Lect 8 - Internal Fixation - II
Lect 8 - Internal Fixation - II
Lect 8 - Internal Fixation - II
OF FRACTURE
HUMERAL FRACTURE
SUPRACONDYLAR FRACTURES
HUMERAL DIAPHYSEAL
FRACTURE
It results in disruption of continuity of diaphyseal cortical bone
Cause : high velocity injuries e.g. Motor vehicle accidents, gunshot
injuries, blunt trauma
Radial nerve injury may occur with fractures involving the distal
humerus
Craniocaudal view
Lateral view
SURGICAL TREATMENT
Pre-operative management :- Before surgery, a spica splint can be
applied to increase patient comfort and protect soft tissue from further injury induced
by bone fragments
Operative management :-
Intramedullary pinning
Orthopaedic wire
Interlocking nails
IM pins plus external skeletal fixation
Bone plates
SUPRACONDYLAR
FRACTURES
These are usually transverse or short oblique fractures
SUPRACONDYLAR FRACTURES
RADIAL AND ULNAR
FRACTURE
Most often seen in young animals and is frequently comminuted
Can occur anywhere in the shaft of bone
Metaphyseal & Epiphyseal fractures are common in young animals
High velocity injuries are the most common type of trauma that causes femoral fractures
Most injuries result from Motor vehicle accidents, gunshot injuries, blunt trauma
Observation of pelvic girdle symmetry and gental rectal palpation help determine the
presence of pelvic fracture
DIAGNOSIS
History
Physical examination :
Non weight bearing lameness,
Swelling over scapula,
crepitation on palpation
Diagnostic imaging : Radiographs of femur should include
Lateral view
Caudocranial view
SURGICAL TECHNIQUES
For femoral diaphyseal fracture
A. Application of intramedullary pins
B. Placement of interlocking nails
C. Application of external skeletal fixation
D. Application of bone plates and screws
A B C D
For metaphyseal fractures
A B
Complications of fracture and repair
A fracture and its repair may lead to number of complication which the course of healing of
injured area
Use of various immobilization devices may cause pressure sores, atrophy of muscles and
joint stiffness
Main complications related to fracture healing are :-
Malunion
Delayed union ,
Non union
Avascular necrosis
Shortening of bones
Infection
CONT.
Nerve injury : Radial, Obtrutor, Suprascapular and Peroneal Nerves are more prone to
injury
Injury to blood vessels : damage to the major blood vessels may occur due to direct trauma
Injury to viscera :
In fracture of ribs, injury to lungs, heart, diaphragm, spleen and liver may occur
In pelvic fracture , urinary bladder and rectum are more prone to injury
Failure of implants
Excessive wear and tear of plaster cast,
Bending of splints
• Faulty reduction.
• Inadequate immobilization.