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LAS - RUSS > Splint Bone/ Proximal Sesamoid Bone Fractures > Flashcards

Splint Bone/ Proximal Sesamoid Bone Fractures Flashcards

1
Q

Splint Bone Anatomy:

  1. Articulate with…
  2. Provides (axial/abaxial) support
A
  1. carpal and tarsal bones

2. axial

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2
Q

Which splint bone has minimal articulation and weight transfer with the 4th tarsal bone?

A

MT IV

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3
Q

Causes of Splint Bone Fractures:
1.
2.

A
  1. Hyperextension of fetlock = closed

2. External trauma = open

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4
Q

T/F: Splint bone fractures can be treated successfully with rest alone

A

T

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5
Q

Splint bone fractures:

Suspensory _____ may cause persistent lameness

A

desmitis

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6
Q

Treatment options for splint bone fractures:

1.
2.
3.
4.
5. Distal fractures? 
6. Proximal fractures
A
  1. Conservative wound management
  2. segmental ostectomy
  3. removal of distal portion
  4. ORIF
  5. distal fractures = surgical removal
  6. Proximal fractures = wound management and removal of loose segments + internal fixation
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7
Q

Surgical treatment of splint bone fractures:

  1. When removing residual distal splint bone, do not remove more than …..
  2. If you do remove more than that, you must…
  3. Exception?
A
  1. the distal 2/3 of the splint bone
  2. Use internal fixation for proximal fragment
  3. except MT IV
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8
Q

Internal fixation of fractured splint bones:

  1. Do not engage ____. Why? If you do it by accident?
A

1.MC III. Will cause persistent lameness. Remove the plate 3-4 months post op.

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9
Q

Splint Exostosis:

Affects (old/young) horses? Which bone?

A

young horses on MC II

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10
Q

2 main causes of splint exostosis

A

direct trauma or ligamentous inflam

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11
Q

Using radiographs to diagnosis splint exostosis:

Start with ____ view, than use ___ view to look for hidden splints

A

oblique

DP

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12
Q

Exostosis Treatment:

Conservative treatment:
1.
2.

A
  1. Rest + NSAIDs

2. Local DMSO or infiltration with corticosteroids

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13
Q

Exostosis Treatment: Surgical

  1. Sx?
  2. Post-op?
A
  1. Linear incision over site with en bloc removal

2. Excellent bandaging required post-op

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14
Q

Surgical Intervention of Exostosis

  1. Incise where?
  2. Be sure to avoid…
A
  1. directly over the splint bone from the middle of the splint bone to the button
  2. muscles, neurovascular structures
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15
Q

What structure do you have to really be careful to avoid during surgical intervention of exostosis?

A

Dorsal metatarsal artery because it runs between the lateral splint bone (MT IV) and MTIII.

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16
Q

Bucked Shins aka

A

dorsal cortical fractures

17
Q

Bucked Shins/Dorsal Cortical Fractures:
Stress fractures:

Usually affects what animals?

A

3 year olds with bucked shins as 2 year olds

18
Q

Bucked Shins/Dorsal Cortical Fractures:

Describe the fracture appearance/location

A

A fissure extending 60% through dorsal cortex at 30 degree angle proximally and disappears.

May curve back to dorsal cortex.

19
Q

Prevention of bucked shins?

A

Allocate more training efforts to regular short distance breezing and less long distance galloping

20
Q

Medical Treatment options for Bucked Shins:

1. Only consider medical if in what regions?
2.
3.
4.
5.
A
  1. Distal/proximal metaphyseal regions
  2. Rest
  3. NSAIDs
  4. Reduced exercise program
  5. Radiographic monitoring
21
Q

Surgical treatment of Bucked Shins:

1.
2. Best results with:

A
  1. Osteostixis

2. Osteostixis in combo with screw, removing screw at 60 days

22
Q

Describe surgical treatment of bucked shins via osteostixis:

A

Use staples pre-op to help ID the fracture during surgery
Drill perpendicular to fracture
Use radiographic guidance during sx
Place single unicortical positional screw
6-8 osteostixis holes drilled 10 mm apart, making sure to drill TOWARDS medullary canal

23
Q

T/F: The chances that a horse with bucked shins/saucer fractures will return to racing are slim

A

F, chances are good.

24
Q

Causes of Proximal Sesamoid Bone Fractures:
1.
2.
3.

A
  1. Excessive tension from suspensory ligament
  2. Trauma
  3. Racing breeds
25
Q

What kind of proximal sesamois bone fracture is most common?

A

Apical fracture

26
Q

Treatment of Apical Sesamoid Fracture:

  1. If small?
  2. if large?
A
  1. Arthroscopic removal

2. internal fixation

27
Q

Apical sesamoid bone fracture:

prognosis?

A

Good - usually don’t cause significant suspensory dz

28
Q

Midbody Sesamoid bone fracture Tx:

  1. Requires _______. Options?
A
  1. Internal fixation
    Lag screw or circumferential cerclage wire.
    Screw fixation in lag fasion best for TB to RTR. Cerclage reserved for SB.
29
Q

Best way to diagnose abaxial sesamoid bone fracture?

A

Radiographs 60 degrees skyline view to see if articular

30
Q

Abaxial sesamoid bone fracture treatment:

  1. If intra-articular?
  2. If extra-articular?
  3. Prognosis?
A
  1. Arthroscopic removal
  2. conservative management
  3. fair to good
31
Q

Basilar sesamoid bone fracture:

  1. Poor prognosis because…
A
  1. It involves origin of all distal sesamoidean ligaments and lag screw fixation is challenging

LAS - RUSS (32 decks)

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