Fracture Repair

Question 1

What are the directions of fracture lines?

Answer 1

Transverse 
Oblique (short or long) 
Spiral 
Comminuted, reducible 
Comminuted, nonreducible

Question 2

What is another name for a cortical fracture?

Answer 2

Green stick

Question 3

What do you calll a fracture of the tibia that involves the distractive forces of the patellar tendon on the fragmented piece?

Answer 3

Tibial tuberosity avulsion

Question 4

What is a closed fracture?

Answer 4

No communication with external environment

Question 5

What is an open fracture?

Answer 5

At some point, developed communication with the external environment

Question 6

Classify this open fracture

Bone penetrating through skin

Laceration <1cm
Clean

Answer 6

Type 1

Question 7

Classify this open fracture

External object penetrates soft tissue
Laceration >1cm
Mild soft tissue trauma

Answer 7

Type 2

Question 8

Classify this open fracture?

Vast soft tissue laceration
Soft tissue available for closure

Answer 8

Type 3a

Question 9

Classify this open fracture

Extensive soft tissue injury and loss
Bone exposure and stripped periosteum

Answer 9

Type 3b

Question 10

Classify this open fracture

Arterial supply damaged
Required arterial repair for limb salvage

Answer 10

Type 3 c

Question 11

What are causes of fractures?

Answer 11

Direct insult

Indirect insult — force transmitted though bone to distant point (femoral neck, tibial tuberosity)

Pathological — weakened bone (neoplasia or nutritional)

Repeated stress — metacarpal and metatarsal in racing greyhounds

Question 12

What type of force causes a transverse fracture?

Answer 12

Bending

Question 13

What type of force causes a reducible comminuted fracture?

Answer 13

Bending and axial compression

Question 14

What type of force causes a oblique fracture?

Answer 14

Axial compression

Question 15

What type of forces cause a spiral fracture?

Answer 15

Torsion

Question 16

What type of force causes irreducible comminuted fractures?

Answer 16

High energy

Question 17

What is fracture reduction?

Answer 17

Reestabilishing normal alignment

Question 18

What is fracture fixation?

Answer 18

Securing fracture fragments to withstand forces acting on fracture

Question 19

What is a closed reduction?

Answer 19

Reduce a fracture without surgically exposing the fractured bones

• preserve soft tissue and blood supply
• decreased risk of infection
• decreased operating time
• difficult to obtain accurate reconstruction

Question 20

What are the indications for external coaptation?

Answer 20

Closed fracture - elbow or stifle

Fracture in which bone will be stable after reduction (no fracture disease)

Amendable small dogs and cats

Greenstick, intact periosteal sleeve, impaction fractures

Question 21

What are indications for open reduction?

Answer 21

Unstable fractures
Articular surfaces
Displaced fractures
Fractures anticipated to have delayed healing

Question 22

How can a transverse fracture be reduced?

Answer 22

Apply traction and lift bone ends from incision
Place bone ends in contact
Apply force to place in normal position

OR

Apply slim instrument as a lever
Reduce fracture

Question 23

How can an oblique fracture be reduced?

Answer 23

Distract bone segments

Use two self retaining pointed reduction bone forceps

Position obliquely and reduce fracture