary to highlight the palmar aspect of bone and fully evaluate the joint?

Tangential view

4

If there is a comminution at the joint surface of a condylar feature, what should be done?

The fragment should be removed.

5

Condylar fractures are seen predominantly in what type of horses?

Young racehorses

6

Are the majority of condylar fractures lateral or medial?
What percentage?

- Lateral
- 85%

7

What do medial fractures tend to do?

Spiral up the leg.

8

Which are more common in TBs, MC3 or MT3 condylar fractures?

MC3

9

Which are more common in SBs, MC3 or MT3 condylar fractures?

Both are about equal.

10

What are 3 possible causes of condylar fractures?

- High compressive load
- Asynchronous longitudinal rotation of the cannon bone
- Young racehorses during fast work or race

11

A history of lameness with acute exacerbation can be seen with what type of condylar fracture?

Non-displaced incomplete condylar fractures

12

An acute onset of severe lameness after intense exercise can be seen with what type of condylar fracture?

Acute displaced condylar fracture

13

Effusion of the MCP/MTP joint can be seen with what type of condylar fracture?

Acute displaced condylar fracture

14

Can on palpation can be seen with what type of condylar fracture?

Acute displaced condylar fracture

15

What is the most common treatment used for the majority of condylar fractures?

Internal fixation with transcortical screws in lag fashion

16

What are 3 first aid components involved with a lateral condylar fracture of the cannon bone?

- Compression bandage
- NSAIDs
- Absolute stall rest until definitive tX is undertaken

17

What should be placed on patient with a fracture if trailering is necessary?

Kimzey splint

18

What type of alignment is important with condylar fracture repair?
What should there not be?

- Articular alignment
- No cartilage gap

19

What should be used during surgery in order to evaluate the reduction and alignment of the articular surface?

Arthroscope

20

Where should the first screw be placed with a condylar fracture?
What is a good target for this?

- Close to the joint
- Epicondylar fossa

21

What kind of screws should be used with lag screw repair?

4.5 or 5.5 mm cortical bone screws

22

Placing screws in a lag fashion across a fracture causes what?

Compression of the fragment together.

23

How far apart should lag screws be placed when used for condylar fracture repair?

20 mm apart

24

Most condylar fractures only require how many lag screws?

2 screws

25

What type of condylar fractures have a 70-80% favorable prognosis?

Non-displaced and incomplete

26

Prognosis for condylar fractures is not as good if what 2 conditions occur?

- Displaced
- Joint communication

27

What are the most common long bone fractures in horses?

Diaphysial fractures of MC3 and MT3

28

What does the prognosis depend on with diaphysial fractures of MC3 and MT3 in horses?

Dependent on immediate management of fracture - how fracture was treated in the field.

29

What type of compression is important with diaphysial fracture repair?
What is the goal of this?

- Inter-fragmentary compression
- Transform comminuted fracture into 2 fragments

30

How should be plates be placed for a diaphysial fracture of the cannon bone?
Why?

- Plates should be staggered
- Allows screws to intersect each other and not hit

31

What needs to be done to a diaphysial fracture before plates can be put on?

Fracture needs to be reduced.

32

What is the optimal treatment for a simple transverse fracture of the diaphysis of a cannon bone?

Double plate fixation

33

Which side of a bone is a plate usually placed on?

Tension side

34

What is a tool that can be used to compress a fracture with a broad DCP plate?

Load drill guide

35

What are 4 types of plates that can be used for fracture repair?

- Dynamic compression (DCP)
- Limited contact-dynamic compression (LC-DCP)
- Locking compression (LCP)
- Anatomic/specialty

36

What does DCP stand for?

Dynamic compression plate

37

What does LC-DCP stand for?

Limited contact-dynamic compression plate

38

What does LCP stand for?

Locking compression plate

39

What is a type of plate that has continuity of bending stiffness and improved blood supply under the plate?

Limited contact-dynamic compression plate (LC-DCP)

40

What are 4 types of plate functions?

- Compression
- Neutralization
- Tension band
- Buttressing

41

2 screws on either side of a fracture are placed under load with what type of plate function?

Compression

42

What type of functioning plate is placed after anatomic reconstruction with screws inserted in a neutral position?

Neutralization

43

What type of functioning plate transforms tensile forces into compressive forces?

Tension band

44

What type of functioning plate is placed to bridge the area of bone defect?

Buttressing

45

A self-compressing plate where screws can be angled in many directions and can be adapted to different internal fixation needs is what?

Dynamic compression plate (DCP)

46

Screws used in a dynamic compression plate (DCP) can be placed up to what angle?

25 degree angle

47

Does a dynamic compression plate (DCP) have uniforms bending stiffness?

No

48

What is a type of plate that is adaptable for different internal fixation needs with limited contact due to a grooved undersurface?

Limited contact-dynamic compression plate (LC-DCP)

49

What type of plate has uniform bending stiffness?

Limited contact-dynamic compression plate (LC-DCP)

50

Screws used in a limited contact-dynamic compression plate (LC-DCP) can be placed up to what angle?

40 degree angle

51

What type of plate provides dynamic compression with atraumatic and minimally invasive application and has limited contact with a grooved undersurface?

Locking compression plate (LCP)

52

"Combi Holes" found in locking compression plates (LCP) can permit what?

Permit combined use of conventional and locking screws.

53

Locking screws used with locking compression plates are what size?
Cortex screws are what size?

- 4.0/5.0 mm
- 4.5/5.5 mm

54

What type of plate can be placed using standard screws or locking screws?

Locking compression plates (LCP)

55

What do locking screws increase?

Stability and fixation strength of the plate/screw construct.

56

T/F: The goal for horses is to be ambulatory and fully weight-bearing in the immediate post-op period after plating for diaphysial fracture repair.

True

57

What is the major problem with using fixation devices in large animals?

Most fixation devices were not designed for horses so may have implant failure.

58

Since large plates occupy more space, this makes what more difficult?

Skin closure

59

Most fractures of the ulna involve which part?

Olecranon

60

What group of muscles inserts on the olecranon?

Triceps

61

What is a common etiology of ulnar fractures?
What are 2 examples of this?

- Direct trauma
- Kick, injury during halter training of weanlings

62

What is a common presentation of an olecranon ulnar fracture?

Dropped elbow with carpus in flexion

63

What are 4 differentials for a horse with a dropped elbow with the carpus held in flexion?

- Humeral fracture
- Radial nerve paralysis
- Olecranon fracture
- Neuro disease

64

Ulnar fractures can result in disruption of what?

Disruption of the stay apparatus.

65

Ulnar fractures require what type of external coaptation?

Splint to fix carpus in extension

66

Where should a splint be placed when being used for an ulnar fracture?

Apply splint palmarly extending from the fetlock to the level of the elbow.

67

What is an important consideration when placing a splint for an ulnar fracture?

Use adequate padding

68

What is a good material to use for a splint when doing a full limb bandage?

Schedule 40 PVC

69

A Salter-Harris type 1 fracture with minimal displacement needs what type of fixation?

Needs internal fixation

70

If a foal weighing less than 250 kg has a Salter-Harris type 1 with minimal displacement, what is a fixation option?
If the horse is larger, what must be used?

- Tension band technique using screws and wires.
- Must use a plate

71

With a displaced Salter-Harris type 1b fracture with comminution of the anneal process, what is an important thing to remember to do?
Why?

- Remove fragments
- If fragments were left, more likely to develop OA

72

What is the treatment of choice for an olecranon fracture?

ORIF

73

What is a special type of plate that can be used for a foal less than 250 kg?

Hook plate

74

What has to be done with the bone plate for an olecranon fracture?

Contoured to fit over the top of the olecranon tuberosity.

75

Where can screws be added with an adult horse to help ensure rigidity of the fixation?

Distal screws can be inserted int eh caudal cortex of the radius.

76

What should not be done with screws used in ulnar fracture repair in horses less than a year old?
Why?

- Distal screws should not engage the radius.
- May lead to subluxation of the elbow.

77

What is the prognosis for ulnar fractures when internal fixation is used?

Good (68-87%)