Tarsal Injuries, and Calcaneal and Superficial Digital Flexor Tendon Injuries

Question 1

Butler, VRU, 2018:
Radiographs vs CT for tarsal fractures

1. In which bone was the greatest subjective difference in sensitivity observed between radiography and CT for fracture detection?
2. What was missed even with CT?

Answer 1

Butler, VRU, 2018:

1. 4th tarsal bone
2. Small calcaneal chip fractures between the body of the talus and the calcaneus

Question 2

Benllock-Gonzalez, VCOT, 2014:
Optimal insertion points and bone corridors for transverse implant placement in the feline tarsus and metatarsus

1. What were the diameters for bone corridors in the majority of the cases?
2. What was length of the bone corridor positively correlated with?

Answer 2

Benllock-Gonzalez, VCOT, 2014:

1. 86% of the corridors were 1.5-2.0mm
2. There was a significant positive correlation between body weight and length of the corridor at each level

Question 3

Frame, VCOT, 2017:

A calcaneotibial screw provided as much medial and lateral stability to the tarsocrural joint as intact collateral ligaments - true or false?

Answer 3

Frame, VCOT, 2017:

True

Question 4

Yardimci, VCOT, 2016:
Transarticular ESF for traumatic tarsal laxations

1. Overall complication rate?
2. Major complication rate?
3. Functional outcomes?

Answer 4

Yardimci, VCOT, 2016:

1. 29% overall complication rate
2. 6% major complication rate
3. 77% very good functional outcome, 12% good functional outcome

Question 5

Yardimci, VCOR, 2018:
Selective talocrural arthrodesis using hybrid transarticular ESF

1. What was observed around the intertarsal and tarsometatarsal joints?
2. Mid-term clinical outcomes?
3. What % had mild intermittent lameness after extensive exercise?

Answer 5

Yardimci, VCOR, 2018:

1. Moderate OA was observed around the intertarsal and tarsometatarsal joints
2. 77% excellent outcomes, 17% good outcomes, 6% poor outcomes
3. 18% had mild intermittent lameness after extensive exercise

Question 6

Armstrong, Vet Surg, 2019:
Central tarsal bone injuries

1. What were the most common injuries?
2. Complication rate?

Answer 6

Armstrong, Vet Surg, 2019:

1. The most common injuries were type V (comminuted) fractures (69%) and luxation of the central tarsal bone (25%)
2. 62% complication rate

Question 7

Perry, Vet Surg, 2017:
Calcaneal fractures

1. What % were comminuted fractures and what % were mid-body fractures?
2. What % were open vs closed fractures?
3. What % were articular fractures?
4. What % had concurrent fractures of other tarsal bones?
5. Overall complication rate?
6. What surgical technique was associated with a lower risk of major complications?
7. What were the odds of a poorer outcome associated with any complications and with major complications?
8. What % had consistent or intermittent mild weight-bearing lameness post-op?

Answer 7

Perry, Vet Surg, 2017:

1. 40% comminuted fractures, 78% mid-body fractures
2. 30% open fractures, 70% closed fractures
3. 40% articular fractures
4. 28% had concurrent fractures of other tarsal bones
5. 61% overall complication rate
6. Plate and screw fixation had a lower risk of major complications compared to fixation with pins and tension band wiring or lag/positional screws
7. Fractures with any complications had 7 times the odds of a poorer outcome, and fractures with major complications had 9 times the odds of a poorer outcome
8. 90% had consistent or intermittent mild weight-bearing lameness post-op

Question 8

Beever, VCOT, 2016:
Surgical stabilization of tarsocrural instability

1. % of medial vs lateral malleolar fractures?
2. What % had talar fractures?
3. What % were shear injuries?
4. Overall complication rate?
5. Which surgical technique was associated with more post-op complications?
6. What % had ongoing lameness or stiffness post-op?

Answer 8

Beever, VCOT, 2016:

1. 50% medial malleolar fractures vs 31% lateral malleolar fractures
2. 19% had talar fractures
3. 31% were shear injuries
4. 92% overall complication rate
5. Placement of prosthetic ligaments was associated with post-op complications
6. 60% had ongoing lameness or stiffness post-op

Question 9

Gunstra, JAVMA, 2019:
Prosthetic ligament placement for stabilization of medial or dorsomedial tarsometatarsal joint luxation

1. Minor complication rate?
2. Long-term function?

Answer 9

Gunstra, JAVMA, 2019:

1. 38% minor complication rate
2. Long-term function was satisfactory

Question 10

Morton, Vet Surg, 2015:
Polyethylene terephthalate prosthesis as a gastrocnemius tendon implant

1. Features of the implant?
2. What was the mechanism of failure in the constructs tested?

Answer 10

Morton, Vet Surg, 2015:

1. The implant is biocompatible, encourages anatomic ingrowth, and is enclosed within the paratendon so that tendon gliding is not compromised
2. The implant itself failed before distal fixation failure in 67% of the constructs

Question 11

Morton, VCOT, 2015:
Polyethylene terephthalate prosthesis as a gastrocnemius tendon implant

1. Functional outcomes?
2. Major complication rate?
3. Minor complication rate?

Answer 11

Morton, VCOT, 2015:

1. 70% returned to full function, 30% returned to acceptable function
2. 20% major complication rate
3. 50% minor complication rate

Question 12

Dunlap, VCOT, 2016:
Non-locking pre-manufactured loop suture technique vs three-loop pulley suture

1. Differences in mean loads to achieve a 1mm gap?
2. Which suture was superior for resisting 3mm gap formation?

Answer 12

Dunlap, VCOT, 2016:

1. No difference in mean loads to achieve a 1mm gap
2. The three-loop pulley polypropylene suture was superior to the non-locking pre-manufactured loop suture using Fiberwire for resisting 3mm gap formation

Question 13

Zellner, Vet Surg, 2018:
Tendon plating with a veterinary cuttable plate + ESF and non-weight-bearing sling

1. What adjunct therapies were administered?
2. A mature fibrous union bridged the site of anastomosis at 8 weeks after surgery - true or false?
3. Long-term outcome?

Answer 13

Zellner, Vet Surg, 2018:

1. Injection of platelet-rich plasma and laser therapy
2. True
3. Excellent long-term outcome

Question 14

Schulz, Vet Surg, 2019:
Loop-suture tenorrhaphy + autogenous leukoreduced platelet-rich plasma

Major complication rate?

Answer 14

Schulz, Vet Surg, 2019:

17% major complication rate

Question 15

Duffy, VCOT, 2015:
Barbed suture vs standard polypropylene suture for tendonorrhaphy

1. Which suture had a higher incidence of gap formation between tendon ends?
2. Which suture pattern caused less gapping between tendon ends?

Answer 15

Duffy, VCOT, 2015:

1. Barbed suture had a higher incidence of gap formation compared to smooth polypropylene
2. The three-loop pulley suture pattern caused less gapping between tendon ends compared to the modified Bunnell-Mayer suture pattern

Question 16

Cocca, Vet Surg, 2019:
3 epitendinous suture patterns as adjuncts to a core locking loop suture for superficial digital flexor tendonorrhaphy

1. Effects of a epitendinous suture in addition to a locking loop suture?
2. Any differences between the 3 epitendinous suture patterns?

Answer 16

Cocca, Vet Surg, 2019:

1. Adding an epitendinous suture reduced gap formation and increased yield, peak and failure loads
2. No differences between the 3 epitendinous suture patterns

Question 17

Putterman, Vet Surg, 2019:
A continuous epitendinous suture as an adjunct to a three-loop pulley suture vs a locking loop suture for superficial digital flexor tendonorrhaphy

1. Which suture pattern (three-loop pulley vs locking loop) best prevented gap formation?
2. Effect(s) of the epitendinous suture?

Answer 17

Putterman, Vet Surg, 2019:

1. Gap formation was best prevented with a three-loop pulley compared with a locking loop suture
2. Tendinorrhaphies combined with an epitendinous suture eliminated gapping between tendon ends until failure, and increased resistance to loads tolerated at the repair site