Tendon and LIgament Dz Flashcards
(44 cards)
How can tendon be damaged? LOOK UP
> trauma - lacerations > strains - breaking/dehiscnece of fibres - mechanically induced or weakening d/t degeneration
How can muscles be damaged?
> less commonly specifically dx
- injuries similar to tendon
How can tendon/lig dz present?
> Lameness - acute with trauma - chronic > swelling - diffuse, painful, oedema if acute - organised and established in chronic cases > specific functional disability
Is laeration always traumatic?
- no can be chronic
Dxx for tendon and liggament dz?
> clinical signs - dysfunction > radiography - swelling, gap > ultrasound - gap, loss of linear orientation of fibres
Outline pathophysiology of tendon injury repair. Which tendons will heal faster? Eg?
- fibroblasts and collage fibres line up along line of actio
- SHEATHED tendons less vascular so hal slower (eg. digital extensors) cf. vascular (eg. common calcaneal Achilles)
Time to heal tendon injuries?
- 6 weeks to regain 50% normal strength (repair must be supported for 6 weeks)
- 1 year to regain average 80% normal strengt h
Tx tendon injury?
> Rest
specific support to protect tendon from loading
- dressings/casts
- trans-articular fixator
1* surgical repair for lacerations
- tendon sutures to manage load
- direc contact of healthy edges (debride if necessary)
- suture of epitendon to promote healing
ultrasound monitoring healing (@6/8 weeks etc.)
How long should ESF be left on for tendon repair?
- 6 weeks
- then bandage for 2 weeks
HOw big a gap will interfere with tendon healing?
3mm
What ar ethe 2 most common tendon repair sutures?
- locking loop
- 3 loop pulley
What is a sprain?
Ligamentous damage
- can be mild/moderate/severe
- 1/2/3* degree (stretch, rupture, total laceration)
- ^ level of soft tissue damage, swelling, pain and instability
What suture material should be used for TENDON repair?
- non-absorbable eg. Prolene
- sheath simple interrupted absorbable
Presentation of strains ? PE?
- acute and chronic presentation > PE: - especially ROM - palaptoin > Dxx: - radiography + stressed views (to demonstrate strains, pull limbs in direction of strains etc.) - ultrasound (not very useful fr ligament) - manipulation under GA > always check for ancillary damage
Tx sprains?
- rest, reduce swelling (drugs, cooling)
- external coaptation (suppot)
- ligament repair
- internal ligament splintage
- attention to oher structures
- arthrodesis (salvage)
- degree of tx depedns on instability, pain and healing potential
LIkely damage associated with ddrop from a height? Tx?
- palmar carpal ligaments sprained
- need arhrodesis, will not heal conservatively
Surgical repair of ligament?
- screws at insertion of the ligament, figure of 8 suture between the 2
How long do ligament injuries take to heal?
slow healing ~ 6-8 weeks
- not always acceptable function (reevaluate)
- extra chronic capsular tisue formed
- 2* OA
> may require arthrodesis at a later stage
What angle is normal for stress radiographs of the carpus?
10*
How is an arthrodesis carreid out? Which joints is this always required in (first line ?
- remove articular cartilage
- bone graft to stimulate bone healing
- stabilise joint
> TMT (tarsal luxation??)
> Carpal ligaments (carpal hyperextension)
Is ligament dz common in smallies?
NO except for cranial cruciate in dogs!
Which direction does cranial and caudal cruciate run?
Cranial = cranial tibia, caudal femur (proximal and lateral to distal and medial) Caudal = caudal tibia, cranial femur
Pathophysiology of cruciate disease?
- normally related to degeneratin
- can be acute (trauma/degenerative ligament gicing way)
- assocated with MPL (medial patella luxation) which is seen in young growing animals so even if only found incidentally in older animals check the cruciates!
- causes a debilitating cranio-caudal instability in the stifle
- 60% cases involve medial meniscus
Does meniscal injury occour spontaneously in animals?
NO rarely, always affected d/t cruciate dz
