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84 Cards in this Set
- Front
- Back
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What are the common causes of pelvis fx?
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-usually traumatic (rarely pathologic)
-car accident -fights -gunshot |
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A pelvis fracture is typically a closed fx, what other injuries should you be aware of?
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-urinary tract injury
-intestinal perforation -nerve damage -vascular damage |
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Due to the shape of the pelvis, what should you assume when you seen 1 fx?
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That there is at least 1 more
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What history and clinical signs will be seen with a pelvic fx?
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-recumbency
-pain -assymetry -hematoma -neuro deficit -anuria -blood in feces |
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What diagnostic tests can help in the case of a pelvic fx?
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-rads
-U/S |
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What are the treatment goals for pelvic fx repair?
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-prevent further injury (confine)
-stabilize -restore pelvic canal diameter -restitution of limb function |
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When would you treat a pelvic fx conservatively?
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-very little displacement
-no risk of narrowing -intact acetabulum -no sharply pointed fragments |
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What are the conditions needed for treating a pelvic fx conservatively?
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-confine 4-6 weeks
-soft floor -restricted exercise -decrease diet -urination/defecation control -analgesia -positional changes every 2 hours |
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When is surgical treatment of a pelvic fx needed?
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-decreased diameter
-articular fxs -triple unilateral fxs -Si luxation/fx -ilial fx -long bone contralateral fx |
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Should surgery take place soon after the injury or later?
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Immediate...never wait more than 10 days
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Surigal repair of an acetabular fx by plating should only be attempted when?
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Only if perfect reduction can be achieved.
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What is the alternative approach to acetabular repair?
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Pins, wires, bone cement
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What surgical approach do you take if only the pubis is fx?
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No surgery
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What are some of the pathologies of the coxofemoral joint?
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-luxation
-acetabular fx -capital/subcapital fx -dysplasia -leg-calve-perthes |
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What is the pathogmnomic sign for hip luxation?
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Trochanter displacement
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In which direction is hip luxation most common?
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Craniodorsal
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What is the typical hx of a dog with hip luxation?
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Previous trauma
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Differential diagnoses for hip luxation include what?
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Any condition that causes hip pain
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When can a hip luxation be reduced by a closed technique?
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When the case arrives early..within a week
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How would you get enough force to reduce a luxated hip by closed technique?
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Use a towel or sheet tied around the joint and yourself
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What is the Knowles technique for the reduction of hip luxation?
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Open technique- round ligament of head of the femur replaced with nylon and T clip
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Is the transarticular pin method still used for tx hip luxation?
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Yes but it is an older technique
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What is a basilar fx?
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Fx of the head and neck of femur
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What ortho device would you use to surgically repair a transcervical fx of the femoral neck?
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K -wires
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What type of disease is hip dysplasia?
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Multifactorial, hereditary disease
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What factors influence the development of HD?
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-large, fast growing breeds
-soft tissue laxity -femoral and acetabular conformation -joint incongruence/subluxation |
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What clinical will you see in a case of HD?
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-shortened stride
-lameness -pain on manipulation -weight shifting -positive Ortolani ("pop") |
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What radiographic signs of HD can be seen?
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-50% subluxation
-osteophyte formation -flattening of acetabulum -remodeling of femoral neck |
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What conservative approaches can you take to treating HD?
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-weight reduction
-exercise -Nsaids -chondroprotection |
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What surgical approach to HD is a pectinectomy>
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Pectineus muscle is cut at insertion, within the same surgery perform capsular denervation of cranial gluteal nerve and rami, dorsalis sciatic nerve
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In a triple pelvie osteotomy, what bones does the surgeon cut and reailign?
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-ischium
-pubis -ilium |
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What is the goal of the TPO?
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Rotate the acetabulum to cover te femoral head
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What is another name for the excision arthroplasty procedure?
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Femoral Head Ostectomy FHO
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What is juvenile symphysiodesis?
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Surgical destruction of the symphaseal growth plate to force the pelvis to grow outwards over the femoral heads
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What is Legg-Calve Perthe's disease?
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Non-inflammatory aseptic necrosis of the femoral head in young animals
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What are the clinical signs of Legg Calve Perthe's dz?
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-lamness
-pain -hyperextension, internal rotation -abduction of hip joint -shortening of affected leg |
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What is the treatment for LCP?
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Femoral head and neck excision (FHO)
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What conditions can affect the articular tissues of the stifle?
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-distal femur fractures
-proximal epiphyseal fx of tibia -avulsion of the tibial crest -cranial-caudal cruciate/menisci rupture -osterochondritis/osteochondrosis |
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Another term for a metaphyseal fx of the distal femur is what?
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Supracondylar
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Another term for a ephyseal fx of the distal femur is what?
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Condylar
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What anatomic factors contribute to a femur fx?
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-metaphysis and epiphysis have noi connecting while growing
-shape of femur makes it susceptible to fx |
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What type of fixation is need for a distal femur fx near the joint?
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rigid
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What type of flexible pin is used for a supracondylar fx?
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Rush pin
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In which age of dogs do avulsion fx of the tibial crest happen?
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Young dogs
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How do you repair an avulsion fx of the tibial crest?
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Wire and figure of 8
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Hwat steps should be taken for the treatment of a SH fx after germinal cells and blood vessels are present?
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-early tx
-light implants -avoid screws and plates -avoid threaded pins |
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What type of implants should be used to repair SH fxs?
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Gliding implants only
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What is the cause of patella fxs?
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Direct trauma
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What findings will be seen on a PE of a dog with a patellar fx?
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-non-weight bearing
-pain on palpation of stifle -depression in the straight patellar ligament |
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What is the ortho tx fo fx patella?
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Tension band, lag screw
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In which breeds does medial patellar luxation occur more often?
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Small and toy breeds
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What are the clinical signs of a patellar luxation?
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Various degrees of lameness, leg extended backwards
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What tx option should you try in a toy breed with a medial patellar luxation?
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Conservative, try to avoid sx.
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What surgical approaches are available for patellar luxation?
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-imbrication
-trochleoplasty -tibial crest transposition -antirotational technique |
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What is the goal of imbrication?
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To bring the capsule together
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What 2 approaches are there for trochleoplasty?
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Wedge and block
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What are the types of menisal lesions (tears)?
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-longitudinal
-bucket handle -transverse -fold |
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What are the causes of meniscal lesions?
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-usually a consequence of CCL rupture
-ligament injuries -meniscocapsular rupture -severe trauma |
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What are the clinical sign sof a meniscal lesion?
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-sever pain
-lameness -sometimes a click -inflammation -joint effusion |
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What are the causes of a ruptures cranial cruciate ligament?
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-aging (degeneration)
conformational abnormalities -female, fat, fifty -usually bilateral -partail or total rupture -joint instability |
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What classic sign can be seen on PE of a cranial cruciate rupture?
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Drawer sign
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When could you choose to tx a cr. cruciate rupture conservatively?
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Only is the animal is less than 10kg
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What 2 surgical approaches are available for repair of a cranial cruciate ligament?
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-intracapsular
-extracapsular -tibial tuberosity advancement -TPLO |
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is a drawer sign seen in the case of a caudal cruciate ligament rupture?
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No
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How is a caudal cruciate ligament tx surgically?
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Stabilization by suture
popliteal tendon entrapment |
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What is osteochondritis dissecans?
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Area where deep endochondral ossification stops, leading to the detachment of a flap of articular cartilage (joint mouse)
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OCD is what type of condition?
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Hereditary
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What is the signalment of a dog with OCD?
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Young, large to giant breed, male
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Where do many OCD lesions occur?
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Medial surface of the lateral femoral condyle
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After removal of the joint mouse, the surgeon forages the bone, meaning what?
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uses a steinman pin to pokes hole into the subchondral bone to stimulate growth
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What conditions affect the scapulohumeral joint of large breed dogs?
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-OCH of the humeral head
-biceps tenosynovitis -infraspinatus muscle contracture -brachial plexus tumor |
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What is the etiopathogenesis of OCD?
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-disturbance of endochondral ossificaiton
-failure of symmetrical maturation of physeal and articular cartilage -results in injury-prone thickened areas of articular cartilage |
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What effect can nutrition have on OCD?
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Feeding of excessive calories to increase rate of growth and mature body size is associated with severe OCD in genetically predisposed breeds
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A dog with OCD can show lameness after rest. What might be seen wtih excercise?
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Lameness in the early phase
Improves with exercise (late pahse) |
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What are the PE finding for scapulohumeral joint OCD?
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-shortened swing at walk
-muscle atropy (deltois, supra, infra spinatous) -pain on hyperextension |
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What are the radiographic finding of OCD of the scapulohumeral joint?
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-flattening of subchondral bone of central humeral head
-defect in head -calcification of cartilaginous flap -detached cartilage flap (joint mouse) |
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What is the Tx for early OCD with minimal pain and lameness?
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-rest
-reduced caloric intake |
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What is the surgical Tx for later stage OCD?
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-surgical removal of moue and lavage
-cruettage or frometage of subcondral bone to stimulate formation of fibrocartilage |
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What is the etiology of biceps tenosynovitis?
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Strain injury of tendon or origin
grade 3 injury with tendon fiber disruption |
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What is the anatomic cause of biceps tenosynovitis?
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Synovial tissue surrounds proximal tendon
Transverse humeral ligament compresses tendon when inflammed and swollen |
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What type of dogs does biceps tenosynovitis affect?
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Middle aged, medium and large breed dogs
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What are the radiographic findings for biceps tenosynovitis?
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Acute case: no changes
Chronic: osteophytes in intertubercular groove (skyline) -calcification of tendon |
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What is the Tx for biceps tenosynovitis in acute cases?
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-strict confinement for 46 weeks
-NSAIDs |
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hat is the surgical tx for biceps tenosynovitis?
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Chronic case- tendonesis of bicipital tendon (fusion of 2 tendons)
split biceps tendon, anchor with washer and screw |
