Flashcards in Steinmann Pins, ESF's, and Orthopedic Wire (Betance 2) Deck (81):
Steinmann pins are often referred to as _______ pins
What are steinmann pins made from?
round stainless steel rods
What are some different options for different types of steinmann pins?
-Diameter from 1/16 to 1/4 inch (2-5 mm)
-Double or single armed
-Trochar or chisel point
-Smooth or threaded
What is the name of the wire that uses small steinmann pins that are usually smooth with a trochar point
What are the disadvantages of steinmann pins? (3)
***Resists bending forces ONLY
cannot maintain bone length
What are some advantages of steinmann pins besides the fact that they involve less surgical time (faster), are smaller to deal with in terms of inventory and inexpensive? (3)
-LESS TISSUE TRAUMA
-Easy to place and remove
What are some different applic. of Steinmann Pins?
What is the most common steinnman pin application and where is it placed in the bone?
Intramedullary placement; placed in the medullary cavity
For intramedullary pins, pin diameter is based on _____ _____
-if used with just _____
-If used with just _____
-If used with just a _____
Intramedullary pin application only resists these forces only?
Resists bending forces only!
What bones can IM pins be used in to aid in fracture reduction? (6)
Thoracic limb: Humerus, Ulna, Metacarpal
Pelvic limb: Femur, Tibia, Metatarsal
What bone in the thoracic limb can we absolutely not use an IM pin in?
What devices are used to place an IM pin? (2)
Jacobs chuck or pin driver
When using IM pins we avoid _____ surfaces it almost always requires _____ ____ and can be placed _____ or ______
articular; adjunct fixation; normograde or retrograde
IM pins once again are contraindicated in this bone of the body
With IM pins, you either cut the end of the pin or leave it long to tie into this device?
What size dogs and type of fracture do we use IM pins for, which size is it contraindicated in?
Indicated for: small breed dogs or cats with a simple stable fracture
Contraindicated for most fractures in medium and large dogs!!!!
If loretta's vet recommended IM pins what am I going to do?
Go to a new fucking vet they're obviously a dumbass who didn't stay awake listening to Surgery!!!!!
IM pins are contraindicated for most fractures in medium and large breed dogs
What's unique about IM pins that we always need todo when using these!!!
Always combine other fixation
______ pinning is 2 or more pins to fill the medullary cavity
What are some disadvantages of stack pinning that lead to why its rarely praticed?
-Clinical results show no advantage
-Higher incidence of pin migration
-Difficult cutting multiple pins
Cross pinning uses _____ diameter pins and used for these types of fractures
smaller; simple proximal/distal fractures/ physeal fractures
Describe the type of forces cross pinning uses and what it engages?
Counteracts rotational and bending forces; engaged both cortices
For cross pinning the pins cross in the _____ _____ segment
What type of pin is a medullary pin that does not have a cutting point
How are rush pins placed and how many point of contact does it have?
Pins are placed in pins and each has 3 points of contact
State the type of pin:
The pin is forced to bend to provide dynamic forces on the bone
What type of pin technique is used to stabilize salter harris 1 fractures of proximal humerus and femur
Diverging Pin technique
What must be done when using the diverging pin technique?
must achieve anatomical reduction
Does the diverging pin technique penetrate the joint surface?
What pin technique uses 3 K wires placed in a triangular fashion
Diverging pin technique
What wire has the largest diameter and the higher tensile strength?
This type of wire is never used as a sole method of fracture fixation except for this instance?
Orthopedic wire; only used solely with interfragmentary
Orthopedic wire is used with ___pins, ____ ____, and plates
IM; external fiaxators
What are the different orthopedic wire uses?
Cerclage means to ______
Full cerclage wire can be used for a maximum of ___ fracture segments
Full cerclage wire can only be if the fracture is ________ reduced
Full cerclage wire is used in ____ _____ or _____ fractures in which the fracture line is at least ___ times the diameter of the bone
long oblique; spiral; 2
Orthopedic wire is often called _____ wire and is often used to hold fragments in position
What do we use in terms of size for full cerclage wire
use the largest diameter wire that seems appropriate to the size and strength of the bone
When placing full cerclage wire place at least ____cm from the fracture ends and ___cm apart
at least (0.5)cm from the fracture ends and (1) cm apart
What do we use to pass and tighten the full cerclage wire around the bone and how many do we have to always at least place?
wire passer; at least 2; wire tightner
We place full cerclage wire ______ to the bone and twist the wire under _____ _____. When we cut the wire we leave __-__ twists or cut leaving ____ twist and then bend it over
perpendicular; tension preload; 2-3; 5
This type of wire is used for short oblique diaphyseal fractures
Hemicerclage wire ____ rotation in only __ direction
State the type of wire where a hole is drilled in proximal and distal aspects of the fracture segment then the wire is passed through the holes and around the IM pin
This pin us used in short oblique fractures and incorporates full cerclage wire and K-wire?
Where is the k wire placed in terms of the fracture with skewer pins?
placed on the line that bisects the perpendicular of the long axis of the bone and the fracture
Where is the cerclage wire placed in terms of the fracture with skewer pins?
placed around the k wire and tightened
With skewer pins, the k wire, skewer pin, and full cerclage wire together ultimately _____ the fracture
What type of wire is indicated for avulsion fractures of tension physes and ______ of _______?
Tension Band wire; closure of osteotomy
With tension band wire 2 ______ forces become _____ forces
2 distractive forces; compressive
State what takes place with tension wire and where the k wire should penetrate?
reduce fragment and 1-2 K wires driven perpendicular to fracture line and parallel to each other
k wire should penetrate both cortices
When placing a tension band wire a hole is drilled in the ____ of the bone around the same distance ____ the fracture line and the ___ are placed above.
Wire is passed through the hole and around the ends of the pin and back to the other end of the wire creating this shape.
Tighten both sides _____. Then bend and twist the ___ wire
cortex; below; pins;
TENSION BAND WIRE INDICATIONS fill in the blank?
_____fracture or ______ of the greater ______
"__same as above___" fracture of _____ tuberosity
Fracture or osteotomy of the ____ _____
Fracture of tuber ______
Fracture of _____ process of the scapula
Fracture or osteotomy of the ______
Avulsion; osteotomy of the greater trochanter
Avulsion; tibial tuberosity
For interfragmentary wire it is placed like "______" holding bone fragments together
For interfragmentary wire, the hole are drilled in ______fragments and ______
The fractures we use interfragmentary wire for are simple fractures of ____, non-_____ _____ bones that ______ well. Also in certain _____ and ______ fractures
flat, non weight bearing, interdigitate well; mandibular and maxillary
State the method of fracture repair:
Smooth or threaded pins inserted through cis and trans cortex, pins secured with specialized clamps and connecting bars made of stainless steel, carbon composite, or titanium
External skeletal fixators
This method of fracture repair is a less invasive fixation and has the ability to resist all forces and works well with infection
External Skeletal Fixation
External Skeletal Fixation is not as stable as ____ fixation
Indications for External Skeletal Fixation:
Many ___ or ____ fractures
When _____ _____ is compromised
Need _______ and ______ access
When bone purchase is ______ for _____
need stabilization and wound access
insufficient for plate
State the pin diameter required for External Skeletal Fixation?
< than or = to 25% of the bone diameter
State the pin angle required for External Skeletal Fixation for smooth pins versus threaded pins?
Smooth pins: 60-65 degrees
Threaded pin: 90 degree (to remember The letter T makes this angle)
State the required numbered of pins for External Skeletal Fixation?
at least 2 PER segment
State the required location for pins on the bone for External Skeletal Fixation?
> than or = to 2 pin diameter from the fracture
How do we place the clamps and connecting rods for External Skeletal Fixation?
AS CLOSE to the skin AS POSSIBLE but AT LEAST 1 cm away
SORRY LONG ASS RESPONSE REQUIRED BUT YA WON'T FUCK THIS UP ON THE FINAL SO YOU'LL THANK ME
State the bone location indicated for each type of external fixator and the official name combine with the type:
UNILATERAL-UNIPLANAR Type 1a
-Radial fractures (cranial and medial)
-Femur and Humerus (Lateral)
UNILATERAL BIPLANAR Type 1b
-Femur and Humerus (lateral)
BILATERAL-UNIPLANAR Type 2
(2 "TOO" good for femur and humerus)
-CANNOT BE USED FOR FEMUR AND HUMERUS
BILATERAL BIPLANAR Type 3 (rarely used)
-ONLY IN RADIUS ANS TIBIA
-to remember type 3: ThRee has T and R in it for radius and tibia
FOR UNILATERAL-UNIPLANAR Type 1a:
they are often combined with an ____ pin on the _____(bone) and _____(bone)?
IM pin on femur and humerus
BILATERAL-UNIPLANAR Type 2
CANNOT BE USED on the _____ and ______
femur and humerus
BILATERAL BIPLANAR Type 3 are ONLY USED in the ____ and _____ and connects 2 _____ together
radius and tibia; connect 2 frames together
The femur and humerus cannot be used in this type of external fixator
BILATERAL-UNIPLANAR Type 2
The radius and tibia can only be used in this type of external fixator
BILATERAL BIPLANAR Type 3
IM pin on femur and humerus are often combined with this type of external fixator
UNILATERAL-UNIPLANAR Type 1a:
Complex fractures with no other alternatives use this method of fracture repair, cane general practitioners do this?
(usually referred to an orthopedic specialist due to complexity of the repair)
Besides complex fractures with no other alternatives, state 2 other indications for circular/ring fixators (2)?
Limb shortening or lenghtening procedure
Circular/ring fixators have ___ rings on ____ side of the fracture. __ pairs of wires intersected at ____degrees. Tension by _____
Circular/ring fixators have (2) rings on (each) side of the fracture. (4) pairs of wires intersected at (90) degrees. Tension by (weight)
External Skeletal fixators (fill in the blank)
what type of anesthesia?
Strict Surgical ______
Placed ____ or _____ (desirable) if fracture adequately ______
Limb often ______ to facilitate reduction and placement
____ ____ ____ accomplished with poly(methyl methacrylate)
Strict Surgical ______(asepsis)
Placed ____(open) or __closed___ (desirable) if fracture adequately ______(reduced)
Limb often (suspended) to facilitate reduction and placement
free form fixators
What kinds of things do you do for post op care for external skeletal fixation?
Radiographs immed. post op and at 4 and 8 weeks
Leash walks-to prevent joint stiffness, limb edema, disuse atrophy
Clean pin ports and bandage changes daily