20.9.2: Mature lame animal - trauma, luxations, surgery Flashcards
1
2
3
Incongruent
joint surfaces are abnormal in shape and do not articulate perfectly
Dysplasia
abnormal joint development
Subluxation
joint surfaces are displaced but maintain some contact
Luxation
no contact maintained between joint syrfaces; describe the luxation by the position of the distal articular joint surface.
Aetiology
* Traumatic - common, takes considerable force e.g. RTA
* Acquired/ developmental - common e.g. hip dysplasia resulting in subluxation
* Congenital - rare
Diagnosis of luxations / subluxations
- Palpation under GA; compare both limbs
- Radiography: orthogonal views are essential. Stressed view may be required to determine site and severity of subluxation. Examine for articular bone fragments which may make reduction impossible or unstable.
Options for treatment of acquired traumatic hip luxations
- Closed reduction - more successful in dog than cat
- Open reduction
- If this fails: arthroplasty or THR
Signalment for congenital luxations
- Rare
- Toy breeds (shoulder), staffies (elbow)
- The bones and joints are abnormal in shape so there are abnormal tensions on the joint and articulation
Management of congenital joint luxation
Conservative
* Many animals show surprisingly little lameness which may be more mechanical than originated from pain
* Analgesia
* Weight restriction
* Physiotherapy
Surgical
* Difficult due to abnormally shaped articular surfaces
* Success improved by early interventions
* Salvage procedures (e.g. arthrodesis, arthroplasty, amputation) may be required
Image: congenital elbow luxation