Long Bone Fractures II

Question 1

Femoral Physeal Fractures:

Etiology:
1.
2.

Answer 1

1. Dystocia

2. Group housed juvenile cattle

Question 2

Femoral Physeal Fractures:

Treatments:

1.
2.
3.

Answer 2

1. Stall rest
2. FHO - not succesfull
3. ORIF via pins/screws

Question 3

Femoral Physeal Fractures:

IM Pin Repair:
1. Use how many pins? What size?

Answer 3

two pins

3/16th inch

Question 4

Femoral Physeal Fractures:
IM Pin Repair:

Insert through ______ from the _____.

Penetrate the ____ with fracture reduction

Answer 4

through femoral neck from caudolateral femur

penetrate the femoral head

Question 5

Femoral Physeal Fractures:

In a foal, you can use ______ as a treatment method.

Answer 5

Dynamic Hip Screw system (DHS)

Question 6

Treatment methods for Tibial Fractures

1
2.

Answer 6

1. External coaptation

2. Thomas Schroeder Splint/Cast combo

Question 7

T/F: If a mostly healed fracture repair site becomes infected, you have to take everything out and treat the infection, than re-apply the fixators again.

Answer 7

F, take everything out and it’ll probably still result in a healed fracture without having to put it back in.

Question 8

Potential complications of stall confinement as treatment for fractures:

1.
2.
3.

Answer 8

1. Non union and mal union
2. Breakdown or laminitis of the opposite limb
3. Negative effect of the age and weight of the patient.

Question 9

Treatment of Humeral Fracture via ORIF with plates:

Reasons it is challenging:

1.
2.
3.
4.

Answer 9

1. Surgical approach is difficult
2. Risk of injury to radial nerve
3. Irregular contour of the humerus
4. Economic concerns

Question 10

Humeral Fracture: Describe the splint design you’d want for 1st aid and transportation?

Answer 10

should be on palmar aspect of elbow, with another splint at 90 degrees that will end up at the shoulder

Question 11

T/F: You should splint a 140kg foal during transport before repair

Answer 11

F

ineffective to splint them and we’d just be adding extra weight which would exacerbate the problem

Question 12

How would you treat a 140 kg foal with a closed short oblique fracture of the humerus with marked displacement and over-riding?

Answer 12

stabilize it with interlocking nail and two cerclage wires

Question 13

Advantages of using interlocking nails to repair a humerus?

1.
2.
3.
4.

Answer 13

1. Resists collapse at the fracture site
2. Rotationally stable
3. Prevents migration of the implant
4. less invasive

Question 14

Disadvantages of using interlocking nails as treatment for humerus fracture?
1.
2.

Answer 14

1. Inadequate for adult large animals

2. Requires specialized equipment and techniques

Question 15

External Fixators:

Transfixation pins can be supported by:
1.
2.
3.

Answer 15

1. External frame
2. Acrylic resins
3. Cast material

Question 16

When applying transfixation pins and casting:

1. (does/does not) require antibiotics?
2. (does/does not) require general anesthesia?
3. What kind of recumbency most of the time?

Answer 16

1. does
2. does
3. dorsal

Question 17

External Fixators as treatment for mid-diaphyseal short oblique tibial fracture:

1. _____ are placed as guides for pin placement?
2. Minimum # of pins per fragment?*****

Answer 17

1. Needles

2. 2 pins/fragment

Question 18

Transfixation Pin Cast Placement:

1. Incision on (medial/lateral) aspect of the limb?
2. Pins inserted between the ____.
3. _ mm drill bit.
4. pin size?

Answer 18

1. lateral
2. muscles
3. 4.5
4. 6.35mm

Question 19

During transfixation pin cast placement, you should constantly be doing what? Why?

Answer 19

Lavaging.

You can cause thermal damage to the bone and potentially lead to sequestrum

Question 20

Two main types of large animal external fixators:

1.
2.

Answer 20

1. Type 2

2. Type 3

Question 21

LA External Fixators:

1. Type 2’s are placed ____ to _____
2. Type 3’s have ____ to ____ directed half-pins.

Answer 21

1. laterally to medially

2. Cranially to caudally

Question 22

How long to remove pins after fixation?

How much more additional stall rest after removal?

Answer 22

6-8 weeks

2 weeks

Question 23

Advantages of TPC (transfixation pin casts) in farm animals:

1.
2.
3.
4.
5.
6.

Answer 23

1. Maintenance of reduction (less motion than cast)
2. Early weight bearing
3. Flexibility in pin positioning
4. Availability of pins and casting material
5. Comparable to side bar/clamp and plates/screws
6. Less expensive than plates and screws

Question 24

Disadvantages of TPC in farm animals:

1.
2.
3.

Answer 24

1. no adjustment after application
2. restricted access to soft tissue
3. requires GA

Question 25

Number of pins/fragment in a larger animal (ie cattle)?

Answer 25

3-5

Question 26

Plate luting:

Uses ____ to create _____

Answer 26

PMMA (bone cement) to create 100% bone-plate contact.

Question 27

End result of plate luting?

Answer 27

increased strength of repair

Question 28

Typically the rule for repairing a fracture of the radius AND ulna together is…..

What is the exception to this rule?

Answer 28

Repair the radius, and the ulna will follow.

If there is an olecranon injury!

Question 29

Transfixation Pin Casting in Equine:

Used for ________ fractures of MTIII or MCIII

Answer 29

comminuted phalangeal fractures

Question 30

Transfixation Pin Casting in Equine:

of pins?

__-__mm diameter pins?

Answer 30

2-3 pins,

4-6 mm in diameter

Question 31

Transfixation Pin Casting for treatment of comminuted phalangeal fractures in Equine:

Pins placed in ____ bone

___ degree divergence of the pins in the frontal plane

use only ____ profile pins

Answer 31

1. metaphyseal bone
2. 30 degree divergence
3. positive profile