IntroSx2- Orthopedics

100%; special care if pain to alignment, growth disturbance, prevent joint disease, prevention of excessive motion, prevention of infection

• anatomic reduction
• stable internal fixation
• preservation of the blood supply
• early, active, pain-free mobilization (avoid fracture disease)

• stabilize the limb above and below the fracture
• evaluate the entire animal (for shock, other injuries, etc)

• PE
• flexion tests
• drawer sign
• nerve blocks
• imaging

• radiographs
• MRI
• CT
• ultrasound (tendons)
• nuclear scan

• Medical management: external coaptation, joint medications
• Surgical management: principals of internal fixation
• Physical therapy: US, shock wave therapy, massage, water therapy, ice, range of motion, strengthening, swimming, rehab exercises

• external fixators
• casts
• splints
• bandages

off-loading the fracture site and keeping it aligned.

decreases LPS-induced joint inflammation in horses.

and NSAID cream in liposomes, which will transfer it through the skin

arachadonic cascade; blocks cyclooxygenase

• intrarticular injection
• reduces joint inflammation and provide lubrication

• [polysulfated glycosaminoglycans] given IM
• promotes cartilage repair and health for early DJD or early OA; must be used early on before cartilage is completely destroyed

• NOT A DRUG
• orally administered, required for normal body function, intent of improving health

compression; if you take the same cells and don't pressurize them, they will become cartilage or fibrous (don't have the same strength)

loading stimulates bone formation; without loading, you get fracture disease, which is fusion and ankylosis of the joint, which will remain painful for life

create compression across a fractured surface by over-drilling the near cortex and tapping the far cortex; when the screw tightens, compression at the fracture occurs [the screw threads and pulls the 2 cortices together]

• countersink not necessary
• reduce and compress fracture
• counter traction of ligaments or muscles by using some level of compression

• oval holes in plate
• fix plate to fracture
• eccentrically load screw on other side of fracture and away from fracture
• tighten screw [the screw wants to go in the center of the oval hole, so it pulls the plate up as it is tightened]

trans-articular screws (lock it with a lag screw in each sesamoid if fetlock) and DCP (dynamic compression plate)

pressure; tension; they can bend; ALWAYS try to put the plate on the tension surface of the bone (convex surface)

use wires across a fracture in a box or figure 8 on the TENSION SIDE of the fracture b/c tension forces counteract distraction forces

wire is subject to failure on motion; must choose right gauge of wire, use multiple wires, and need some level of immobilization to prevent breaking of wire

• Exercise: decreased inflammatory cytokines, improve joint mobility
• Massage: improve tissue fluid exchange
• Ice: decrease inflammation, reduce pain

• to fit the head of the screw so that it does not bend when you put it in
• if you hit the opposite cortex and it's at an angle (not exactly perpendicular), the screw will bend at its weakest point, the junction of head and body

• bone clamps
• muscle relaxation (neuromuscular blocking drugs, guaifenesin)