Small animal MSK disease 6 Flashcards Preview

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Flashcards in Small animal MSK disease 6 Deck (100)
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Describe grade 3 canine patellar luxation

Patella usually luxated, can be replaced into trochlea


Describe grade 4 canine patellar luxation

Patella permanently luxated, cannot be replaced into trochlea


Compare the treatment options and prognoses for the different grades of canine patellar luxation

- Grade 1: usually conservative management
- Grade 2:based on presentation, conservative or surgical
- Grade 3 and 4: surgical correction
- Prognosis good for all except grade 4


List the surgical treatment options for canine patellar luxation

- imbrication of soft tissue lateral side of joint
- Deepening of trochlea (wedge or block recession)
- Tibial Tuberosity transposition (TTT)


Explain recession sulcoplasty in the treatment of canine patellar luxation

- Block or wedge recession, reduce size then replace to deepen the trochlea
- Allows quadriceps mechanism to be aligned
- Fixation of wedge not required, held in place by patella
- Block may have better stability on extension


List common hock injuries in small animals

- Ligamentous injuries leading to sub-luxations/luxations
- Shearing injuries
- Osteochondrosis/OCD
- Fracture of tibia or tarsal bones


Describe the fractures commonly seen in greyhounds and their treatment

- Acute non-weight bearing lameness of RH due to running in left landed circle
- Central tarsal bone Fracture (crushed) leads to collapse of hock, leading to fracture of 4th tarsal bone, calcaneous and 5th metatarsal bones
- Surgical repair of fractures (refer) and partial arthrodesis
- Will never race again


What should be performed in all cases of HL lameness and why?

Rectal exam, in order to identify nerve root tumour which may also cause HL lameness


How may lumbosacral disease present

- HL lameness, may look like hip dysplasia
- Pain on palpation, pain when raise tail head, muscle atrophy


Where are osteosarcomas typically located in the HL?

Distal femur, proximal tibia (NB greyhounds get osteosarc in neck of femur)


List the hindlimb disease common in cats

- Hip dysplasia
- Stifle: cruciate disease, patellar luxation (often related)
- Hock: shearing injuries and luxations
- Pad/digital injuries similar to dog
- Fractures and cat bites common


What is the common signalment for collateral ligament injury of the hock in small animals?

RTA, trauma, jumping from height


What is commonly found on physical examination in collateral ligament injury of the hock

- Moderate to severe lameness
- Swelling
- Joint instability including extended and flexed


Outline the treatment of collateral ligament injury of the hock

- Wound management where necessary
- Rigid external coaptation following repair
- Primary ligament repair
- Prosthetic reconstruction
- Transverse screw at origin and insertion of long and short paths of collateral ligament


Describe the signalment for osteochondrosis of the talus in dogs

- Juvenile dogs
- Esp. large and giant breeds


Describe the findings on physical examination in osteochondrosis of the talus in dogs

- Lameness, worse with exercise
- Joint effusion palpable
- Decreased ROM in flexion
- May appear hyperextended


Which radiographic views are used for the diagnosis of osteochodnrosis of the talus in dogs

- Extended plain and craniocaudal, slightly flexed mediolateral, skyline view of tarsus
- Include lateral, flexed lateral and dorsoplantar views of both tarsi
- Additionl: imaging of craniocaudal proximal trochlear ridges, dorsolateral-plantomedial oblique
(DLPMO) view, dorsomedial-plantolateral oblique (DMPLO) view


List the imaging modalities/tests used in the diagnosis of OCD of the talus in dogs

- Radiography
- CT
- Arthrogram


Outline the treatment of OCD of the talus in dogs

- Conservative: can fall away naturally, but painful, medical management in older dogs with severe regenerative changes
- Removal of flap via arthrotomy/arthroscopy


Describe the clinical signs of malleolar fractures in dogs

- Shearing injuries commonly, RTA
- Acute onset HL lameness
- Non-weight bearing
- extensive soft tissue damage and possible bone loss
- Severe hock instability
- Pain, swelling


Describe the treatment of malleolar fractures in dogs

- Initial wound management
- Rigid coaptation following repair (or transarticular ESF) for several weeks
- Surgical: prosthetic repair of collateral ligaments, ESF until granulation tissue covers defect talocrucral/pantarsal arthrodesis if axial part of trochlear ridge involved
- Generally good prognosis


What degree of alignment is required for ESF, open-but-do-not-touch and open reduction fracture repairs?

- ESF: >50%
- Open but do not touch: at least 50% overlap in both planes
- Open reduction: close to 100%


Which factors should be assessed when evaluating fracture repair?

- Alignment
- Rotation
- Implant positioning
- Apposition of fracture edges


Give examples inappropriate fracture fixation

- Implants too small/large
- Too large: risk of fracture at stress riser
- Fail to address forces applied to site
- Too rigid leading to disuse atrophy (esp. with ESF)


Outline the general discharge instructions that should be given to an owner following fracture repair in dogs and cats

- Garden on lead to 3 weeks
- Then lead for 8 weeks
- Cats: restrict to house for 8 weeks
- Cage if very boisterous, or concerns regarding repair itself
- Modifications made to house: e.g. carpets, allow easy access onto furniture to prevent jumping
- Appropriate analgesia


Under what condition may post-operative antibiotics not be required following fracture fixation?

If surgery 45mins-1hr long, perioperative may be enough


Outline the instructions that should be given to an owner regarding dressing management following fracture repair in small animals

- Keep dry: polythene and sock when outside
- Check toes and top of dressing twice daily to ensure toes are warm, no discharge, animal able to feel toe
- Any smell, bring to surgery
- If off colour, bring in with dressing on


Outline the potential complications that may occur with external coaptation

- Casts: pressure sores, loss of digits
- Robert-Jones: pressure sores (esp. over accessory carpal bone and calcaneous), avascular necrosis over digits


In what way do IM pins tend to fail?

- Imperfect construction of column of bone leads to collapse
- Fracture may rotate or collapse


In what way do cerclage wires tend to fail?

Loosen, fail to maintain reduction of fragments, resulting in instability