Fracture types & managemental approach

Different Fractures and their Approaches

Prepared By: Dr. ALOK BHARTI (M.V.Sc.),C.V.Sc (SVVU), Rajendranagar, Hyderabad. Hyderabad.

Mandibular Fracture

Branch of facial artery and vein

Parotid Duct

Incision In the masseter muscle

Scapular Spine Fracture

large, flat bone composed of a body with a longitudinally running, flat spine; a neck; and the glenoid, or articular surface.

prominence at the ends of the scapular spine, the acromion – predisposed to fracture or avulsion

trapezius muscle, supraspinatus muscle, and the infraspinatus muscles to be retracted to expose the body and spine

Fracture of humerus

Humerus is broader, stronger towards the proximal extremity from the mid shaft – fractures are usually found towards the distal part of the shaft

1. M. triceps brachii (long head)2. M. triceps brachii (lateral head)3. M. triceps brachii (medial head)4. M. teres minor5. M. branchialis6. Radial nerve7. Medial branch of superficial8. Lateral branch; ramus9. Deep ramus10. Muscular branches to triceps11. M. extensor carpi radialis 12. M.anconeus

Humeral Head Fracture

Fracture of Humeral Shaft

Brachiocephalicus

Cephalic veinBrachialis muscle

Radial nerve

Lateral head of triceps muscle

Lateral Approach

Lateral head of

triceps muscle

Brachialis muscle

Radial nerve

Lateral Approach

Superficial

pectoral muscle

Biceps brachii muscle

Long head of triceps muscle

Neurovascular bundle

Medial Approach

Biceps brachii muscle reflected caudally

Brachiocephalicus muscle

Fracture of distal extremity (LA)

Lateral aspect of the left elbow joint of a dog.The M. triceps brachii has been left in situ after removal of the other surrounding musculature.

1. Humerus2. Supratrochlear foramen3. Capitulum4. Trochlea5. Lateral epicondyle6. Lateral collateral ligament7. M. triceps brachii

8. Olecranon9. Annular ligament10. Radius

I I. Cut edge of M. anconeus12. Ulna13. Interosseus membrane14. M. abductor pollicis longus

1. Humerus2. M. triceps brachii3. Olecranon4. Trochlea5. Capitulum6. Medial collateral ligament7. Oblique ligament8. Medial epicondyle9. Radius10. Ulna

Medial aspect of the left elbow joint of a dog.

The M. triceps brachii has been left in situ after removal of the other surrounding musculature.

Medial Approach

Radial Fracture The radius is formed proximally by the oval and concave

radial head, which articulates with the humeral capitullum. The metaphyseal area tapers slightly to become the flattened radial diaphysis. The diaphysis is of uniform shape, flattened cranial-caudally, and curves slightly as it moves from a lateral position at the elbow to a medial position at the carpus. Distally the metaphysis enlarges and enters the epiphysis. The distal epiphysis has a concave articular surface that sits upon the radial carpal bone. A medial pointed prominence, the styloid process serves as proximal attachment of the medial collateral ligament.

The medullary canal of the radius is usually uniform in size and much wider medial-laterally than cranialcaudally.

Lateral aspect of the pelvic and thigh regions of the left pelvic limb of a dog.The fascia lata and biceps femoris muscle have been removed to reveal the deeper muscles.The gluteal muscles have been reflected dorsally.

1 M. gluteus medius2 M. gluteus superficialis3 M. gluteus profundus4 M. piriformis5 Hip joint capsule6 M. sartorius7 M. tensor fasciae latae8 M. rectus femoris9 M. vastus lateralis10 Femur11 M. quadratus femoris12 Ischiatic nerve13 Caudal gluteal artery and vein

14 M. adductor15 M. semimembranosus16 M. semitendinosus17 M. abductor cruris caudalis

Condylar Fracture of femur

Patellar tendon

Vastus lateralis

Incision in fascia lata & joint capsule

Subluxation of Patella in Cattle

Three forms exist:

• dorsal patellar luxation or fixation in adults;

sporadic incidence -Temporary or permanent fixation of patella on upper part of medial femoral trochlear ridge.

• lateral patellar luxation; congenital, uncommon Complete or incomplete lateral displacement of patella.

• medial patellar luxation; congenital, rarelimb flexed with patella freely moveable

Lateral view of left stifle joint of cow.

1. femur; 2. patella; 3. and 4. medial and lateral menisci; 5. tibia; 6. fibula; 7. and8. medial and lateral trochlear ridge; 9. patellar fibrocartilage; 10. tibial tuberosity;11. medial straight patellar ligament (sectioned distally in patellar desmotomy);12. and 13. middle and lateral straight patellar ligaments; 14. tendon of bicepsfemoris muscle; 15. lateral femoropatellar ligament; 16. lateral collateral ligament.