The Revision Guide for Student Nurses (Part I)

Fractures, Dislocations, Sprains - Answers

ANSWERS

  1. Define fracture.
    A break in the continuity of bony tissue; a broken bone.
  2. What is the term that is used to describe a bone broken cleanly into 2 pieces?
    A simple fracture.
  3. What is meant by a compound fracture?
    A fracture where there is a wound communicating between the skin (or mucous membranes) and the site of the broken bone.
  4. What is the term used to describe a fracture where important structures or organs around the site of the broken bone are damaged?
    A complicated fracture.
  5. What is meant by a multiple fracture?
    This describes a break to the bone in 2 or more places but where there is an appreciable distance between the 2 sites.
  6. What is the name given to the incomplete fracture commonly seen in young dogs?
    A greenstick fracture.
  7. What is a distracted fracture?
    A fracture where the broken ends of the bone are driven apart from one another.
  8. What is the name given to a fracture where the fracture line runs at right angles to the bone cortex?
    A transverse fracture.
  9. List 6 signs that may be detected in the event of a fracture.
    • Crepitus (a grating sound heard when the broken ends of the bone rub against one another).
    • Deformity (caused by severe displacement).
    • Loss of function (an animal is usually 90-100% lame if a limb bone is fractured).
    • Pain.
    • Swelling (due to inflammation of the tissues surrounding the fracture site).
    • Unnatural motility.
    • Commonly, shortening of the limb.
  10. Explain why a complete compound fracture would be more painful than an incomplete simple fracture.
    The bone fragments are likely to rub against each other in a complete fracture, which would prove more painful than an incomplete fracture in which there is little movement. In addition, a compound fracture involves damage to other tissues in addition to that of the bone and is therefore another source of discomfort.
  11. A cat is brought to the surgery as an emergency following an RTA. The owner has noticed that the cat is walking with a strange gait and that the hindquarters are carried very low. What is the most likely problem, and what first aid would you carry out.
    The cat may have a fractured pelvis.
    • Assess the seriousness of the emergency (remember your ABC).
    • Take a full history (see Module 2).
    • Ensure that the owner signs a consent form permitting examination and the administration of first aid treatment.
    • Ask a colleague to contact the veterinary surgeon and to set up equipment for fluid therapy (in most RTA cases, the patient is likely to be shocked).
    • Carefully transport the cat to an examination room handling the affected area as little as possible.
    • Observe for any signs of haemorrhage both at the suspected fracture site and elsewhere on the body.
    • Stem haemorrhage from any other wounds that may be present.
    • Get the cat onto fluids.
    • Clean and dress any minor wounds; it is not necessary to dress the pelvis since it would be difficult to effectively support this area, and confinement is usually suffice.
    • Ensure that the cat is confined within a small, warm hospital cage and discourage movement.
    • Assist the veterinary surgeon upon his or her arrival with the administration of analgesia .
    • Radiography is likely to be necessary, but if the cat is suffering from shock it is advisable to ensure that the animal is stable and comfortable prior to further procedures.
  12. If a spinal fracture is suspected, why is it very important to move the patient with extreme care?
    The animal is likely to be in intense pain due to pressure exerted on the spinal cord by the displaced bones/fragments
    The spinal column must be supported at all times and not twisted in order to prevent further damage
  13. Name the support dressing that includes maximum padding and is ideal for the immobilisation of fractured limbs?
    Robert Jones dressing.
  14. Why might the two distal flanges of the middle two toes be left exposed following the application of a Robert Jones dressing?
    Robert Jones dressings may be left in place for some time, and it is therefore sensible to leave the tips of these two toes exposed so that the temperature of the digits may be checked. If the digits are cold, swollen or lacking in sensation then the dressing is too tight and must be promptly removed.
  15. List 4 types of splint that may be used to temporarily immobilise a limb fracture.
    • Aluminium Zimmer splint.
    • Plastic gutter splint.
    • Plaster or resin splint.
    • Inflatable air bag.
  16. State 2 instances when it may be possible to immobilise an injured part of the body by using a healthy part of the body as a splint.
    • A fractured scapula which may be bound against the rib cage.
    • A single fractured metacarpal, metatarsal or digit which may be bound to the adjoining unaffected bones of the same foot.
  17. Define dislocation.
    A persistent displacement of the articular surfaces of the bones which form a joint.
  18. What is another name for a dislocation?
    Luxation.
  19. Name the 4 joints that are common sites for dislocation.
    • Carpus.
    • Hip.
    • Shoulder.
    • Tarsus.
  20. What is the correct term for a partial dislocation?
    Subluxation.
  21. What is the name of the dressing that may be used to support the hind limb following reduction of hip luxation?
    Ehmer sling.
  22. What is the name of the dressing that may be used support the shoulder joint following luxation?
    Velpeau sling.
  23. What is the difference between a sprain and a strain?
    A sprain is damage to the ligaments, synovial membrane and soft tissues of a synovial joint, whilst a strain is damage to a muscle or tendon.
  24. Name the 4 joints that are common sites of sprains.
    • Carpus.
    • Shoulder.
    • Stifle.
    • Tarsus.
  25. What is the cause of "kangaroo stance"?
    Ruptured Achilles tendon.