SA: Carpal and Tarsal Injuries

Question 1

Answer 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

What radiographic views are necessary for collateral ligament damage?

Answer 4

Stress views

Question 5

What part of the tarsus is affected by OCD?

Answer 5

Talus
Medial ridge > lateral ridge > both
Often (~50%) bilateral

Question 6

Signalment: Tarsal OCD

Answer 6

Young, large breed dogs (developmental)
Adult dogs with arthritis

Question 7

History: Tarsal OCD

Answer 7

Rear limb lameness (uni or bilateral)
Acute onset or slow insidious, chronic progressive
Stiff, slow, lame after “cool down”

Question 8

PE: Tarsal OCD

Answer 8

Tarsal hyperextension
+/- Positive sit test
Severe joint effusion/periarticular swelling
Painful ROM (especially flexion)

Question 9

What is the recommended treatment for OCD?

Answer 9

Scrope vs open arthrotomy
Unloading osteotomy
Arthrodesis (end stage)
Total ankle replacement
OA treatment

Question 10

What causes carpal hyperextension?

Answer 10

(Traumatic) disruption of palmar fibrocartilage

Question 11

What is the treatment for carpal hyperextension?

Answer 11

Mild cases: amenable to coaptation
Severe: arthrodesis

Question 12

What are the treatment for tarsal ligament injury?

Answer 12

First degree (stretch): RICE, NSAIDs, +/- soft padded bandage
Second degree (partial): external coaptation
Third degree (complete): surgery with anchors or bone tunnels with support of repair (splint, external fixator)

Question 13

Partial Tarsal Arthrodesis

Answer 13

Any of the distal low motion joints
Retain almost normal range of motion

Question 14

Tarsal Panarthrodesis

Answer 14

Fusion of all joionts
Injuries that involve high motion joint

Question 15

What are the principles of arthrodesis surgery of the tarsus?

Answer 15

Remove all cartilage, forage bone
Use bone graft to encourage fusion of bone
Fix at standing angle (135 degrees)
Provide stable fixation (bone plates) +/- splints