1. LIVE FOR TODAY
“We must be willing to get rid of the life we’ve planned, so as to have the life that is waiting for us.”
-Joseph Campbell

2. DISEASES OF THE MUSCULOSKELETAL SYTEM

3. FUNCTIONS OF THE MUSCULOSKELETAL SYSTEM
Support
structural support/framework for the entire body
Storage
Minerals (calcium) and lipids.
Blood cell production.
site of formation for all types of blood cells.
Protection
vital organs of the body
Leverage
Many of the joints of the body act as levers therefore
assisting with movement.
Provides a place for muscles, tendons, ligaments to attached

4. MUSCULOSKELETAL SYSTEM
Flexible articulations
form joints
The skeleton is the rigid frame
Muscles, tendons, and ligaments form a system of pulleys

5. DISRUPTION OF THE MUSCULOSKELETAL SYSTEM
POOR CONFORMATION
TRAUMA
DEGENERATIVE DISEASE
INFLAMMATION
NEOPLASIA

6. TRAUMA: LONG BONE FRACTURES
Lameness, swelling, hx of abuse
Deformity of bone, swelling

7. TRAUMA: CLASSIFICATION OF FRACTURES
Open or Compound: broken bone exposed through skin
Closed: broken bone beneath intact skin
Simple: 1 fracture line (oblique, transverse, greenstick)
Comminuted: multiple pieces
Stable: ends opposed and fixed (ie. greenstick)
Unstable: ends are not aligned, overlapped
Compression: a crushing type injury usually of the vertebrae or growth plate

8. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES
Transverse fracture
Oblique fracture

9. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES
Greenstick fracture
Comminuted fracture

10. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES
Fissure fractures

11. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES
Spiral Fractures

12. TRAUMA: DIAGNOSIS OF FRACTURES
COMPRESSION FRACTURE

13. TRAUMA: OPEN or COMPOUND
In open fractures bone is exposed through the skin

14. METHODS OF FIXATION External Coaptation Internal Fixation Splints
Casts
Internal Fixation
IM pins
Bone plates, screws
Cerclage wire

15. METHODS OF FIXATION OF LONG BONE FRACTURES
ROBERT JONES
BANDAGE

16. METHODS OF FIXATION OF LONG BONE FRACTURES: SPLINTS
QUICKSPLINT
METASPLINT or SPOON SPLINT
It is critical that the splint support both the
joint above and below the injury !

17. METHODS OF FIXATION OF LONG BONE FRACTURES: CASTS
Casts can be made plaster of paris or other moldable material

18. METHODS OF FIXATION: SPLINTS AND CASTS
NOTE: Casts and splints may not prevent rotation or overriding of fracture pieces, and may result in delayed healing or nonunion in some fractures.
Splints should be changed weekly
Casts can be left in place for several weeks.

19. METHODS OF FIXATION OF FRACTURES
IM (Steinmann) pins with cerclage wires

20. METHODS OF FIXATION OF FRACTURES
Advantages of IM pins
Prevent bending forces
Disadvantages
Do not prevent rotation or compressive (axial) forces
Should be combined with other methods such as cerclage wire to prevent other forces

21. METHODS OF FIXATION OF LONG BONE FRACTURES: BONE PLATES & SCREWS

23. METHODS OF FIXATION: EXTERNAL FIXATORS
External fixators are pins that penetrate the skin and bones
that are attached to fixed bars or acrylic using special clamps: Kirschner-Ehmer apparatus

24. CLIENT INFO Restrict activity
Watch for drainage, swelling, heat from surgical sites or from splints/casts
Metal (plates & pins) stronger than bone – refracture may occur
Follow up x-rays necessary
Metal should be removed after healing
Metal may cause cold sensitivity