Symptoms and Surgical Interference in Fractures and Dislocations | Animal Husbandry & Veterinary Science Optional for UPSC PDF Download

Fractures

Presentation of a fracture involves a disruption in hard tissues such as bone and cartilage.

Symptoms of Fracture

• (i) Pain: Pain results from the movement of fractured parts. It can vary in intensity based on the type of fracture, being less severe in impacted fractures and potentially absent in pathological ones.
• (ii) Crepitus: Crepitus is a sensation or sound felt when fractured bone ends grind against each other. Soft tissue between the fragments can sometimes prevent this sensation.
• (iii) Abnormal Mobility: Movement of the affected area in an unnatural direction or way not typically possible.
• (iv) Deformity: Deviation from the normal shape or position of a body part due to fragment displacement.
• (v) Loss of Function: Inability of the fractured limb to bear weight, with the degree of dysfunction varying based on the severity of the fracture.

Treatment of Fracture

• (i) Reduction of the Fracture: Involves realigning the bone fragments.
• (ii) Immobilization: Stabilizing the affected area to promote healing.

Surgical Treatment of Fracture

Intramedullary Pinning:

• Closed Reduction: The pin is inserted through the bone without surgical opening, guided by anatomical landmarks.
• Open Reduction: Surgical incision exposes the fracture site, allowing precise pin placement through both bone fragments.
• Types of Pins: Examples include Steinman pins, Kutcher nails, and Kirschner wires.

 Bone Plating:

• Utilizing stainless steel or Vitallium plates fastened to fractured ends with screws to maintain alignment.
• Multiple screws per fragment are recommended to prevent shifting.

Dynamic Compression Plating (DCP):

• Special instruments and techniques are employed, using plates and screws to enhance stability during the healing process.

Skeletal Fractures and Dislocations:

• Internal Fixation:

  Internal fixation involves the use of plates and screws to stabilize fractures, allowing direct healing without callus formation.

• External Skeletal Fixation:

  Transfixation pinning is utilized by driving pins into fragments, penetrating skin, soft tissues, and bone. This technique is beneficial for managing compound fractures.

Dislocation(Luxation):

• Dislocation refers to the separation of bone surfaces, leading to symptoms like pain, restricted mobility, functional interference, deformity, and swelling.
• Treatment involves reduction and retention, with immobilization followed by gradual exercise for recovery.

Hernia

• Definition and Types: Hernia is the protrusion of organs through openings, classified into various types like umbilical, inguinal, diaphragmatic, and more based on location
• Parts of Hernia: 
  • Hernial opening (ring)
  • Hernial swelling
• Components of Hernia: 
• Hernial Sac:
  • Defined as a protrusion of organ or tissue.
• Hernial Contents:
• Enterocele (Intestine and mesentery)
  Epiplocele (Omentum)
  Enteroepiplocele (Intestines and omentum)
  Gastrocele (Stomach)
  Vesicocele (Bladder)
  Hepatocele (Spleen, Liver, etc.)
  Sub-peritoneal fat (in pups)
  Hysterocele (Uterus)

• Classification of Hernia: 
  I. Congenital and Acquired 
  II. External Abdominal Hernia and Internal Abdominal Hernia III. According to Location:
  Umbilical hernia (Omphalocele, Examph ilos)
  Inguinal hernia (Bubonocele)
  Scrotal hernia (Oschococele)
  Diaphragmatic hernia
  Ventral hernia
  Crural hernia
  Femoral hernia
  Perineal hernia

• IV. Reducible and Irreducible Hernia:

  • Incarcerated hernia
  • Strangulated hernia
  • Hernia with adhesions
• Etiology:

  Causes of hernias include factors like weak abdominal walls, increased intra-abdominal pressure, and trauma.

• Symptoms and Diagnosis:

Symptoms

1. Physical: Hernial swelling, shape and size of the hernial sac and the nature of the hernial contents.

2. Functional:

(a) Reducible hernia - Rarely indigestion

(b) Incarcerated hernia Digestive disturbance and colic

(c) Strangulated hernia - Severe continuous abdominal pain, animals lic on its back, febrile reaction.

(d) Ifgangrene pain subsides, animal becomes dull, listless, has subnormal temperature.

Diagnosis

1. By palpating the hernial ring

2. By palpating hernial contents

3. Exploratory puncture

4. Radiography - by plain or contrast radiography

5. Rectal examination.

Differential Diagnosis:

• Abscess
• Tumour
• Cyst
• Haematoma
  
• Prognosis:
  • Guarded prognosis
  • Favorable outcomes with proper treatment in many cases
  • Spontaneous recovery in conditions like umbilical hernia (congenital)

 Treatment

• Treatment (General Principles)

  • Reduction and retention by bandage (Elastoplast)
  • Application of blisters at the hernial ring after reduction using substances like sodium chloride, zinc chloride, absolute alcohol, tincture iodine, and biniodide of me
  • Ligature for slow development
  • Use of hernial clamps
  • Set of mattress sutures to induce sloughing
  • Radical operations such as herniorrhaphy and hernioplasty using materials like fascier lates, stainless steel wire mesh, dacron, nylon, or prolene
  • Mere reduction and spontaneous healing

• Umbilical Hernia (Omphalocele, Examphalos)

  Umbilical hernia typically involves omentum, intestine, or both and is caused by imperfect closure of the umbilical opening. Compression during birth, straining, and omphalophlebitis are contributing factors.
  Diagnosis:
   (a) Symptoms i.e., hernial swelling at the umbilical region
  (b) Physical examination - palpation of the umbilical ring
  (c) Exploratory puncture
  (d) Rarely X-ray will help
  
  Differential diagnosis
  Abscess, Haematoma, Urachal cyst due to persistent urachus.
  Treatment:
   (1) Spontaneous recovery in foals and calves below one year. Recovery hastened by reduction and bandaging (elastoplast) and laxative diet to prevent straining. 
  (2) Other methods like ligation and clamps. 
  (3) Radical operation under general anaesthesia (open reduction).
  
  

• Ventral Hernia

  Ventral hernias occur in the abdominal wall due to various causes like violent trauma, increased intra-abdominal pressure from pregnancy or other conditions.
  Symptoms: There will be hernial swelling due to herniation of omentum, intestine or

  both. Strangulation is rare unless the opening is small.

  Diagnosis: Palpation (it is difficult to palpate if the ring is large) and X-ray (if hernia

  involves lower abdomen.)

  Treatment: Radical operation

• Inguinal Hernia

  Inguinal hernias involve the abdominal viscera passing into the inguinal canal, commonly congenital but can be acquired from accidents or muscle contractions.
  Symptoms (i) Hernial swelling

  (ii) Abduction of hind limbs

  (iii) Race horse suddenly stops and evinces pain due to pulling and contraction of cremaster muscle

  (iv) In acute cases colic pain

  (v) Stallion and bulls reluctant to serve

  Diagnosis: (i) Hernial swelling and other clinical symptoms

  (ii) Physical examination

  (iii) Rectal examination

  Differential Diagnosis

  (i) Sarcocele (swelling of testicle)

  (ii) Hydrocele (fluid thrill and feeling)

  (iii) Cyst

  (iv) Enlarged lymph node

  (v) Scirrhous cord

  Treatment

  (1) Congenital hernia - gets corrected in 1 year

  (2) Castration by covered method (if the animal is not meant for breeding)
  (3) Surgical correction (if the animal is meant for breeding).

Choking

• Causes: Large size or rough surface of swallowed material, esophageal structure, or muscle spasm, and tumors pressing the esophagus.
• Seat of obstruction: Commonly in the post-pharyngeal region of cattle and the posterior part of the esophagus in horses.

Choking Material

• Horse: Fine dry feed, pieces of carrot, turnip, or potato.
• Cattle: Potatoes, beets, silage, turnip pieces, apple.
• Dog: Bones, toys.

Symptoms

• Anorexia
• Food swallowed partially returns
• Restlessness with an anxious expression
• Swallowing movements
• Salivation
• Vomiting attempts
• Cough
• Breathing distress
• Bulging of the esophagus
• Edema of the head due to pressure on jugular veins
• Tympany in cattle

Symptoms in Different Animals

• Cattle: Lowering of head and salivation
• Horse: Arching of neck
• Dog: Salivation with attempts to vomit

Diagnosis

• Diagnosed by symptoms, passing a stomach tube or probang, physical examination, radiography, esophagoscopy, and ultrasonography.

Treatment

• Use of Pilocarpine or Arecoline injection to induce copious mucus secretion.
• Injection of eserine to stimulate peristaltic movement.
• Injection of Apomorphine to induce vomiting in dogs, cats, and pigs.
• Usage of oesophageal forceps.
• Pushing foreign bodies using a probang into the stomach (contraindicated in dry food impaction).
• Using an esophagoscope if choking is caused by small objects, especially in dogs.

Abomasal Displacement

• Displacement of the abomasum towards the left side along the floor of the abdomen is a common issue in cows.

Etiology

• Abomasum displacement is often due to pressure from neighboring organs like the gravid uterus, causing it to move towards the left side.

Symptoms

• Manifested during the last few weeks of pregnancy or after parturition.
• General dullness and anorexia.
• May resemble acetonemia and coexist with displacement of the abomasum.
• Asymmetrical appearance of the abdomen with a distended left anterioventral aspect.

Differential Diagnosis

• Acetonemia, Traumatic reticulitis, and Torsion of the abomasum are considered in the differential diagnosis.

Diagnosis

• Based on symptoms and exploring through the 9th intercostal space to aspirate abomasal contents for pH analysis.

Treatment

• Spontaneous resolution may occur when the animal fasts, reducing rumen contents and relieving pressure on the displaced abomasum.
• Correction can be attempted after casting by pushing the abomasum towards the right side.
• Rumenotomy can be performed to remove part of the rumen contents, aiding in correcting abomasal displacement.
• Two laparotomy incisions are made on the right and left flank to correct the abomasal position.
• Abomasopexy involves suturing the abomasum to the ventral abdominal wall to prevent future displacement. This is done using non-absorbable synthetic material without penetrating the abomasum's lumen.

• Cesarean Operation

  • Indications for Cesarean section include cases of dystocia that cannot be resolved within 15 to 20 minutes.
  • Anesthesia involves paravertebral anesthesia supplemented with local infiltration.
  • Preparation of the patient includes closely clipping and scrubbing the left flank area before making the incision.
  • The approach can be upper flank or lower flank based on the specific condition of the patient.
  • During the procedure, abdominal contents are carefully managed, and the fetus is delivered with precision.
  • Post-operative care includes administering antibiotics, removing sutures after 7 days, and caring for the calf.

• Rumenotomy

  • Rumenotomy involves a surgical incision into the rumen and is typically performed under local anesthesia.
  • Indications for rumenotomy include rumen impaction, recurrent bloat, foreign body presence, and as a stage surgery for diaphragmatic hernia.
  • The surgical technique includes suturing the rumen to the abdominal wall and using trocar and cannula for puncturing the rumen.
  • Post-operative care includes administering antibiotics and dressing the wound appropriately.
• The metabolic alterations due to rumen and reticulum surgical diseases depend on factors like the duration of illness, extent of peritonitis, systemic infection presence, anorexia duration, and digestive tract blockage.
• Electrolyte or acid-base imbalances are not common even in severe, extensive, and prolonged diseases.
• Post-surgery, intravenous administration of normal saline and Dextrose saline is based on estimated dehydration levels determined by body weight.
• Post-operative complications may include tissue death from Adrenaline, peritonitis, sepsis, adhesions, and subcutaneous emphysema.

Castration 

• Castration Definition: Castration involves the removal of testicles.
• Methods:
  • Closed Method: Techniques like the Burdizzo method where no incision is made, causing thrombus formation in spermatic vessels, leading to testicle atrophy.
  • Open Method:
    • Open Uncovered Method: Involves incisions to expose testicles and spermatic cord for removal.
    • Open Covered Method: Testicle removal without incising the tunica vaginalis.
• Castration of Bovine:
  • Indications: Enhancing docility and manageability of work animals.
  • Methods: Closed method using Burdizzo castrator preferred for simplicity and minimal wound production.
• Castration of Horse:
  • Indications: Rendering the horse docile, managing the animal, treating diseases or injuries, and selective breeding.
  • Age: Typically performed around one year old.
  • Pre-operative Preparation: Ensuring animal health, ruling out infectious diseases, and fasting before surgery.
  • Anaesthesia: General or local anaesthesia approaches used.
  • Operative Technique: Detailed steps involving incisions, separation of vascular bundles, cord severing methods, and post-operative care.

Castration of Sheep and Goat:

The procedure for sheep and goats is similar to that for cattle, using a smaller Burdizzo castrator.

Castration of Pigs

For pigs, the open covered method is preferred due to the common occurrence of inguinal/scrotal hernia. Local infiltration anesthesia is used for small pigs, while large pigs receive general anesthesia.

Incisions are made on the posterior aspect of the scrotum, either with a single transverse incision or two separate vertical incisions.

Castration of Dogs

Dogs undergo castration through a single prescrotal incision using the open covered method under general anesthesia with thiopentane sodium.

Cats are castrated through a double scrotal incision using the open covered method under thiopentane or ketamine general anesthesia.