Textbook of Veterinary Orthopaedic Surgery

Preface
Contents
About the Authors
1: Basic Considerations
	Learning Objectives
	Summary
	1.1 Structure and Types of the Bone
		1.1.1 Components of the Bone
			1.1.1.1 The Bone Cells
			1.1.1.2 Organic Matrix
			1.1.1.3 Inorganic Mineral
		1.1.2 Structure of the Bone
		1.1.3 Circulation of the Bone
	1.2 Bone Development and Growth Regulation
		1.2.1 Development of the Bone
		1.2.2 Calcium Regulation
			1.2.2.1 Dietary Calcium and Phosphorus
			1.2.2.2 Calcium-Regulating Hormones
	1.3 Fracture Biomechanics and Classification
		1.3.1 Mechanical Properties of the Bone
		1.3.2 Fracture Forces
		1.3.3 Classification of Fracture
		1.3.4 Incidence of Fractures
	1.4 Fracture Healing and Methods to Enhance Healing
		1.4.1 Fracture Healing
		1.4.2 Methods to Enhance Fracture Healing
			1.4.2.1 Nutrition
			1.4.2.2 Anabolic Steroids
			1.4.2.3 Herbal/Homeopathic Drugs
			1.4.2.4 Exercise
			1.4.2.5 Other Physiotherapy Modalities
	1.5 Implants Used for Fracture Fixation
		1.5.1 Stainless Steel
		1.5.2 Titanium
		1.5.3 Cobalt-Chrome
		1.5.4 Aluminum Alloy
		1.5.5 Non-biodegradable Polymers
		1.5.6 Biodegradable Metals
		1.5.7 Bioresorbable Polymers
			1.5.7.1 Polyglycolide (PGA)
			1.5.7.2 Polylactide (PLA)
			1.5.7.3 Co-polymers
	1.6 Instrumentation for Fracture Fixation
		1.6.1 Basic Instruments (Fig. 1.20)
		1.6.2 Instruments for Bone Plating
			1.6.2.1 Screwdrivers (Fig. 1.22)
		1.6.3 Instruments for Intramedullary Pinning (Fig. 1.23)
		1.6.4 Instruments for Interlocking Nailing (Fig. 1.24)
		1.6.5 Instruments for Rush Pinning (Fig. 1.25)
		1.6.6 Instruments for Kuntscher Nailing (Fig. 1.26)
		1.6.7 Instruments for Bone Stapling (Fig. 1.27)
		1.6.8 Instruments for Orthopedic Wiring (Fig. 1.28)
		1.6.9 Instruments for External Skeletal Fixation (Fig. 1.29)
	1.7 Examination of the Animals with Fracture
		1.7.1 Things we Should Avoid while Examining an Injured Animal
	1.8 Emergency Treatment of Fracture and First Aid
	1.9 Anesthesia and Pain Management in Animals with Fracture
		1.9.1 Anesthesia in Cattle
			1.9.1.1 General Anesthetic Techniques
			1.9.1.2 Local/Regional Anesthetic Techniques
				Anesthetics Used for Local/Regional Analgesia
				Techniques of Local/Regional Anesthesia
		1.9.2 Anesthesia in Sheep/Goat
			1.9.2.1 General Anesthetic Techniques
		1.9.3 Anesthesia in Horse
			1.9.3.1 General Anesthetic Techniques
			1.9.3.2 Local/Regional Anesthetic Techniques
		1.9.4 Anesthesia in Pig
			1.9.4.1 General Anesthesia
			1.9.4.2 Intravenous Techniques
		1.9.5 Anesthesia in Dog
		1.9.6 Anesthesia in Cat
		1.9.7 Management of Pain
			1.9.7.1 Treatment of Pain
				Analgesic Drugs
	1.10 Methods of Fracture Reduction
	1.11 Timing and Selection of Fracture Fixation Technique
		1.11.1 Timing of Definitive Fixation
		1.11.2 Selection of Fixation Technique
	Chapter 1: Sample Questions
	References
2: Principles of Fracture Fixation Techniques
	Learning Objectives
	Summary
	2.1 External Fixation Techniques
		2.1.1 Bandages
		2.1.2 Splints
		2.1.3 Slings
		2.1.4 Plaster Cast
			2.1.4.1 Indications and Contraindications
			2.1.4.2 Biomechanics
			2.1.4.3 Technique
			2.1.4.4 Post-application Care and Management
		2.1.5 Fiberglass Cast
			2.1.5.1 Advantages over Plaster Cast
			2.1.5.2 Drawbacks
			2.1.5.3 Technique
			2.1.5.4 Post-application Care and Management
		2.1.6 Modified Thomas Splints
			2.1.6.1 Indications and Contraindications
			2.1.6.2 Materials Required
			2.1.6.3 Technique of Application
			2.1.6.4 Application of Traction
			2.1.6.5 Postoperative Care
		2.1.7 Thomas Splint-Cast Combination
			2.1.7.1 Indication
			2.1.7.2 Biomechanics
			2.1.7.3 Technique
			2.1.7.4 Postoperative Care, Management, and Complications
	2.2 Internal Fixation Techniques
		2.2.1 Intramedullary Pin/Nail
			2.2.1.1 Single IM Pin
			2.2.1.2 Stack Pins
			2.2.1.3 Rush Pins
			2.2.1.4 Cross IM Pins
			2.2.1.5 Kuntscher Nail
			2.2.1.6 Interlocking Nail
			2.2.1.7 Interlocking Nails for Bovine
		2.2.2 Bone Plate and Screw Fixation
			2.2.2.1 Dynamic Compression Plate
			2.2.2.2 Veterinary Cuttable Plate (VCP) and Reconstruction Plates
			2.2.2.3 Special and Mini Plates
			2.2.2.4 Locking Plate-Screw Systems
				Locking Compression Plate
				Locking Plate (UniLock)
				String of Pearls (SOP) Plate
				Clamp-Rod Internal Fixator (CRIF)
			2.2.2.5 Contoured Locking Plates for Bovines
			2.2.2.6 Minimally Invasive Percutaneous Plate Osteosynthesis (MIPO)
		2.2.3 Ancillary Fixation Devices
			2.2.3.1 Screws
			2.2.3.2 Wires
			2.2.3.3 Postoperative Care and Management with Internal Fixation
	2.3 External Skeletal Fixation
		2.3.1 Indications
		2.3.2 Advantages of ESF
		2.3.3 Disadvantages of ESF
		2.3.4 Fixator Configurations and Types
		2.3.5 Biomechanics of ESF
			2.3.5.1 The Material Characteristic of the Bone and Fracture Configuration
			2.3.5.2 The Material Properties of the ESF Components
			2.3.5.3 The Design of the ESF
		2.3.6 Linear External Skeletal Fixation Systems for Small Animals
			2.3.6.1 Frame Configurations
			2.3.6.2 Fixation Pins
			2.3.6.3 Linkage Devices (Fixation Clamps/Pin Grippers)
			2.3.6.4 General Principles of ESF Application
			2.3.6.5 Postoperative Care and Management
		2.3.7 Transfixation Pinning and Casting in Large Animals
			2.3.7.1 Hanging Limb Pin Cast
				Principle of Hanging Limb Pin Cast
				Technique
				Postoperative Care and Management
				Limitations/Disadvantages
			2.3.7.2 Transfixation Pinning and Casting (TCP) as an ESF
				Technique
				Advantages
				Disadvantages
		2.3.8 Linear External Skeletal Fixation Systems for Large Animals
			2.3.8.1 Fixator Components
			2.3.8.2 Indications
			2.3.8.3 Advantages
			2.3.8.4 Principles and Guidelines for Application
			2.3.8.5 Postoperative Care and Management
			2.3.8.6 Removal of Fixator
		2.3.9 Circular External Skeletal Fixation
			2.3.9.1 Fixator Components
			2.3.9.2 Indications
			2.3.9.3 Application of CEF
			2.3.9.4 Postoperative Care and Management
			2.3.9.5 Removal of Fixator Assembly
		2.3.10 Acrylic- or Epoxy-Pin Fixation Systems
			2.3.10.1 Fixator Components
			2.3.10.2 Indications
			2.3.10.3 Advantages
			2.3.10.4 Technique of Application
			2.3.10.5 Construction of ESF Frame Using Acrylic
			2.3.10.6 Construction of Pin Scaffold for Epoxy-Pin Fixation
			2.3.10.7 Application of Epoxy Dough Along the Pin Scaffold
			2.3.10.8 Postoperative Care and Management
			2.3.10.9 Removal of Fixator Assembly
		2.3.11 Complications of ESF
	Chapter 2: Sample Questions
	References
3: Management of Specific Fractures in Small Animals
	Learning Objectives
	Summary
	3.1 Fractures of Scapula
	3.2 Fractures of Humerus
		3.2.1 Fractures of the Proximal Humerus
		3.2.2 Diaphyseal Fractures of Humerus
		3.2.3 Fractures of the Distal Humerus
	3.3 Fractures of Radius-Ulna
		3.3.1 Fractures of the Proximal end of Radius/Ulna
		3.3.2 Diaphyseal Fractures of Radius-Ulna
		3.3.3 Fractures at the Distal Radius and Ulna
	3.4 Fractures of Femur
		3.4.1 Femur Head-Neck and Subtrochanteric Fractures
			3.4.1.1 Surgical Approach
			3.4.1.2 Surgical Fixation
			3.4.1.3 Postoperative Care and Possible Complications
		3.4.2 Femoral Diaphyseal Fractures
			3.4.2.1 Surgical Approach
			3.4.2.2 Surgical Fixation
			3.4.2.3 Postoperative Care and Possible Complications
		3.4.3 Distal Femoral Fractures
			3.4.3.1 Surgical Approach
			3.4.3.2 Surgical Fixation
			3.4.3.3 Postoperative Care and Possible Complications
	3.5 Fractures of Tibia-Fibula
		3.5.1 Proximal Physeal Fractures
		3.5.2 Diaphyseal Fractures
		3.5.3 Distal Tibial/Malleolar Fractures
	3.6 Fractures of Metacarpus and Metatarsus
	3.7 Fractures of Mandible
		3.7.1 External Fixation
		3.7.2 Internal Fixation
		3.7.3 External Skeletal Fixation
		3.7.4 Complications and Prognosis
	3.8 Fractures of Pelvis
		3.8.1 Surgical Approach
		3.8.2 Surgical Management
			3.8.2.1 Ilial Fractures
			3.8.2.2 Acetabular Fractures
			3.8.2.3 Fracture of Sacroiliac Joint
			3.8.2.4 Fractures of the Ischium and Pubis
		3.8.3 Postoperative Care and Complications
	3.9 Fractures of Spine
		3.9.1 Nonsurgical Stabilization of the Spine
		3.9.2 Surgical Stabilization of the Spine
		3.9.3 Thoracic and Lumbar Fracture/Luxations
			3.9.3.1 Hemilaminectomy
			3.9.3.2 Dorsal Laminectomy
		3.9.4 Reduction and Surgical Fixation
			3.9.4.1 Spinal Process Fixation
			3.9.4.2 Vertebral Body Fixation
		3.9.5 Lumbosacral Fractures
	Chapter 3: Sample Questions
	References
4: Management of Specific Fractures in Large Animals
	Learning Objectives
	Summary
	4.1 Fractures of Scapula and Humerus
	4.2 Fractures of Radius-Ulna
	4.3 Fractures of Femur
	4.4 Fractures of Tibia
	4.5 Fractures of Metacarpus, Metatarsus, and Phalanges
	4.6 Fractures of Pelvis
	4.7 Fractures of Mandible
	Chapter 4: Sample Questions
	References
5: Fractures in Young, Osteoporotic, and Avian Bones
	Learning Objectives
	5.1 Fractures in Young Animals
		5.1.1 Open Reduction and Internal Fixation
		5.1.2 Fractures Involving the Growth Plate
	5.2 Fractures in Osteopenic/Osteoporotic Bones
	5.3 Fractures in Avian Bones
		5.3.1 Methods of Fracture Repair
	Chapter 5: Sample Questions
	References
6: Open Fractures
	Learning Objectives
	Summary
	6.1 Classification of Open Fractures
	6.2 Soft Tissue Infection, Osteomyelitis, and Antibiotic Therapy
	6.3 Management of Soft Tissue Injuries and Wound Closure
	6.4 Treatment of Open Fractures
	6.5 Postoperative Care of Open Fractures
	Chapter 6: Sample Questions
	References
7: Bone Grafts and Scaffolds in Fracture Repair
	Learning Objectives
	Summary
	7.1 Functions of Bone Grafts or Implants
	7.2 Types of Bone Grafts
		7.2.1 According to Origin
		7.2.2 According to Composition
	7.3 Processing of Bone Grafts
	7.4 Process of Bone Graft Incorporation
	7.5 Bone Substitutes
		7.5.1 Demineralized Bone Matrix
		7.5.2 Calcium Phosphate Synthetic Substitutes
		7.5.3 Synthetic Polymers
	7.6 Bone Inducers
		7.6.1 Bone Morphogenic Protein (BMP)
		7.6.2 Transforming Growth Factor-β
		7.6.3 Insulin-like Growth Factor
		7.6.4 Growth Hormone
	7.7 Stem Cells
	Chapter 7: Sample Questions
	References
8: Complications of Fracture Fixation
	Learning Objectives
	Summary
	8.1 Delayed Union
	8.2 Nonunion
	8.3 Malunion
	8.4 Fixation Failure
	8.5 Soft Tissue Infection and Osteomyelitis
	8.6 Fracture Disease
	8.7 Supporting Limb Laminitis
	Chapter 8: Sample Questions
	References
9: Metabolic Bone Diseases
	Learning Objectives
	Summary
	9.1 Nutritional Secondary Hyperparathyroidism
	9.2 Rickets
	9.3 Hypertrophic Osteodystrophy
	9.4 Osteochondrosis
	9.5 Retained Cartilage Core
	9.6 Metaphyseal Chondrodysplasia
	9.7 Panosteitis
	9.8 Hip Dysplasia
	9.9 Prevention and Control of Bone Disorders
	Chapter 9: Sample Questions
	References
10: Antebrachial Bone Deformities
	Learning Objectives
	Summary
	10.1 Closure of Distal Ulnar Growth Plate
	10.2 Closure of Distal Radial Growth Plate
	10.3 Closure of Proximal Radial Physis
	10.4 Closure of Both Growth Plates: Distal Radius and Ulna
	10.5 Postoperative Care, Management, and Prognosis
	Chapter 10: Sample Questions
	References
11: Joint Luxations
	Learning Objectives
	Summary
	11.1 Small Animals
		11.1.1 Shoulder Luxation
			11.1.1.1 Transposition of Biceps Brachii Tendon
			11.1.1.2 Shoulder Arthrodesis and Excision Arthroplasty
		11.1.2 Elbow Luxation
		11.1.3 Carpal Luxation
		11.1.4 Hip (Coxofemoral) Luxation
			11.1.4.1 Open Reduction and Fixation of the Femoral Head
			11.1.4.2 Femoral Head and Neck Excision (Ostectomy)
		11.1.5 Stifle Luxation
		11.1.6 Patellar Luxation
		11.1.7 Tarsal Luxation
	11.2 Large Animals
		11.2.1 Shoulder Luxation
		11.2.2 Elbow Luxation
		11.2.3 Coxofemoral Luxation
		11.2.4 Patellar Luxation
		11.2.5 Carpal and Tarsal Luxations
		11.2.6 Metacarpophalangeal and Metatarsophalangeal Luxations
	Chapter 11: Sample Questions
	References
12: Arthritis
	Learning Objectives
	Summary
	12.1 Traumatic Arthritis
		12.1.1 Clinical Signs
		12.1.2 Diagnosis
		12.1.3 Treatment
	12.2 Septic (Infectious) Arthritis
		12.2.1 Causes of Infection
		12.2.2 Clinical Signs
		12.2.3 Diagnosis
		12.2.4 Treatment
		12.2.5 Follow-Up Care, Management, Complications, and Prognosis
	12.3 Osteoarthritis
		12.3.1 Pathophysiology
		12.3.2 Predisposing Factors
		12.3.3 Clinical Signs
		12.3.4 Diagnosis
		12.3.5 Management
	12.4 Rheumatoid Arthritis
		12.4.1 Clinical Signs
		12.4.2 Diagnosis
		12.4.3 Treatment
	Chapter 12: Sample Questions
	References
13: Common Tendon and Ligament Injuries
	Learning Objectives
	Summary
	13.1 Tendon Injuries
		13.1.1 Achilles Tendon
		13.1.2 Superficial and Deep Digital Flexor Tendons
		13.1.3 Contracted Flexor Tendons
		13.1.4 Principles and Techniques of Tendon Suturing
	13.2 Ligament Injuries
		13.2.1 Cranial Cruciate Ligament
		13.2.2 Patellar Ligament
		13.2.3 Collateral Ligaments
		13.2.4 Postoperative Care and Management of Tendon/Ligament Injuries
	Chapter 13: Sample Questions
	References
14: Bone Tumors
	Learning Objectives
	Summary
	14.1 Dogs and Cats
		14.1.1 Clinical Signs
		14.1.2 Diagnosis
		14.1.3 Treatment
			14.1.3.1 Use of Analgesics
			14.1.3.2 Radiation Therapy
			14.1.3.3 Bisphosphonates
			14.1.3.4 Chemotherapy
			14.1.3.5 Excision of Tumor (Limb-Sparing Surgery)
			14.1.3.6 Amputation of the Limb
		14.1.4 Prognosis
	14.2 Large Animals
	Chapter 14: Sample Questions
	References
15: Physiotherapy and Rehabilitation of Orthopedic Patients
	Learning Objectives
	Summary
	15.1 Techniques
		15.1.1 Cryotherapy
		15.1.2 Thermotherapy
		15.1.3 Passive Range of Motion
		15.1.4 Massage
		15.1.5 Hydrotherapy
		15.1.6 Therapeutic Exercise
		15.1.7 Other Modalities
	15.2 Rehabilitation in Chronic Cases and Muscular Contracture
	15.3 Assessment and Monitoring
	Chapter 15: Sample Questions
	References
Chapter-Wise Answers for Objective Questions
	Chapter 1: Sample Questions
	Chapter 2: Sample Questions
	Chapter 3: Sample Questions
	Chapter 4: Sample Questions
	Chapter 5: Sample Questions
	Chapter 6: Sample Questions
	Chapter 7: Sample Questions
	Chapter 8: Sample Questions
	Chapter 9: Sample Questions
	Chapter 10: Sample Questions
	Chapter 11: Sample Questions
	Chapter 12: Sample Questions
	Chapter 13: Sample Questions
	Chapter 14: Sample Questions
	Chapter 15: Sample Questions