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Orthopedic Emergencies - Coggle Diagram
Orthopedic Emergencies
shock
Stage 1
increased HR and RR
injected mm
CRT<1 sec
normal BP
Stage 2
increased HR and RR
pale or toxic mm
prolonged CRT
cold extremities
Stage 3
low HR
pale-cyanotic mm
absent CRT
weak/absent pulses
low temp
no urine production
coma
sedatives
horses
xylazine
butorphanol
morphine
detomidine
:forbidden: acepromazine
cattle
butorphanol
morphine
xylazine
flunixin meglumine
small ruminants
buprenorphine
xylazine
camelids
meloxicam
hemorrhage
What are your options for controlling arterial bleeding?
Temporary tourniquets
Ligation of the artery
Clamping of the artery
Tight bandages
Long bone fractures w/ severe hemorrhage
Pastern fractures (lacerate digital artery)
Femoral and radial fractures = most likely causes
Damaged arteries are deep and not accessible without significant surgical trauma
standard treatments for traumatic acute nerve injury
Stall confinement with deep bedding (sand = good base)
Steroids or NSAIDs are administered
dexamethasone
flunixin meglumine
Treatments for tendon damage
Prevent full weight bearing by splinting
For complete lacerations
should similarly stabilized,
surgical repair does not change success rates
fracture classifications affect prognosis?
Open = worse prognosis
Comminuted = worse prognosis
Articular = worse prognosis
Better: closed, simple non-articular
physeal damage
Can lead to fractures but more often impacts growth
If 1 side of physis grows well but the other doesn’t
angular limb deformities
Physitis
inflammation of the physis
excessive trauma on normal physis
normal trauma on abnormal physis
Causes
rapid growth d/t genetics and/or diet
excessive exercise
uneven weight d/t angular limb deformity
anormal cartilage
Cellulitis or Septic joint?
Adults develop septic arthritis due to wounds and injections
Septic joints in foals - usually due to hematogenous spread
CS
joint effusion
lameness
lay down a lot
Diagnosis
palpate all joints
ultrasound umbilicus
Joint tap → culture and cytology
Normal
low protein
low cell count
high viscosity fluid
Infected
high protein
high cell count
low viscosity fluid
radiographs
many cases of juvenile septic arthritis occur due to extension from an infected physis or metaphysis
Early ID necessary for soundness and to maintain life → can result in euthanasia
Treatment
systemic IV antibiotics
amikacin in foals
penicillin/gentamicin or cephalosporin until C&S results)
Foals: joint lavage with through and through needle technique
Chronic cases/adults: arthroscopic lavage
Local (intra-articular) antibiotics
infusion of amikacin or high powered antibiotic
Synovial resection may be required to remove deep seated bacteria and damaged synovium
Cellulitis
disseminated infection where bacteria grow in the tissue planes instead of the abscess capsule
CS
affected area is hot, swollen, painful
animal is febrile and may have changes in WBC counts
Treatment
systemic antibiotics and NSAIDs,
bandage limbs to reduce swelling and pain
Is not life threatening
streetnail injury
stepping on a nail
Navicular bursa, SDFT, DDFT, suspensory ligament, coffin joint
specific conditions
field stabilization