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Question 1

Clinical Assessement for fracture assessment score

Answer 1

Question 2

Mechanical fracture assessment

Answer 2

Question 3

Biological fracture assessment scoring

Answer 3

Question 4

Primary objective of fracture management

Answer 4

Promote an early &
complete return to
function

Question 5

alignment vs. reduction

Answer 5

a= spacial arrange of joint above and below the fracture

reduction= process of re-
apposing the fracture
fragments &/or
segments

Question 6

The combination of the fixation device and the fracture segments is called

Answer 6

osteosynthesis

Question 7

Steps of secondary bone healing

Answer 7

Endochondral Ossification:

inflammatory phase- hematoma

granulation tissue

fibrous tissue

fibrocartilage

cartilage

woven bone

lamellar bone

Question 8

Requirements for primary bone healing

Answer 8

rigid fixation & anatomic reduction

Question 9

What two types of healing occur w/ primary bone healing?

Answer 9

contact healing

gap healing <1mm gaps

Question 10

When should a callus be present?

Answer 10

2-4wks

Question 11

What are the 4 main fxns of bone grafts?

Answer 11

osteogenic (fresh autogenous graft)

osteoconduction (scaffold- for ingrowth of capillaries & mesenchymal cells)

osteoinduction (induces bone synthesis; BMP)

structural support (cortical grafts)

Question 12

Harvest sites for cancellous bone graft?

Answer 12

Greater tubercle of the humerus • Iliac crest • Proximal tibia

Question 13

Biological vs. mechanical fixation

Answer 13

The underlying concept is protection of the surrounding soft tissues and blood supply to the fracture fragments. This is achieved by spanning the fracture with implants which do not substantially disrupt the fracture site. This is often referred as bridging osteosynthesis. In all fracture repairs there must be a balance between the biology and the mechanics of the repair. An excess of either may result in nonunion and or loss of function.

Question 14

When do you pad the protuberances vs. the depressions?

Answer 14

Rigid pre-formed
splints: pad
depression

Malleable splints:
pad protuberances

Question 15

With a rigid lateral splint, what do you pad extra?

Answer 15

depressions

Question 16

What does the figure 8 sling do for coxofemoral luxations?

Answer 16

abducts

flexes

internally rotates

Question 17

What forces does ESF overcome?

Answer 17

axial (compression)

bending

rotational

Question 18

What are the three types of external fixators?

Answer 18

Question 19

Which of the ESF is the strongest? Weakest?

Answer 19

III > II > I

Question 20

What should the core diameter of the pilot hole for ESF pins be compared to the pin’s diameter?

Answer 20

0.1mm less than actual pin diameter

Question 21

What are the fixation pins locations for the various bones?

Answer 21

Question 22

what speed & torque should be used when placing fixation pins for ESF?

Answer 22

slow speed

high torque drill

Question 23

Fixation pin diameter should not exceed % of diameter of bone

Answer 23

30%

Question 24

With application of ESF, how many pins should be placed in each fracture segment?

Answer 24

3-4 pins

Question 25

What forces are intramedullary fixation devices resistant to? Which ones are they not?

Answer 25

bending little resistance to shear forces not compression, tensile, or torsional

Question 26

What force does using an interlocking nail in IM fixation prevent against?

Answer 26

axial collapse

Question 27

What type of fracture is sole use of IM pins not enough?

Answer 27

comminuted fractures

Question 28

When is it common to use rush pins?

Answer 28

young animals w/ salter harris fractures

Question 29

If you use interlocking nails w/ the IM pin, what forces can be overcome?

Answer 29

bending rotational axial

Question 30

How can an IM pin be inserted in the humerus? What is the direction the pin should take?

Answer 30

retrograde cranio-lateral to caudo-medial (avoid olecranon fossa)

Question 31

expected time for union

Answer 31

3-6 months old: ~ 4-6 weeks \> 1 year old: ~ 12 weeks

Question 32

normal fracture healing requires &

Answer 32

vascularity stability

Question 33

What are the classifications of non-unions?

Answer 33

Question 34

Tx for non-unions

Answer 34

Question 35

Requirements for osteomyelitis to occur?

Answer 35

bacterial contamination & vascular compromise

Question 36

Rad findings for osteomyelitis

Answer 36

Soft tissue swelling • Irregular periosteal reaction far from fracture • lysis/bone resorption

Question 37

What three structures are shown here?

Answer 37

Sequestrum: necrotic bone fragment • Involucrum: periosteal reaction surrounding the sequestrum • Cloaca: opening in involucrum, resulting in drainage

Question 38

TX for osteomyelitis

Answer 38

Question 39

Causes of quadriceps contracture

Answer 39

prolonged immobilization quadriceps m. trauma

Question 40

For the different implants, what fracture forces are neutralized?

Answer 40

Question 41

What is the requirement of the fracture to use cerclage wires?

Answer 41

oblique 2-21/2 length the diameter of bone

Question 42

Rules about applying cerclage wires

Answer 42

• Wires should be 1 cm apart •The wire must be placed 5 mm from the end of the fracture segments 3+ wires (never use just one)

Question 43

twist vs. loop cerclage wires

Answer 43

Question 44

10 commandments of cerclage wires

Answer 44

Question 45

fxn of pin & tension band

Answer 45

Converts distractive/tensile forces to compressive forces