Page 106 - Veterinary diagnostic imaging birds exotic pets wildlife

102 SECTION I III The Birds

based on the skill and experience of the operator. Addi-
tional factors include the condition of the patient, espe-
cially the presence of any other serious injuries. Once
these matters are considered, comparable cases should
be reviewed and a prognosis formulated, and one
should remember that healing time is first and fore-

most a prediction, which can and must be modifi ed
according to what is observed in subsequent progress
fi lms.
Immediate Postoperative Films. After surgery, imme-
diate postoperative radiographs must be made for the
purpose of technical evaluation. If the occasion arises,
these radiographs can be proof that the surgery was
performed as agreed on (Figure 10-9). The importance
of making a complete set of postoperative radiographs
once the surgery has been completed cannot be stressed
enough. If for any reason immediate postoperative
films cannot be made, for example, if the power goes

out or there is an equipment failure, then the medical
record should be so annotated and the responsible
party notifi ed.

Progress Films. As the name implies, progress fi lms
are made to monitor, as well as predict, fracture healing.
Because no two fractures heal in exactly the same
manner or at the same rate, each injury must be
assessed in its own right, according to the following A
criteria:

• The severity of the original injury, especially the
degree of comminution, and whether it is open
(potentially infected)
• The effectiveness of the surgery, particularly with
respect to the apposition and alignment of frac-
ture fragments
• The maintenance of fragment position
• The maintenance of implant position
• The maintenance of implant integrity
• The relative appearance of the fracture compared
with all previous radiographic examinations
• The physical appearance of the fractured part
and the degree to which it has regained
function
• The overall health and condition of the bird
during the time it is being monitored
These data may then be used to derive a current
status report. For example, an initial 1 month progress
report might read: “Early healing as indicated by new
bone formation in and around fracture site; fragment
and implant positions have been well maintained”
(Figure 10-10). The same data can also be employed in
a predictive fashion, for example, “Anticipate callus
should be strong enough in another 2 weeks to allow
removal of support wrap. Recommend wing be radio-
graphed again in 1 month’s time.”
Alternatively, a progress report might read: “Cur-
rently, there is no evidence of callus formation, although B
the bone appears healthy and the fracture fragments Figure 10-9 • A, Close-up, ventrodorsal view of a badly displaced,
and implants stationary. Based on its current appear- compound, midshaft humeral fracture. The bones are actually
poking out of the skin in two places. B, An immediate
postoperative film made the next day showing anatomical

reduction.

2/11/2008 10:56:11 AM
ch010-A02527.indd 102
ch010-A02527.indd 102 2/11/2008 10:56:11 AM