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Flashcards in Small animal MSK disease 2 Deck (100)
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Outline the aetiology of carpal hyperextension injuries

- Usually traumatic, associated with fall from height
- Can be degenerative (Collies)


What other injuries may be associated with carpal hyperextension injuries?

Carpal bone fractures esp. when traumatic as well as the rupture of palmar ligaments and fibrocartilage


Describe the diagnosis of carpal hyperextension injuries

- Characteristic seal stance
- Careful palpation
- Radiographic examination including stressed views - establish joints involved and therefore required treatment


Outline the treatment of carpal hyperextension injuries

- Pancarpal arthrodesis most common
- Use bespoke plates, bone graft, removal of all articular cartilage
- Further support until partial arthrodesis occurred
- Splints an support bandages will fail


Explain the difference between luxation and subluxation

- Luxation: cartilage surfaces not in contact at all
- Subluxation: partial contact of cartilage surfaces


What is meant by joint incongruency?

Abnormal shape to bones and cartilage so cartilage does not fit together properly


What are the possible underlying aetiologies of luxations?

Trauma (common), congenital (rare), developmental (frequent)


Describe how traumatic luxations occur

Associated with third degree sprain (except in elbow luxation), joint capsule and other peri-articular structure damage


Outline the consequences of traumatic luxation

- Traumatic arthritis
- Individual ligaments may never heal
- Capsule thickens to assume some function of the supporting ligaments


Outline the treatment of traumatic luxation

- Surgery to restore acceptable function of ligaments
- May require salvage procedures
- Talocrural/tibiotarsal luxation - fixator will restore acceptable function


Explain the cause of congenital luxations

- Malformation of joint, bone or soft tissue leading to abnormal articular surfaces
- Often severe associated bone deformity


Describe the typical presentation of congenital luxations

- May be symmetrical
- Small breed dogs (e.g. cavvie) with shoulder luxations are rarely lame (mechanical rather than painful lameness)
- Congenital elbow luxation in Staffies


Outline the treatment options for congenital luxations

- Conservative: first option, pain releif and weight management
- If unsuccessful, attempt surgical but poor success due to abnormal joint surfaces
- Salvage procedures typically required


What is the prognosis for surgical treatment of congenital luxations?



Explain the cause of developmental subluxations/incongruencies

- Common
- Hip/elbow dysplasia
- Incongruency of joints leading to joint effusion and luxation


Describe the typical presentation of developmental subluxation

- Commonly bilaterally symmetrical
- Develop secondary arthritis


Outline the treatment of developmental luxations

- Conservative/medical management of the arthritis
- Salvage surgical procedures


Explain the cause of degenerative luxation

Very common e.g. cranial cruciate ligament degeneration/rupture leading to cranial subluxation of the tibia


Which joints are predisposed to luxation in dogs and cats?

- Hip and tarsus
- Patella (intermittent)


Outline the assessment for luxation in dogs and cats

- Clinical examination (+/- GA): pain,asymmetry
- Laxity (depends on chronicity of disease)
- Orthogonal radiographs of limb, +/- stressed views


When qould thoracic and abdominal radiographs be indicated when investigating joint luxation in cats and dogs?

Where traumatic luxation has occurred


What test would indicate hip luxation on clinical examination of a cat/dog?

- Finger and thumb placed between ischial tuberosity and greater trochanter, hold both HLs
- When HLs extended behind animal, luxated limb will be shorter due to dorsal luxation


Explain why laxity may not always be a good indicator of joint luxation

- Depends on chronicity of condition
- With time, partiarticular fibrosis and muscle contraction can stabilise the joint


Outline the principles of repair of acquired/traumatic luxations

- Reduce joint into normal anatomical alignment, maintain reduction while capsule and other soft tissues heal
- Re-attach bone if avulsion present
- May require prosthetic ligament
- Post-op support as for sprains


What are the 3 main stabilisers of the hip?

- Round ligament
- Joint capsule
- Acetabular rim


List the options for the management of hip luxation

- Closed reduction
- Open reduction and stabilisation such as:
- Salvage procedures
- Transarticular pin
- Rectus femoris or ilio-femoral suture for craniodorsal luxation
- Hip toggle


Describe closed reduction of hip luxation

- Manipulate hip back into acetabulum without surgery within 1 day of luxation
- Always readiograph after
- Care re/ soft tissue injuries and re-luxation
- May also require Ehmer sling


What is the success rate for closed reduction of hip luxation?

50%, higher in dogs than cats


Describe open reduction and stabilisation of hip luxation and give success rare

- Always includes soft tissue repair/imbrication
- E.g. transarticular pin, toggle, rectus femoris or ilio-femoral suture
- 75-85% success


What salvage procedures may be used for hip luxation?

Replacementof excision