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55 Cards in this Set
- Front
- Back
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What does a complete orthopedic exam entail?
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Detailed history,
Gait evaluations, Standing palpation, Recumbent palpation |
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What does the acronym CREPI stand for?
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Crepitus,
Range of motion, Effusion, Pain, Instability |
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What two tests are used to diagnose CrCL rupture?
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Cranial drawer sign,
Tibial compression test |
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What does the Ortolani maneuver evaluate?
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Hip joint for excessive laxity due to hip dysplasia
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What is the most common cause of pelvic limb lameness in dogs?
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CrCL rupture
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What diagnostic tools should be used to rule in/out CrCL rupture?
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Sit test,
Joint palpation, Radiographs |
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Does the absence of cranial drawer sign/cranial tibial thrust rule out CrCL rupture when considered alone?
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NO!
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Why is medical management not the treatment recommendation for CrCL rupture?
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Controls clinical signs, but does NOT address joint instability
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What two components are involved in the surgical treatment of CrCL rupture?
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Arthrotomy/Arthroscopy - inspect ligament, debride fibers, diagnose/remove meniscal tears;
Stabilization - to eliminate cranial tibial thrust |
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What is a common cause of lameness in small and toy breed dogs?
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Patella luxation
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Does patella luxation occur in large and giant breeds?
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Yes! (Cannot r/o based on size of dog)
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What 3 main factors are used to determine the method of treatment for patella luxation?
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Severity/Frequency of lameness,
Quality of life, Client's willingness to pursue surgical treatment |
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When should patella luxation cases be referred?
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Grade 4 (Grade 1-3 are frequently successfully treated by GPs)
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What is the 2nd most common cause of pelvic limb lameness in dogs?
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Hip dysplasia
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What 3 tests/procedures should be performed to accurately diagnose CHD?
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Sit test,
Hip palpation under sedation, High-quality, well-position radiographs |
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What is the underlying cause of clinical signs w/ CHD?
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Excessive Joint Laxity
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If not corrected, what does excessive joint laxity in the hip lead to?
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osteoarthritis
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What two procedures are used to surgically treat young dogs w/ CHD and no OA?
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(JPS) juvenile pubic symphysiodesis,
(TPO) Triple pelvic osteotomy |
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What two procedures are used to surgically treat mature dogs w/ CHD and moderate to severe OA?
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THR,
FHO |
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What is the most commonly luxated joint in small animals?
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Hip
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How frequently is closed reduction of the hip successful?
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50% of time if performed w/in 2-3 days of luxation
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How successful are open reduction techniques?
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80-90% in maintaining hip reduction and restoring limb function
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What is OC/OCD?
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Common developmental disorder of endochondral ossification, affecting young, rapidly growing large breed dogs
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What is the prognosis for OCD of the shoulder?
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Good to excellent
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What is the prognosis of OCD of the elbow?
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Fair
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For which type of OCD are radiographs a good diagnostic tool?
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Shoulder (easily miss elbow)
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What is elbow dysplasia?
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Catch-all term describing conditions of abnormal elbow development such as UAP, OCD, and FCP
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What is the most common cause of thoracic limb lameness in dogs?
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Elbow dysplasia
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Which condition associated w/ elbow dysplasia is the most common?
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FCP
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What are the goals of elbow dysplasia treatment?
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Improvement of lameness,
Slow progression of OA (more conservative in general, hard to "cure") |
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What is the 2nd most common traumatic joint luxation in dogs and cats?
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Elbow
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What is the prognosis for closed reduction of a luxated elbow?
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80-90% successful
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What is a common cause of multi-limb lameness, especially in middle-aged, female, toy to medium breed dogs?
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Immune-mediated polyarthritis
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What causes immune-mediated polyarthritis?
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Primary/Idiopathic,
Secondary to infectious or neoplastic process |
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What is the cause of most fracture fixation failures?
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Poor decision-making prior to surgery - tx the patient NOT the radiograph
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What three factors compose the fracture assessment score?
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Mechanical,
Biologic, Clinical |
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What FAS has little load sharing ability, poor soft tissue health, poor client compliance, and a potential for delayed/non-union?
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0-3, consider robust systems w/ excellent implant-bone stability
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What FAS has poor load-sharing ability, extensive soft tissue injuries or partially compliant clients?
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4-7, consider moderately strong implant systems w/ good implant-bone stability
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What FAS score has excellent load sharing and excellent soft tissue health?
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8-10, consider less robust fixation systems or those that interface w/ bone by friction
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With what does a pro-active analgesic protocol begin?
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Preemptive peri-operative analgesic techniques administered prior to creation of the surgical incision
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What are some preemptive analgesics?
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Opioids, Epidurals, regional nerve blocks, intra-articular anesthetics
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What are the mainstay of peri- and post-op analgesia?
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Opioids
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When would you consider the use of a pure mu agonist?
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Immediate post-operative analgesics (effective, titratable, reversible)
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When should NSAIDs be administered?
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On a case by case basis peri- and post-operatively
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What rehab exercises should be considered?
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PROM,
Massage, Controlled weight bearing exervises |
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What factors (7) lead to post-operative wound infections or seromas?
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Poor aseptic technique,
Pre-existing infection or bacterial inoculation, Long duration of anesthesia or surgery, Poor tissue handling, Open approaches, Incomplete obliteration of dead space, Failure to protect surgical wound post-operatively |
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What are seromas?
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Sterile accumulations of wound fluid and should NOT be lanced, stabbed, drained or otherwise violated
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What are delayed unions?
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Fractures that are healing more slowly than expcted?
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What is a common cause of delayed union?
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Excessive fracture motion (fracture instability)
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How do you treat non-infected delayed unions?
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Continued confinement,
Regular leash walking, Time |
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What are non-unions?
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Fractures which have stopped healing and w/o further treatment will not progress to union
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What are the two categories of non-unions?
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Viable,
Non-viable |
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How do you treat non-unions?
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Rigid stabilization of fracture fragments,
Removal of infected implants or sequestra, Deep tissue cultures, Bone grafting, Long-term antibiotic therapy (if infected) |
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What is fracture disease (quadriceps tie-down)?
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Debilitating condition, affects quadriceps muscle group after femur fracture repair in young patients treated w/ overly aggressive, open surgical approaches
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How can fracture disease be prevented?
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ID at-risk patients,
Maintain meticulous tissue handling, Utilize minimally invasive repair techniques, Aggressively treating pain, Initiating early stifle joint mobilization w/ 90/90 slings, PROM, weight bearing exercises |
