External coaptation

Question 1

indications for external coaptation

Answer 1

1. First aid/temporary tx of fx
2. 2nd support/compression post sx fx repair
3. Primary repair of suitable fx

Question 2

main req. for use of cast as primary repair of fx

Answer 2

1. Fx distal to elbow and stifle joint
2. Closed, minimally displaced, inherently stable (good biomechanical)
3. Young animal w/ good healing potential (good biologic)
4. No complicating factors that could delay healing
5. No soft tissue injury
6. Heal w/in 4-6wks

Question 3

contraindications for use of cast as primary repair of fx

Answer 3

1. Fx above stifle/elbow joint
2. UNstable fx where adequate reduction cannot be achieved/maintained
3. Animals where healing potential is poor
4. Open fxs/soft tissue injury
5. Healing expected >4-6wks

Question 4

General principles in application of external coaptation

Answer 4

1. Jt above and below fx immobilised
2. Limb should be cast at a standing angle w/ jts flexed rather than extended
3. Bone prominences should be adequately padded prior to casting to prevent pressure/friction sores. use ‘donuts’ of cotton wool

Question 5

complications w/ external coaptation

Answer 5

• delayed/non/malunion
• jt stiffness (usu self resolving if cast on <4-6wks)
• skin: presssure, friction sores, tissue necrosis, infections
• soft tissue swelling (cast put on too acutely) - first manage swelling for 24-48hs post trauma - then cast

Question 6

ongoing cast care

Answer 6

• hospital observation 12hrs post application
• weekly recheck
• fast growing animal change cast q2-3wks