
How To Fix Fractures
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Session 1: How To Use Bone Plates and Screws
Areas covered in this session will include: the principles and application of dynamic compression plates, how to use a DCP plate as either a compression plate, neutralisation plate or bridging plate, the difference between cortical and cancellous and locking bone screws, the difference between plate screws, lag screws, positional and locking screws, when and how to lag screw, locking plates – advantages and indications – the importance of pre-operative temporary fracture support, how to position and drape animals for fracture repair to simplify surgery, comminuted fractures – what to do with all the ‘bits’ when and when not to bone graft, reinforcing bone plates – plate-rod and orthogonal plate constructs.
Session 2: External Skeletal Fixation
In this webinar Mark will cover: the importance of the pin-bone interface, why threaded pins will double the life expectancy of your ESF, why pre-drilling before you place the ESF pin buys you time, why using ESFs on the femur is a major biomechanical challenge, why knowing which way the nut goes is not just for when you are castrating horses, how updating your ESF kit will make your life easier, why the textbooks may not be telling the whole story when they say comminuted open fractures should be treated with an ESF, the principles and application of linear ESFs, applying ESFs to antebrachial and tibial fractures, how to position and drape animals for fracture repair to simplify surgery, why simpler is better and why less is more, why, for most of us who want an easy life, the two frames we should be placing on antebrachial and tibial fractures are the Type1a and Type 1b, why, for most of us who want an easy life, we should not take our ESFs above the elbow or stifle joint, the use of hybrid ESFs in very distal juxtarticular fractures, why carbon fibre and titanium are not just for bicycles, when to destabilize an ESF and which bits to remove.
Session 3: Effective Use of Pins and Orthopaedic Wire
In this webinar Mark will use case examples to review common errors in the use of pins and wires and highlight the decision-making and principles of application of intramedullary pins, cerclage wire, K wires and tension band wires that are necessary for consistent success. Areas Mark will also explore in this webinar include: the fracture decision-making table and how to use it to know when friction fixation is a good idea and when it isn’t! why IM pins are good at resisting three biomechanical forces; bending, bending and bending! why placing twist cerclage wire effectively in dogs is technically very challenging, why double loop cerclage is stronger, easier and more reliable than twist cerclage, how spending 110 quid on a single piece of equipment will help you sleep better at night! why cats are better than dogs (and it’s not because of the incorrect old adage of putting the fractured cat bones in the same room and they will heal!!!) why the tibia is a challenge for cerclage wire – and why winemakers don’t use triangular wine casks – why you should update your insurance before you pin a radius or insert a pin retrograde into the tibia – why the question of ‘how do I reinforce an IM pin repair to make it stronger?’ needs a paradigm shift to ‘how do I use an IM pin to reinforce another method of fracture repair?’ how to simplify fracture reduction when repairing distal femoral physeal fractures with crossed K wires, how to simplify placing K wires in tibial crest osteotomies.>