Principles of Large Animal Fracture Fixation Flashcards
(40 cards)
what are the causes for large animal fractures?
- trauma induced: huge forces needed, most start at the site of stress concentration
- exercised induced: propagated stress fractures, not as commonly seen
what is the first primary goal when dealing with a horse fracture/
keep from becoming an open fracture: decreases outcome by 50%
what risk of complications do large animals have?
- increased infection risk
- lack of soft tissue and vascular supply in limbs
- concerns with recovery
- necessity for weight bearing and stability immediately after recovery
- SUPPORT LIMB LAMINITIS IS THE MOST COMMON CAUSE OF EUTH IN HORSE FRACTURES
T/F: equine species have a much higher infection rate in open fractures than any other species
true
prognosis of open fractures in horses
- no good options
- cannot delay repair to resolve infection
- cannot have instability and infection together and have a successful case!
describe horse recovery after fracture repair
- needs to be able to walk 1-2 hours post op
- patient compliance: unlikely to protect limb
- large torsional forces associated with ambulation
if you dont have a load sharing limb by what time post op what do you do
need to have weight sharing limb by 6 weeks post op, if not likely will euth
risk of death with horse fractures
4.9% risk of death with fractures with anesthesia
- lower solubility with inhalables so more titratable, can wake up faster
- positioning: myopathies/neuropathies
- monitoring: direct arterial blood pressure
- swimming pool recovery
what is the safest recovery system for a horse
swimming pool
T/F: phalangeal fractures are really common in horses
true
how is a fracture in a large animal different than a small animal?
- fracture types all are the same: transverse, oblique, short oblique, transverse with butterfly
T/F: olecranon fractures are common in horses
true, usually slip and fall fractures
present with dropped elbow
resolve well as long as not articular
does prognosis get worse or better the higher up on the limb you go in a horse?
worse the higher you go
what is the most common cause of horses being euthanized with fractures?
support limb laminitis
how to approach a call of a non-weightbearing horse
- where is horse: field, caught under fence?
- what to do until you get there: sedate/quiet, don’t lead anywhere until splinted, go to horse and don’t let it move
ambulatory truck fracture kit
- sedation
- NSAIDS
- bandaging supplies
- duct tape: best to secure splints from slipping
- PCV splints or fiberglass casting material
- Kimzey leg saver splint : ideal for phalangeal fractures
objectives when approaching a horse with a nonweightbearing limb
- minimize further damage
- prevent closed fractures from becoming open
- prevent further contamination if there are wounds
- assess/stabilize
- radiographs
- prognosis CONSULT
- determine intended goals: athlete vs brood mare, ability to do after care, prognosis
what factors affect fracture prognosis in horses?
- fracture location
- displaced vs non displaced
- close vs open
- degree of soft tissue injuyr
- contamination
- articular surfaces? minimizes athletic capability
- synovial structures
- age, breed, use temperatment
- intact strut of bone between articular surfaces
what should you place the splint over?
a bandage! should never go on skin
objectives of a good splint
- neutralizes damaging forces
- allows horse to ambulate
- doesnt require general anesthesia
- economical
types of splints
- wood
- PCV pipe
- plastic adjustable
- fiberglass
- kimzey
measurements for PVC pipe splints in horses
- 6-8 inches
- at least 1/4 inch wall thickness
- can be bent with propane torch
- cut into thirds with rasped edge
- multiple lengths
what splint is best for phalangeal fractures?
kimzey splint
aluminum, different sizes, investment good
if you are using a fiberglass casting material, what structure does it need to include?
the foot!
