Orthopaedics: Foot and Miscellaneous Flashcards
(26 cards)
What are the main conditions that can affect the foot?
- Fractures
- Luxations of joints
- Pad injuries- corn
- Foreign bodies
- Nail injuries
Sesamoid disease
What is a corn?
Focal area of hyperkeratosis
* excess keratin, thickening of pad
Keratin is a structural fibrous protein
How is a corn treated?
Historically:
* Hulling/excision (primary cause not addressed- recur)
Regression:
* Silicone gel implants
* Revision surgery on distal amputations
If the pad is unloaded then the corn will grow out
Superficial digital flexor tendonectomy
* removal of 1cm + of tendon
How are fractures of metatarsals/metacarpals treated?
What are the potential complications?
Single
* External coaptation
Multiple
* III IV need internal fixation
* Dowel pinning
* Spider
Complications
* Extensive soft tissue injuries- check viability
* Synostosis between bones
What are indications for toe amputation?
What is the technique?
Severe luxations/fracture/neoplasia
Y-shaped incision to preserve the pad- can cut through joint
What is the scientific name for marie’s disease?
What kind of disease is it?
Hypertrophic Oesteopathy
Paraneoplastic bone disease
What nutritional bone diseases can develop in small animals?
- Nutritional secondary hyperparathyroidism
- Renal secondary hyperparathyroidisim
- Hypovitaminosis D
- What is panostitis?
- What are the clinical signs?
- What bones are more commonly affected?
- Painful inflammation of the periosteum
- Classically shifting lameness, acute onset, morelikely forelimb
- Ulna > radius > Humerus
How is panostitis diagnosed?
How is it treated?
Diagnosis- signalment, history, clinical signs and radiographs (young large breed dogs)
Treatment
* Self limiting
* Excercise control/restriction
* Analgesics
- What is the usualt signalment of metaphyseal osteopathy?
- What is the aetiology?
- What are the clinical signs?
- How is it diagnosed?
- How is it treated?
- Young, rapid growing breeds- 2-6mo
- Unknown
- Mild lameness to severe collapse- swelling
- Signalment, history, CS, radiography
- Self-limiting- supportive care, analgesics
- What is the usualt signalment of metaphyseal osteopathy?
- What is the aetiology?
- What are the clinical signs?
- How is it diagnosed?
- How is it treated?
- Young, rapid growing breeds- 2-6mo
- Unknown
- Mild lameness to severe collapse
- Signalment, history, CS, radiography
- Self-limiting- supportive care, analgesics
Possible anglular limb deformities
- What is craniomandibular osteopathy?
- What is the signalment?
- What are the CS?
- How is it diagnosed?
- Non-inflammatory, non-neoplastic proliferative bone disease
- 4-10mo, WHWT, scottish terrier, cairn terrier
- Mandibular swelling/thickening, inability to open mouth, salivation, anorexia, pain on eating
- Signlament, history, CS, radiography
Whar radiographic changes can be seen with craniomandibular osteopathy?
How is it treated?
- Changes usually bilateral
- Palisading proliferation on the mandible and tympanic bullae
- Temporal, frontal and maxillary bones
- Occasionally affects long bones
Treatment
* Supportive care
* Analgesics
Prognosis
* Self limiting at 11-13 months
* Euthanasia may be requested
What is the aetiology of marie’s disease?
What are the clinical signs?
Aetiology
* Paraneoplastic- secondary to intrathoracic or abdominal neoplasia
* Neural- ?
Clinical signs
* Lameness can develop over several months
* Single or multiple limbs
* FIrm swelling along bone of distal extremities
* Pain in early stages
How is maries disease diagnosed or treated?
Diagnosis
* History and clinical signs
* Thoracic radiographs and abdominal ultrasound
* Radiographic changes- periosteal new bone formation, increased bone density
Treatment
* Symtomatic
* Remove primary cause- resolution of new bone formation
What causes nutritional secondary hyperparathyroidism?
- Diets high in phosphorous or low in calcium
- Usually meat based diets
- Ideally 1.2: Ca:P 1:1 in cats
- Hypocalcaemia- increased PTH
What are the clinical signs of Secondary hyperPTH?
How is it diagnosed?
How is it treated?
CS:
* Lameness
* Skeletal pain
* Swollen metaphysis
* Pathological fracture
Diagnosis- history and radiographs
* Decreased bone density/thinned cortices
* Mushroom shaped metaphysis
Treatment
Rest, diet correction, oral calcium supplementation, NSAID
Why does CKD cause increased PTH?
Why does impaired vit D cause increased PTH?
Impaired phosphate excretion
* Hyperphosphataemia- causes hypocalcaemia
Impaired vit D production causes depressed enteric calcium absorption- rickets
What are the clinical signs of CKD osteopenia?
How is it treated?
CS
* Pliable mandible
* Loose teeth
* Skeletal pain
* Pathological fractures
* Bowing of bones
Treatment
* Reduce phosphate intake/phosphate binder
* Calcium or calitrol supplementation
What is 1st, 2nd and 3rd degree ligament injuries?
1st- minimal tearing, rapid healing
2nd- partial rupture associated with haemorrhage and oedema
3rd- complete rupture- avulsion
Sprain is ligament, Strain is tendon
How are different degree ligament injuries treated?
1st degree
* Healing is rapid- transient lameness
* 1 week rest- restricted excercise and NSAIDs
2nd degree
* Weight bearing- support for 3-4 weeks
* Excercise controlled for upto 3 months
3rd degree
* Not weight bearing, joint alterations
* Surgical repair, reattachment or replacement
How are stains of tendons treated?
- In acute phase need to reduce inflammation- alternate cold warm compresses
- Surgical treatment for ruptures or displacement- monofilament nylon sutures
- Immobilisation for 4-6 weeks post op
- Gradual increase in excercise over the following 2 months
How are tendons surgically treated?
What post-operative care is needed?
- Early repair better
- Monofilament nylon sutures used to attach ends
Imombilisation necessary for 4-6 weeks
* Splint for DFT/extensor tendons
* Transarticular external skeletal fixator
* Hock/ankle held in extension with bone screw for common calcanean tendon
What extra support is needed after surgical repair of which tendon injuries?
- Splint for digital flexor/extensor tendons
- Transarticular external skeletal fixator
- Hock/ankle held in extension with bone screw for calcanean tendon
