Fracture management for the small animal practitioner

List of Contributors xvPreface xviiSection 1 General Information 11 Fracture Identification 3Anne M. Sylvestre1.1 Number of Fragments 31.2 Fracture Configuration 31.3 Location on the Bone 71.4 Salter- Harris Fractures 72 Open Fractures 9Anne M. Sylvestre2.1 First Degree 92.2 Second Degree 92.3 Third Degree 9Reference 103 Patient Management 11Anne M. Sylvestre3.1 The Patient 113.1.1 Upon Admission 113.1.2 Immediate Postoperative Care 113.1.3 Upon Discharge From Hospital 113.1.4 Outside and Walks 123.1.5 Follow?up Radiographs and Healing Times 133.1.6 Implant Removal 133.2 The Owner 143.2.1 Slippery Floors 143.2.2 Stairs 153.2.3 No Jumping 153.2.4 Common Stressors 153.2.5 Crates 153.2.6 Icing 153.2.7 Gentle Passive Range of Motion (PROM) 163.2.8 Urination and Bowel Movements 163.2.9 Food and Water 163.2.10 Cats 173.3 Managing Osteoarthritis (OA) 17References 174 Bandages and Splints 19Jennifer White and Anne M. Sylvestre4.1 The Bandage 194.1.1 Layers of a Bandage 194.1.2 Creating the Bandage 194.2 Forelimb 274.2.1 Velpeau Sling 274.2.2 Spica Bandage 304.2.3 Antebrachial Bandages 314.2.4 Bandages for a Manus 374.2.5 Carpal Flexion Sling 374.3 Hind Limb 394.3.1 Ehmer Sling 394.3.2 Robert Jones Bandage 394.3.3 Crural and Tarsal Bandages 394.3.4 Bandages for a Pes 474.3.5 Robinson and 90?90 Slings 474.4 Bandage Care 474.4.1 Home Care Instructions 474.4.2 Bandage Changes 504.4.3 Bandage/Splint Complications 50Reference 60Section 2 The Forequarter 615 Mandible and Maxilla 63Teresa Jacobson5.1 Mandibular Fractures 635.1.1 Mandibular Symphyseal Separation 635.1.2 Rostral Mandibular Fractures 635.1.3 Fracture at the Level of the Mandibular First Molar 645.1.4 Temporomandibular Luxation 655.1.5 Other Mandibular Fractures 685.2 Maxillary Fractures 685.2.1 Fracture and/or Avulsion of the Incisive Bone 685.2.2 Fractures of the Maxillary Bone 685.3 Managing Expectations 685.4 Alternatives When the Treatment of Choice is Not an Option 685.5 Potential Complications of Maxillofacial Fracture Repair 69References 746 Scapula 75Anne M. Sylvestre6.1 Fractures 756.1.1 Fractures Through the Body and Spine of the Scapula 756.1.2 Acromion Fractures 766.1.3 Fractures of the Neck of the Scapula 766.2 Managing Expectations with Recommended Treatments 786.3 Alternatives When Treatment of Choice is Not an Option 78References 797 Shoulder Joint 81Anne M. Sylvestre7.1 Fractures and Luxations 827.1.1 Avulsion of the Supraglenoid Tuberosity 827.1.2 T or Y Fractures of the Scapular Neck and Glenoid Rim 827.1.3 Other Fractures Involving the Shoulder Joint 827.1.4 Medial Luxations 827.1.5 Lateral Luxations 847.2 Managing Expectations with Recommended Treatments 847.3 Alternatives When Treatment of Choice is Not an Option 867.3.1 Fractures 867.3.2 Luxations 86References 868 Humerus 87Catherine Popovitch, Thomas W.G. Gibson, and Anne M. Sylvestre8.1 Fractures 888.1.1 Physeal Fractures of the Proximal Humerus 888.1.2 Two?Piece Humeral Shaft Fractures 888.1.3 Multifragmented Humeral Shaft and/or Supracondylar Fractures 898.2 Managing Expectations with Recommended Treatments 908.3 Alternatives When Treatment of Choice is Not an Option 90References 919 Elbow Joint 93Anne M. Sylvestre9.1 Fractures and Luxations 949.1.1 Condylar Fractures 949.1.2 Bicondylar Fractures 949.1.3 Acute Luxations 949.1.4 Chronic Luxations 999.1.5 Proximal Ulnar Fractures 1009.1.6 Monteggia Fractures 1009.2 Managing Expectations with Recommended Treatments 1019.3 Alternatives When Treatment of Choice is Not an Option 1019.3.1 For Patients with a Fracture 1019.3.2 For Patients with a Luxation 102References 10210 Radius and Ulna 105Catherine Popovitch, Thomas W.G. Gibson, and Anne M. Sylvestre10.1 Fractures 10610.1.1 Fractures of the Proximal Ulna 10610.1.2 Fractures of the Proximal Radius 10610.1.3 Fractures of the Radius in Toy Breed Dogs 10610.1.4 Fractures of the Radius and Ulna in Non?Toy Breed Dogs and Cats 10710.1.5 Isolated Fractures of the Shaft of the Ulna 11210.1.6 Physeal Fractures of the Distal Radius 11210.2 Managing Expectations with Recommended Treatments 11410.3 Alternatives When Treatment of Choice is Not an Option 114References 11711 Carpal Joint 119Anne M. Sylvestre11.1 Fractures and Ligamentous Injuries 12011.1.1 Fractures of the Styloid Process of the Radius or Distal Ulna 12011.1.2 Fractures of the Radial Carpal Bone 12011.1.3 Fractures of the Accessory Carpal Bone 12211.1.4 Fractures of the Ulnar Carpal Bone 12311.1.5 Collateral Ligament Injuries 12311.1.6 Shearing Injuries 12411.1.7 Hyperextension Injuries 12511.1.8 Luxation of the Antebrachiaocarpal Joint 12511.1.9 Luxation of the Accessory Carpal Bone 12511.1.10 Luxation of the Radiocarpal Bone 12611.2 Managing Expectations with Recommended Treatments 12711.3 Alternatives When Treatment of Choice is Not an Option 12711.3.1 For Patients with a Fracture 12711.3.2 For Patients with Ligamentous Injuries 12811.4 About Pancarpal Arthrodesis 12811.5 About Partial Carpal Arthrodesis 128References 129Section 3 The Hindquarter 13112 Pelvis 133Anne M. Sylvestre12.1 Co?morbidities 13412.2 Fractures 13412.2.1 SI Luxations/Fractures 13412.2.2 Fractures of the Ilial Shaft or Wing 13412.2.3 Acetabular Fractures 13712.2.4 Ischial Fractures 13712.2.5 Fractures of the Pelvic Floor 13712.2.6 Summary of Indications for Surgical Repair of Pelvic Fractures 13812.3 Managing Expectations with Recommended Treatments 13912.4 Alternatives When Treatment of Choice is Not an Option 139References 14013 Coxofemoral Joint 141Thomas W.G. Gibson and Anne M. Sylvestre13.1 Fractures and Luxations 14113.1.1 Acetabular Fractures 14113.1.2 Hip Luxations 14213.1.3 Alternative Treatment of Choice: Open Reduction 14613.1.4 Capital Physeal Fractures of the Proximal Femur 14813.1.5 Fractures of the Femoral Neck 14913.2 Managing Expectations with Recommended Treatments 15013.3 Alternatives When Treatment of Choice is Not an Option 15013.3.1 Acetabular Fractures 15013.3.2 Luxations 15013.3.3 Femoral Head and Neck Fractures 15113.4 About the FHO 151References 15214 Femur 153Thomas W.G. Gibson and Anne M. Sylvestre14.1 Fractures 15414.1.1 Avulsion Fractures of the Greater Trochanter 15414.1.2 Fractures of the Femoral Shaft 15414.1.3 Physeal Fractures of the Distal Femur 15714.2 Managing Expectations with Recommended Treatments 15914.3 Alternatives When Treatment of Choice is Not an Option 159References 16115 Stifle Joint 163Anne M. Sylvestre15.1 Fractures and Luxations 16415.1.1 Articular Distal Femoral Fractures 16415.1.2 Patellar Fractures 16415.1.3 Traumatic Patellar Luxations 16615.1.4 Collateral Ligament Damage 16615.1.5 Luxation of the Stifle Joint 16615.1.6 Articular Proximal Tibial Fractures 16915.2 Managing Expectations with Recommended Treatments 17015.3 Alternatives Treatment When Surgery is Not an Option 170References 17016 Tibia and Fibula 171Thomas W.G. Gibson and Anne M. Sylvestre16.1 Fractures 17216.1.1 Tibial Tuberosity Avulsion Fractures 17216.1.2 Tibial Plateau Physeal Fractures 17216.1.3 Proximal Tibial Shaft Fractures 17316.1.4 Fractures of the Mid? and Mid?to?Distal Portions of the Tibial Shaft 17316.1.5 Fractures of the Distal Tibial Shaft 17716.1.6 Physeal Fractures of the Distal Tibia/Fibula 17716.1.7 Fractures of the Fibular Shaft Alone 17716.2 Managing Expectations with Recommended Treatments 17816.3 Alternatives When Treatment of Choice is Not an Option 178References 18117 Tarsal Joint 183Anne M. Sylvestre17.1 Fractures and Ligamentous Injuries 18417.1.1 Articular Distal Tibial Fractures 18417.1.2 Fractures of the Medial Malleolus or the Lateral Malleolus 18417.1.3 Medial or Lateral Collateral Ligament Injuries 18617.1.4 Luxations of the Tarsocrural Joint 18617.1.5 Shearing Injuries 18617.1.6 Fractures of the Calcaneus 18817.1.7 Fractures/Luxations of the Talus 19217.1.8 Fractures/Luxations of the Central Tarsal Bone 19317.1.9 Fractures of the Numbered Tarsal Bones 19317.1.10 Luxation of the Intertarsal and/or Tarsometatarsal Joints 19417.2 Managing Expectations with Recommended Treatments 19417.3 Alternatives When Treatment of Choice is Not an Option 19517.4 About Pantarsal Arthrodesis 19517.5 About Partial Tarsal Arthrodesis 195References 19718 Paw (Manus and Pes) 199Anne M. Sylvestre18.1 Fractures and Luxations 19918.1.1 MC/MT Fractures 19918.1.2 Phalangeal Fractures 20218.1.3 Luxations of the Inter?Phalangeal or MC/MT?Phalangeal Joints 20318.2 Managing Expectation with Recommended Treatments 20418.3 Alternatives When Treatment of Choice is Not an Option 204References 204Section 4 Fracture Repair Techniques 20519 Essential Information on Fracture Repair 207Anne M. Sylvestre19.1 Forces Applied to a Bone 20819.2 Techniques for Reducing a Fracture 20819.2.1 Distraction 20919.2.2 Lever 20919.2.3 Toggle 20919.2.4 Oblique Fractures 21019.2.5 Using the Plate 21119.3 Instrumentation 21119.3.1 Drills 21119.3.2 Fracture Repair General Instruments 213References 21420 Pins and Wires 215Catherine Popovitch20.1 Case Selection 21520.2 Instrumentation 21520.3 Fundamentals of Application 21520.3.1 Cerclage Wires 21520.3.2 Pins 21620.4 Pinning Techniques for Various Long Bones 21820.4.1 Humerus 21820.4.2 Radius 21820.4.3 Femur 21820.4.4 Tibia 220References 22121 Plating 223Anne M. Sylvestre21.1 Case Selection 22321.2 Instrumentation 22321.2.1 Bone Screws 22321.2.2 Bone Plates 22421.2.3 Plating?specific Instruments 22521.3 Fundamentals of Application 22621.3.1 Selecting a Plate 22621.3.2 At Surgery 22721.3.3 Pin-Plate Combination 22821.3.4 Stack Plating 23021.4 Postoperative Care 23021.5 Plating Techniques for Various Long Bones 23021.5.1 Humerus 23021.5.2 Radius 23021.5.3 Femur 23021.5.4 Tibia 232References 23322 External Fixators 235Kathryn Wander22.1 Case Selection 23522.2 Basic Rules of External Fixation 23522.2.1 Pins 23522.2.2 Connecting Bars 23622.2.3 Clamps 23622.3 Fundamentals of Application 23722.4 Fixators: Biomechanics/Constructs 23722.4.1 Acrylic Splints/Constructs 23822.4.2 Circular External Fixators 23922.5 Postoperative Care 23922.6 Complications 24122.7 Preferred Technique for Various Long Bones 24222.7.1 Tibial Fractures 24222.7.2 Humeral Fractures 24222.7.3 Femoral Fractures 24222.7.4 Radial Fractures 242References 24323 Repair of Physeal Fractures 245Thomas W.G. Gibson23.1 Physeal Fractures 24523.1.1 Crossed Pin Technique 24623.2 Avulsion Type Physeal Fractures 24723.2.1 Tension Band Wiring Technique 24723.3 Repair Techniques for Various Physeal Fractures 24723.3.1 Proximal Humerus 24723.3.2 Proximal Ulna 24723.3.3 Proximal Radius 24723.3.4 Distal Radius 24723.3.5 Greater Trochanter 24823.3.6 Distal Femur 24823.3.7 Tibial Tuberosity 24823.3.8 Proximal Tibial Physis 24823.3.9 Distal Tibial Physis 248References 24824 Fractures of the Jaw 251Teresa Jacobson24.1 Anatomical Considerations 25124.2 Jaw Fracture Management 25124.2.1 The Principles of Jaw Fracture Management 25224.2.2 Intubation Considerations for the Fracture Repair 25324.2.3 Feeding Plan Post Jaw Fracture Repair 25324.3 Pain Management 25424.4 Maxillofacial Fracture Repair 25524.5 Methods of Maxillofacial Fracture Stabilization 25724.5.1 Tape or Nylon Muzzles 25724.5.2 Osseous Wiring Techniques for Maxillofacial Fracture Repair 25724.5.3 Intra?Dental Wiring Techniques with Acrylic Reinforcement 26024.5.4 Bonding the Maxillary to the Mandibular Canines 26524.6 Bone Grafts 26624.7 Teeth in the Fracture Line 26624.8 Antibiotic Therapy in Maxillofacial Fracture Repair 26724.9 Irrigation of the Appliance 26724.10 Recheck Examinations 267References 26725 Approaches to the Long Bones 269Anne M. Sylvestre25.1 Approach to the Diaphysis of the Humerus 26925.1.1 Patient Position 26925.1.2 The Surgical Approach 26925.2 Approach to the Diaphysis of the Radius 27125.2.1 Patient Position 27125.2.2 Surgical Approach 27125.3 Approach to the Femoral Diaphysis 27125.3.1 Patient Position 27125.3.2 The Surgical Approach 27225.4 Approach to the Tibial Diaphysis 27225.4.1 Patient Position 27225.4.2 The Surgical Approach 272Reference 27426 Implants 275Harold Wotton26.1 Maneuvering Orthopedic Implants 27526.2 Quality Implants: Essential Information on Quality Implants 27626.3 Titanium vs Stainless Steel 276Index 279