Lecture 17: Sx of the Carpus, MC, & Phalanges (Exam 3)

Question 1

Wat occurs when foot is positioned such that palmar surface of metacarpus contacts the ground

Answer 1

palmigrade

Question 2

Definition

outward deviation of the foot

Answer 2

valgus position

Question 3

Definition

Inward deviation

Answer 3

varus position

Question 4

What is this showing

Answer 4

palmigrade stance

Question 5

Carpal fractures are rare in companion animal but often disabling because the carpal joint serves as what

Answer 5

major weight bearing structure

Question 6

Most frequently diagnosed fracture of carpal bones in companion animal is?

Answer 6

radial carpal fracture

Question 7

Radial carpal bones fractures may involve chronic lameness WITHOUT history of trauma so it is speculated these fractures are a result of what?

Answer 7

incomplete ossification of radial carpal bone

Question 8

What Is the most common breeds to have chronic radial carpal fractures

Answer 8

boxers and sporting breeds

Question 9

What type of fracture is most commonly seen in greyhounds and sled dogs (rare in other companion animals)

Answer 9

accessory carpal bone fracture

Question 10

Accessory carpal bone fracture is most common in what leg & What direction

Answer 10

• right leg
• counterclockwise direction of racin g

Question 11

Fill in the ?s

Accessory carpal fractures are considered ? injuries

Answer 11

avulsion

Question 12

Is this acute or chronic fracture of the carpus

• Weight-bearing lameness (which may be intermittent)
• Reduced carpal range of motion
• Soft tissue swelling

Answer 12

Chronic

Question 13

Is this acute or chronic fracture of the carpus

• Non-weight-bearing (NWB) lameness
• Placing weight on limb cause carpus to collapse in palmigrade stance

Answer 13

Acute

Question 14

Can you use medical or conservative management on carpal fractures

Answer 14

no (not indicated)

Question 15

Dogs w/ chronic radial carpal bone fractures, severely comminuted fractures, osteoarthritis, luxation, bone loss, or infection are best treated with what technique

Answer 15

carpal arthrodesis

Question 16

Fill in the ?s

Large fragmented radial carpal fractures ar anatomically reduced and rigidly stabilized by ? or a combination of ? and ?

Answer 16

• lag screws
• lag screws and K wires

Question 17

Small chip fragments of radial carpal bone are treated how

Answer 17

surgically removed

Question 18

Fill in the ?s

Reduction of a radial carpal bone fracture with ?

Answer 18

lag screw

Question 19

Most common injuries of the carpus is

Answer 19

hyperextension (trauma, immune mediate)

Question 20

What radiographs should be taken for a suspected carpal fracture

Answer 20

stress views (lateral and Dorso palmer)

Question 21

Best treatment of carpal hyperextension

Answer 21

arthrodesis (can do conservative management- splint)

Question 22

Pancarpal or partial carpal arthrodesis can be performed by?

Answer 22

removing cartilage, autogenous cancellous bone graft, rigid fixation

Question 23

What treatment method is considered for carpal hyperextension when the radiocarpal joint is normal and works to fuse the middle intercarpal and carpometacarpal joints?

Answer 23

Partial carpal arthrodesis

Question 24

What is used to perform a partial carpal arthrodesis

Answer 24

T plate

Question 25

What techniques are appropriated for intercarpal and carpometacarpal hyperextension

Answer 25

partial and pancarpal arthrodesis

Question 26

What is indicated for most dogs in post operative care from carpal hyperextension

Answer 26

Coaptation with splint for up to 6 weeks

Question 27

Should screws for reconstruction of radial carpal bone be removed?

Answer 27

not unless they cause a problem

Question 28

Carpal fractures have a fair to good return to function depending on what

Answer 28

degree of articular damage, whether articular surface can be reconstructed

Question 29

partial carpal arthrodesis for carpal hyperextension provides what prognosis? pancarpal arthrodesis?

Answer 29

* Carpal: fair * Pancarpal: Good

Question 30

What is seen in young puppies in variety of breeds with carpal hyperextension, hyperflexion or flexural deformities?

Answer 30

Carpal laxities

Question 31

What is a theorized cause of carpal laxity

Answer 31

* over/under supplemented diet * concrete surfaces with no exercise

Question 32

What age is carpal laxity syndrome seen in

Answer 32

5-27 weeks

Question 33

What is the Treatment of carpal laxity syndrome includes

Answer 33

* appropriate diet * controlled exercise * floors with good traction * recovery in 1-4 weeks

Question 34

# **Definition** Small, round or oblong bones found adjacent to metacarpophalangeal joints

Answer 34

sesamoid bones

Question 35

What may result from a direct blow or force to paw or from hyperextension injuries

Answer 35

Metacarpal bone fractures

Question 36

Complete metacarpal fractures are common in what breed due to fatigue and overload?

Answer 36

greyhound

Question 37

Fractures of the sesamoids are more common in what two breeds

Answer 37

* greyhound * rottweilers

Question 38

What sesamoid bones are most commonly affected in sesamoid fractures

Answer 38

2 and 7 ( occur after excess tension from ddf)

Question 39

**What provides better outcomes of sesamoid fractures: ** conservative therapy or surgery?

Answer 39

conservative therapy

Question 40

When should you remove proximal fragments of sesamoid bones

Answer 40

chronic lameness

Question 41

A rottweiler presents with history of acute lameness that subsided but recurred with exercise what might be on the top of your differentials?

Answer 41

Sesamoid fracture

Question 42

Luxation of metacarpophalangeal or interphalangeal joints typically occur in what dogs?

Answer 42

working dogs and racing greyhounds

Question 43

**What treatment of metacarpal luxation's yield the best results:** closed reduction and splintage or early surgical repair?

Answer 43

early surgical repair (chronic instability leads to DJ0 D and less than optimal function)

Question 44

What radiographs should be taken for a suspected metacarpal luxation

Answer 44

* dorsopalmar * mediolateral * oblique with digits spread * lateral with affected digit pulled cranially * stressed (if needed)

Question 45

# **Fill in the ?s** Acute luxation in working or racing dogs is best treated with **?** an **?**

Answer 45

* open reduction * suturing of joint capsule and collateral ligaments

Question 46

# **Fill in the ?s** Chronic luxation's of 2nd and 5th toe can be treated by **?**

Answer 46

amputation

Question 47

What can you perform on metacarpophalangeal and interphalangeal joints to improve function and relieve pain in a luxation

Answer 47

arthrodesis

Question 48

Fixation systems applicable for phalangeal fracture/luxation's include

Answer 48

* orthopedic wire * IM pins * plates and screws

Question 49

Digital masses are typically neoplastic with 61% malignant what treatment is recommended

Answer 49

amputation

Question 50

IDK how to ask this so just look at the diagram, the answer is i am over this

Answer 50

i am over this

Question 51

What are the weight bearing digits

Answer 51

3rd and 4th

Question 52

# **Fill in the ?s** The more **?** the amputation the better the prognosis

Answer 52

distal

Question 53

What type of incision should be made for digit amputation

Answer 53

elliptical (Starting proximodorsally & ending distally on palmarsurface)

Question 54

If amputating the digit at the interphalangeal joint what should you preserve?f

Answer 54

the pad

Question 55

If you perform a metacarpophalangeal joint amputation what should you ensure to remove

Answer 55

sesamoid bones

Question 56

What can you do during a digit amputation to make it more cosmetic or in the case of neoplasia

Answer 56

resect the distal end of the remaining proximal bone

Question 57

What are the 7 steps to digit arthrodesis

Answer 57

* expose joint * open joint cartilage * remove articular cartilage * contour surfaces * temporary hold bones in position * contour a small plate to dorsal surface of the bones * attach plate wit lag screw

Question 58

What can be used to remove articular cartilage in digit arthrodesis

Answer 58

* rongeurs * high speed burs

Question 59

What can be used to temporarily hold bones in position in digit arthrodesis

Answer 59

K wires

Question 60

What is used to fixate a digit in digit arthrodesis

Answer 60

small pate and lag screws

Question 61

What is used in digit arthrodesis of small cats and dogs when rapid healing is anticipated

Answer 61

K wire and tension bands

Question 62

**What fixation method is used in the digit arthrodesis seen here:** A? & B?

Answer 62

* A: Plate & lag screws * B: K wires & tension band