Fracture management and bone healing:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1999
|
| Schriftenreihe: | [The veterinary clinics of North America / Small animal practice]
29,5 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 1029 - 1279 Ill., graph. Darst. |
Internformat
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| 245 | 1 | 0 | |a Fracture management and bone healing |c Steven A. Martinez, guest ed. |
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| 650 | 7 | |a Fracture Fixation |2 cabt | |
| 650 | 7 | |a Healing |2 cabt | |
| 650 | 7 | |a Bones |2 cabt | |
| 650 | 4 | |a Domestic animals |x Diseases | |
| 650 | 4 | |a Fractures in animals |x Treatment | |
| 650 | 4 | |a Veterinary orthopedics | |
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| adam_text | FRACTURE MANAGEMENT AND BONE HEALING
CONTENTS
Preface xi
Steven A. Martinez, DVM, MS
Bone and Bone Healing 1029
Audrey Remedios
Bone is composed of cells and organic matrix (30%), and minerals
(70%). A vascular network consisting of nutrient, metaphyseal,
and periosteal vessels richly supplies adult bone. Fracture healing
consists of three interrelated phases: inflammatory, repair, and
remodeling, and culminates in the ability of bone to return to
original tissue structure. Many growth factors and regulatory
proteins have been implicated in bone repair. Of these, trans¬
forming growth factor B appears to be the major regulator of
bone metabolism. This regulates differentiation and proliferation
of mesenchymal cells into chondroblasts, osteoblasts, and osteo
clasts.
Biomechanics of Bone and Fractures 1045
Robert M. Radasch
A basic understanding of biomechanics, the material and struc¬
tural properties of bone, and the effects that forces have on long
bones enables the veterinary orthopedic surgeon to make rational
decisions in selecting the most appropriate method of fracture
fixation. This knowledge should enhance a surgeon s clinical abil¬
ity to create a biomechanically stable environment at the fracture
site that is conducive to rapid bone healing and early return to
function of the patient. Furthermore, the ability to comprehend
biomechanics as it pertains to fracture management enables the
surgeon to scientifically critique new implant systems as they
VETERINARY CLINICS OF NORTH AMERICA:
SMALL ANIMAL PRACTICE
VOLUME 29 • NUMBER 5 • SEPTEMBER 1999 V
are developed with regard to their inherent ability to effectively
neutralize the potential disruptive forces acting on a fracture after
stabilization.
External Coaptation 1083
Rodney E. Oakley
The goal of any method of fracture repair should be the early
return to full limb function and the prevention of fracture disease.
This can be accomplished through adhering to the basic principles
of good patient and fracture assessment, choosing the correct
method of fracture repair, and appropriate patient care. The com¬
plications of external coaptation can be minimized by appropriate
patient and fracture selection and correct cast and splint applica¬
tion. Choosing external coaptation as a method of fracture repair
can be rewarding as long as the appropriate steps are taken to
ensure success.
Internal Fixation: Intramedullary Pins, Cerclage Wires,
and Interlocking Nails 1097
Ron McLaughlin
The article reviews the principles of intramedullary pinning, cer¬
clage wire application, and interlocking nail fixation for the stabi¬
lization of long bone fractures. Equipment, surgical techniques,
and mechanical principles are explained. Methods to improve
success with these techniques are described, as are the complica¬
tions associated with their use in small animals.
Fracture Fixation with Screws and Bone Plates 1117
Mike Conzemius and Scott Swainman
The treatment goal of fracture fixation is to restore the patient to
normal function as quickly as possible. Fracture fixation can be
accomplished by various means; fixation with screws and bone
plates is not only a popular but a successful technique. In this
article, the authors provide concepts that a surgeon must under¬
stand for successful screw and bone plate use. In addition, case
examples demonstrating the application of many of the concepts
are included.
External Skeletal Fixation: Linear Fixators 1135
Allen L. Johnson and Charles E. DeCamp
Linear external skeletal fixators offer some unique advantages
over other fixation systems; they are biomechanically versatile,
minimize surgical trauma to the fracture environment, and allow
for simple staged disassembly to help promote bone healing.
Historically, the use of linear external skeletal fixators has been
reported to result in numerous complications, primarily related
vi CONTENTS
to the pin bone interface. External skeletal fixators have experi¬
enced a resurgence in the past two decades. Increased knowledge
of proper pin insertion techniques and advancements in pin de¬
sign have greatly enhanced the longevity of the pin bone inter¬
face, resulting in fewer complications. This article reviews some
of the potential advantages of linear external skeletal fixators and
principles of application to help strengthen the pin bone interface
and minimize complications.
Fracture Treatment With Circular External Fixation 1153
Denis J. Marcellin Little
Circular external skeletal fixation (CEF) has been used in recent
years to treat acute and chronic fractures and bone deformities,
to stabilize joints while maintaining range of motion, and to
perform arthrodeses and limb sparing in dogs. Dr. Ilizarov de¬
fined the general principles and methods of CEF. This article
reviews these principles. It also describes the indications, preopcr
ative planning, surgical placement, postoperative management,
clinical results, and complications of CEF used to treat fractures
in dogs.
Biological Osteosynthesis 1171
Ross H. Palmer
Methods of fracture treatment must strike a balance between
fracture stability and soft tissue integrity. With highly commi¬
nuted diaphyseal fractures, exhaustive attempts at anatomical
reconstruction often fail to achieve a load sharing fixation and
concurrently traumatize the vascular supply of the already dam¬
aged tissue. The lack of balance in this scenario makes failure
likely. The strategies of biological osteosynthesis are used when
the surgeon determines before surgery that anatomical recon¬
struction of the multiple cortical fragments is unlikely to result in
load sharing. In these highly comminuted fractures, better results
can be achieved by applying a set of biological osteosynthesis
strategies in which preservation of vascular supply to the dam¬
aged bone is balanced with rigid fracture fixation.
Distraction Osteogenesis 1187
Robert D. Welch and Daniel D. Lewis
Distraction osteogenesis and the use of circular external skeletal
fixation has increased the capacity of veterinary surgeons to man¬
age difficult orthopedic conditions including limb length discrep¬
ancies, angular deformity, distal and severely comminuted frac¬
tures, and bone defects. This article discusses the historical
developments of the Ilizarov method of distraction osteogenesis
in veterinary surgery, circular external skeletal instrumentation,
and the biological principles. There is also discussion of use of
CONTENTS vii
this method for correction of angular deformity and bone trans¬
port and complications associated with this technique.
Bone Grafts 1207
Steven A. Martinez and Tamara Walker
Bone grafting provides a method of enhancing bone healing in
veterinary orthopedic patients. Specifically, autogenous cancel
lous bone graft provides the cellular components and matrix
proteins that can accelerate bone healing dramatically. Allografts
provide immediate mechanical support for fracture repair and
patient function, but these grafts do not create the osteogenic
environment seen with the use of autogenous cancellous bone
graft. Xenograft bone implants may also hold a place for use in
fracture management. With the advent of recombinant bone
derived tissue growth factor technology, bone grafting may one
day become a practiced technique of the past. But for now, bone
grafting still holds a very strong place in orthopedic surgery
when dealing with bone defects in animals.
Bone and Non Bone Derived Growth Factors and
Effects on Bone Healing 1221
Darryl L. Millis
The role that growth factors play in bone healing is fascinating.
Growth factors help direct the recruitment, differentiation, prolif¬
eration, and function of cells at the fracture site. Research is
providing many answers regarding the roles of growth factors
in bone healing, and some growth factors, such as the bone
morphogenetic proteins, may have clinical applications in the
future to enhance fracture healing in humans. The area of bone
and growth factor research is dynamic, advancing rapidly, and
will provide veterinarians with information regarding healing in
dogs and cats, and clinically useful treatments to enhance fracture
healing in patients.
Radiography of Orthopedic Trauma and Fracture Repair 1247
Ron Sande
Radiographic interpretation of orthopedic trauma and healing
should include only those findings that can be validated by radi¬
ography. The radiographic report should be structured and pro¬
vide a clear verbal image of the fracture. Objective radiographic
evaluation made at stages of bone healing and signs of nonunion
can be interpreted. Malunion and delayed union are subjective
determinations that require additional clinical observation. Osteo¬
myelitis is recognized by complex and dichotomous radiographic
findings. New, sophisticated imaging modalities are evolving that
will give more objectivity to evaluating the skeleton in health
and disease.
viii CONTENTS
Treatment of Severe Orthopedic Infections 1261
William S. Dernell
Severe infections are uncommon following orthopedic surgery,
yet they can be frustrating for the veterinarian and owner to treat
and can result in devastating consequences for the patient. This
article reviews the common causes for postoperative infection,
reviews established treatment, and introduces newer methods for
treatment and control. A thorough understanding of the patho
genesis, application of appropriate diagnostic procedures, the in¬
stitution of aggressive treatment regimens, with adherence to
established principles, will often result in satisfactory outcomes
even with severe orthopedic infections. For those more refractory
to treatment, the use of newer treatment methods, specifically
locally implantable materials for sustained release of antimicrobi¬
als can improve success in the treatment of these more difficult
cases.
Index 1275
Subscription Information Inside back cover
CONTENTS ix
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| spelling | Fracture management and bone healing Steven A. Martinez, guest ed. Philadelphia [u.a.] Saunders 1999 XII S., S. 1029 - 1279 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier [The veterinary clinics of North America / Small animal practice] 29,5 Fracture Fixation cabt Healing cabt Bones cabt Domestic animals Diseases Fractures in animals Treatment Veterinary orthopedics Knochenbruch (DE-588)4031318-9 gnd rswk-swf Kleintiere (DE-588)4114226-3 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Kleintiere (DE-588)4114226-3 s Knochenbruch (DE-588)4031318-9 s DE-604 Martinez, Stseven A. Sonstige oth Small animal practice] [<<The>> veterinary clinics of North America 29,5 (DE-604)BV000001819 29,5 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008744760&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Fracture management and bone healing |
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| title_full_unstemmed | Fracture management and bone healing Steven A. Martinez, guest ed. |
| title_short | Fracture management and bone healing |
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| topic | Fracture Fixation cabt Healing cabt Bones cabt Domestic animals Diseases Fractures in animals Treatment Veterinary orthopedics Knochenbruch (DE-588)4031318-9 gnd Kleintiere (DE-588)4114226-3 gnd |
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