Pre-Op Appendicular (Betance 5) Pics added need to input answers

Question 1

Classify the fracture, state score, tx and reasoning behind this

Answer 1

• Salter-Harris Type II Fracture
• Fracture assessment score: 7-10
• patient is young.
• Tx
  
  • Place diverging pins that will resist rotation at the point of the fracture site.
  • Growth physis will continue to grow despite having pins going through it.

Question 2

Classify the fracture, assign a score, and tx and reasoning

Answer 2

• Medial maleolar fracture
• if this causes an instability, must repair because there are distractive forces associated with flexors pulling on maleolus.
• TX
  
  • Would use a tension band or a lag screw.
  • Would treat a lateral maleolar fraction in the same way.

Question 3

Classify the fracture, assign score, and TX

Answer 3

• Communited diaphyseal fracture.
• Short oblique. Non-articular.
• Fracture assessment score is 7-9.
• TX
  
  • Type 1a external fixator on the lateral humerus.
  • Bone plate.
  • OR Interlocking nail.

Question 4

CLASSIFY THE FRACTURE, STATE SCORE, AND TX AND WHY?

Answer 4

• Because this dog has multiple limb injuries, it decreases the fracture assessment score (now 4-7).
• TX
  
  • Would reduce this luxation, but then need to place leg in an Ehmer sling so the other leg will need to bear significant weight.
  • Placed an intermedullary pin and a type 1a external fixator to repair the front left leg.

Question 5

Classify the fracture, state score, TX and why?

Answer 5

• Transverse, mid diaphysial fracture in a large dog.
• Fracture assessment score is based on size of patient: 5-7.
• TX
  
  • Plate
  • interlocking nail because of size of patient
  • Watch out for the radial nerve!

Question 6

you know the drill state whatcha know

Answer 6

• Olecranon fracture
  
  • distractive forces from the triceps.
• Fraction assessment score 5-7.
  
  • (multiple limb fracture so score goes down)
• TX
  
  • Would use tension band to repair this fracture.

Question 7

You know the drill

Answer 7

• Fracture assessment score is pretty high because young patient, and simple fracture.
• TX
  
  • Repair with a tension band.

Question 8

You know the drill

Answer 8

• Salter Harris II of distal femur.
• Fracture assessment score is high.
• TX
  
  • use cross pins or rush pins in patients that are older (8-9 months of age) and almost have closed growth plates.
  • Need to worry about quadriceps contracture with this fracture.
  • Make sure to do rehab therapy with these dogs and do not cast or splint this leg.
  • Also can use a single IM pin with a single cross pin if you don’t want as much stability as the cross pin gives.

Question 9

You know the drill

Answer 9

• Femur: mid diaphysial, comminuted fracture (3 segments)
  
  • TX
    
    • -repair with IM pin+ external fixator
• Tibia: Comminuted, mid diaphysial fracture short oblique
  
  • TX
    
    • -repair with type 1 or 2 external fixator
• Fracture assessment score: 4-6

Question 10

you know the drill, also state the 3 As for why we have to monitor this patient closely

Answer 10

• Spiral fracture.
• Fracture assessment score (patient is old): LOW.
• TX
  
  • Need to provide ultimate stability.
  • In repair of this fracture, used calcaneus and spanned the joint because there was not much bone in the distal fracture segment to place any pins for fixation.
  • Placed a type II external fixator.
• • Need to monitor this patient closely.
    
    • 3 A’s of fracture assessment:
      
      • 1. Alignment: are fracture fragments in same position as in immediate postoperative radiograph?
      • 2. Apparatus: is the apparatus stable?
      • 3. Activity: does the fracture site show progression in healing?

Question 11

you know the drill

Answer 11

• Avulsion fracture of the tibial tuberosity
  
  • distraction forces from the patellar tendon.
  • Fracture assessment score: high.
• TX
  
  • Can repair with tension band.

Question 12

You know the drill

Answer 12

• Salter Harris type I of the femoral head.
• Fracture assessment score: high.
• TX
  
  • Would repair with diverging pins, but do not allow the pins to go into the joint.

Question 13

You know the drill

Answer 13

• Green stick fracture.
• Fracture assessment score= 12.
• TX
  
  • Can splint this, but don’t really have to.
  • The fracture should heal, but the patient still has growth potential.
  • Any time there is trauma in the radius and ulna diaphysial area, worry about injury to the physis.

Question 14

Question 15

Question 16

Classify the fracture and assign a score:

Answer 16

• Long oblique
• Simple femur fracture
• High fracture score: 9-10

Question 17

Classify the fracture and assign a score:

Can you use full cerclage wire for this fracture?

Treatment?

Answer 17

• Short Oblique
• Fracture score: 8-9
• Can’t use full cerclage wire for short oblique
• TX:
  
  • ESF Type 1a or B
  • Plate
  • Interlocking nail

Question 18

Classify the fracture and assign a score:

Answer 18

• Short Oblique of proximal diaphysis of tibia and fibula
• Fracture score: 9-10
• Treatment:
  
  • ESF
  • IM pin normograde
  • cerclage
  • lag screw
  • bone plate?
  • External coaptation

Question 19

Classify the fracture and assign a score:

Answer 19

• Comminuted fracture
• FX score: 3-4
• Tx
  
  • NO IM PIN or CERCLAGE wire

Question 20

Classify the fracture and assign a score:

Answer 20

• Distal humerus (diaphyseal comminuted)
• Fracture Score 2-3
• Treatment:
  
  • Bone plate with rod
  • ESF

Question 21

Classify the fracture and assign a score:

Answer 21

• Transverse radius and ulna distal piaphysis
• FX score: 4-5
• Treatment: ?

Question 22

What is the treatment?

Answer 22

bone plate

Question 23

Classify the fracture and assign a score:

Answer 23

• Ulnar fracture
• Luxation of prximal radius
• Monteggia fx

Question 24

Classify the fracture and assign a score:

Answer 24

• Salter harris IV
• Lateral Condylar fx
• Score 5-7
• Treatment
  
  • Lag screw

Question 25

Classify the fracture and assign a score:

Answer 25

* T or Y bicondylar fracture * Score: 3-5 * Tx: * Bone plate xz

Question 26

Classify the fracture and assign a score:

Answer 26

* Transverse Radius and Ulna fracture * Score: 6-8 * Tx: * External coaptation * need more support * bone plate