Fractures of the Pelvic Limb II

Lecture 13

True or false: While the fibula is usually fractured, it is seldom stabilized unless stability of the stifle or hock is threatened.

True

What aspect of the tibia and fibula increases the possibility of open fractures, potentially decreases extraosseous blood supply, and is advantageous for placing an ESF?

paucity of soft tissue

Tibial fractures mostly occur how?

trauma

What radiographic views should be taken for diagnosis of tibial and fibular fractures?

craniocaudal and lateral of affected and unaffected limb

What should be included for medical management of tibial and fibular fractures?

analgesics

antibiotics for open fractures

cast/splint fixation for closed, nondisplaced, or greenstick fractures

When placing a splint or cast on a tibial or fibular fracture, what joints should be immobilized?

stifle and hock (want to stabilize joint above and below fracture)

The decision to perform open or closed reduction of tibial disphyseal fractures is made on the basis of what?

fracture configuration

fracture assessment score

implant selected

What are the accessible sites for a cancellous bone harvest in cases of tibial fractures needing a bone graft?

ipsilateral proximal humerus

wing of ilium

ipsilateral distal femur

IM pins can be used in what type of tibial fractures?

transverse or short oblique

In spiral or oblique tibial fractures where the length of the fracture line is 2-3 times diaphyseal diameter, you should use an IM pin paired with what to stabilize?

multiple cerclage wires

Why do we avoid using retrograde IM pinning and instead use normograde placement in dogs and cats?

risks damage to intra-articualr structure in dogs

risks damage to patellar ligament in cats

What type of bone plate is used for transverse fractures of the tibia?

compression plate

What type of bone plate is used to support long oblique fractures reconstructed with lag screws in tibia?

neutralization plate

What type of bone plate is used with or without an IM pin to span a nonreducible fracture in the tibia?

bridging plate

What type of bone plate must be used to match normal configuration of tibia since failure to reproduce normal curve of tibia results in valgus or varus angulation of limb?

contouring plate

What are potential complications associated with tibial and fibular diaphyseal fractures?

osteomyelitis

implant migration

malunion

delayed union

nonunion

complication with ESF include pin loosening and pin tract damage

Why are radiographs at the time of injury for tibial and fibular physeal fractures difficult to use to determine an accurate prognosis for growth?

radiographs do not provide information about crushing injuries to physis or damage to physeal blood supply