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Eq SX Musc Skel Exam > Principles of equine fx repair > Flashcards

Principles of equine fx repair Flashcards

(50 cards)

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1
Q

Classification of fractures

A
  1. complete/incomplete
  2. stable/unstable
  3. open/closed
  4. configuration
    - Greenstick/fissure
    - Transverse
    - Oblique
    - Spiral
    - Comminuted
    - Multiple
    - Impacted
    - Avul/Diaphy/Metaphy/Pyseal (salt-H)/Epiph/apophy/articular
    - Other
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2
Q

Stable fracture

A

Cortical continuity, positive prognosis

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3
Q

Open fracture classification

A

Type 1: < 1cm diameter skin perf, no loss soft tissue, no bone exp or gross contam
Type 2: Larger skin lac, little loss skin tis, minimal exp bone, min gross contam
Type 3: Extensive lac, massive skin defects, gross contam soft tis and fx bone

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4
Q

Main criteria for repair

A
  1. Minimal comminution
  2. 180 degress cortex (strut) for axial load
  3. Closed fx
  4. Sensible horse
  5. Pain control, well trained staff, well designed recovery system
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5
Q

Foals are less likely to suffer from

A

Support limb laminitis

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6
Q

Foals are more likely to develop

A

Angular limb deformity from abnormal load of physes

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7
Q

Foal implant removal may be indicated

A

When fracture has completely healed

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8
Q

Stall rest

A

-Splints (don’t require fixation)

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9
Q

Fractures that will heal w/ minimal intervention

A
  1. Deltoid tubercle of humerus
  2. Non-articular patellar fractures
  3. Fractures of scapular spine
  4. Some pelvic fractures
  5. Third trochanter of femur
  6. Stress fractures
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10
Q

Risk of conservative tx

A

catastrophic propagation of long bone fx

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11
Q

Splint coaptation

A

Tx incomplete fx tibia or radius

  • emergency support, not only means
  • prevent animals from lying down with head tie/sling
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12
Q

Casts

A 
Supplements internal fixation/P3 wing fx 
Can cause
-calus formation
-delayed/failed union
-breakdown opposite limb
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13
Q

Casting procedure

A
  • Palpate daily for heat/swelling/moisture
  • First cast changed after 3-4 days
  • Foal casts then changed q10-14d
  • Adult casts then changed q5-6 weeks
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14
Q

When casted watch for

A 
Lameness
Swelling
Odor
Moisture
Heat
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15
Q

Three types external fixation constructs in horses

A
  1. transfixation-pin casts
  2. external fixators
  3. external skeletal fixation devices
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16
Q

External fixation constructs indications

A
  1. Open fractures
  2. Severely comminuted fractures distal limb
    - when ORIF is not possible
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17
Q

External fixation constructs not used for

A

proximal limb fractures, not possible to apply

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18
Q

Transfixation pin casts indications

A
  1. Comminuted phalangeal fractures
  2. Distal MC/MT3 fx
  3. Breakdown injuries of the MCP joint
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19
Q

Transfixation pin cast procedure

A
  • 2-3 cross pins placed in metaphyseal region bone proximal to fracture
  • Pins incorporated into full/half-limb fiberglass cast
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20
Q

External skeletal fixators

A
  • Allow immediate sub-normal weight bearing
  • Allow access to open wounds for tx
  • Not enough axial support for most adults
  • Used in non-weight bearing fractures (mandibular)
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21
Q

External fixation complications

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A
  1. Pin loosening, likely infection
    - removal and curettage
  2. Pin tract infection/fx
  3. Grade 1-3 minor infection can continue external fixation
  4. Grade 4-6 major infection must abandon external fixation
22
Q

Insufficient external fixation

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A

Limb remains painful and increases risk of supporting limb laminitis

23
Q

Required cortex for successful repair

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A

180 degrees of intact cortex

24
Q

Anatomic reconstruction joint surfaces required for

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A

preventing development of Osteoarthritis

25
Long bone fx repair
Screws and plates
26
Intramedullary fixation with pins and orthopedic wiring
Can only be applied in a few, limited circumstances
27
Orthopedic screws weakest in
Bending and shear
28
Screw strength determined by
Core diameter
29
Resistance of screw to bending related to
radius to the fourth power
30
Cortical screws
Larger core diameter and small diameter threads | -preferred in adult equine bone
31
Cancellous screws
Smaller core diameter with larger diameter threads | -reduces screw pull out
32
Cortex screws can be
1. Inserted as position screws 2. Inserted as implant screws 3. Placed in lag fashion
33
Cortex screws expected to withstand weight-bearing loads should be placed
perpendicular to the long axis of the bone
34
Screws may be used to
reconstruct fracture fragments | -then a plate is applied to withstand weightbearing forces
35
Commonly used plates
1. DCP (Dynamic compression plate) 2. LC-DCP (limited contact dynamic compression plate) 3. LCP (locking compression plate)
36
Recommended rate of drilling
1mm/s
37
Temp that causes bone necrosis and protein coagulation
54 degrees celsius
38
Saline used as
lubricant | -not to cool drill or bone
39
Temperature generation is inversely related to
Drilling rate
40
Plate fixation procedure
1. Minimum of 3 screws (6 cortices) should be engaged on each side of fracture frag 2. Plate generally applied to entire length of the bone (prevents stress riser at plate termination) 3. Screw placed into every plate hole when possible
41
Plates strongest in
tension | -apply to tension side of fracture
42
Plates weak in
torsion
43
Plates weakest in
bending
44
Persistent cyclic loading results in
implant failure
45
Inability to transmit load across the fracture site will result in
implant deformation
46
Load transmission across fracture line for anatomic reduction results in
stability
47
plate applied in compression contoured to fit bone perfectly
compression of fracture only occurs on cis cortex - trans cortex remains decompressed - slight over-bending of plate at fx line results in compression across entire fracture line
48
Locking compression plates
Two treatments in one 1. compression plating 2. internal fixation
49
Equine fx repair complications
1. Implant infection 2. breakdown of implants/fracture repair 3. Supporting limb laminitis
50
Foal fx repair complications
1. Supporting limb angular deformity 2. Premature closure of affected physis in salter-Harris fracture 3. flexural deformity 4. OA 5. Lameness

Eq SX Musc Skel Exam (20 decks)

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