Amputation and Arthrodesis Flashcards
What is: a surgical treatment leading to joint fusion?
Arthrodesis
What is: a non-surgical condition leading to joint fusion?
Ankylosis
What is: the removal of an appendage, or a portion thereof?
Amputation
What are the 4 major indications for arthrodesis?
- Irreparable fracture of the joint
- A chronically unstable joint
- Chronic, severe degenerative joint disease
- Neurologic injury causing partial paralysis of the limb
Which joint is NOT amenable to arthrodesis?
Hip joint
What are 4 alternatives to arthrodesis?
- Medical management
- Total joint replacement
- Excision arthoplasty
- Amputation
What are the 4 major principles to a successful arthrodesis?
- Articular cartilage removal
- Bone graft
- Joint fusion at an anatomic standing angle
- Rigid fixation
For a successful arthrodesis, you’ll want to remove the articular cartilage and expose the ___ ___.
Subchondral bone
Bone grafts are used in arthrodesis to speed the formation of what?
Callus
What is the advantage to callus formation in an arthrodesis joint?
Decrease of implant fatigue and implant failure
Which of the following stimulates bone healing and inducting other cells to come into the area: osteogenesis, osteoconduction, osteoinduction, osteopromotion?
ALL OF THE ABOVE
What are the 4 sources from which you can get an autogenous cancellous bone graft?
- Proximal humerus
- Distal femur
- Proximal tibia
- Ilial wing
What is the name of the instrument used intraoperatively to measure the anatomic standing angle of a joint?
Goniometer
True or False: The arthrodesis will not heal if it is not rigidly fixed.
TRUE
Following an amputation, for how long should you support that limb with external coaptation?
6-8 weeks
For how long should that limb be in a splint?
The first 4-6 weeks
For how long should that limb be in a soft padded wrap?
The remaining 2-4 weeks
What are the 3 indications for a carpal arthrodesis?
- Carpal hyperextension injury
- Shearing injury
- Carpal luxation
What are 3 indications for a pantarsal arthrodesis?
- Severe loss of bone and soft tissues
- Rupture of the common calcaneon tendon
- Talocrural luxation
A tourniquet may not be applied for more than ___ hours.
1.5 hours
True or False: A tourniquet has no effect on infection rate.
FALSE: A tourniquet can increase infection rate
What are 4 complications associated with arthrodesis?
- Infection
- Implant loosening
- Fracture of bone above or below implant
- Irritation by the plate
True or False: The owner should expect a gait abnormality following an arthrodesis.
TRUE
What are 4 specific indications for amputation?
- Neoplasia
- Severe vascular injury (gangrene, trauma)
- Neurological injury
- Intractable pain
What are the 5 important principles of amputation?
- Gentle tissue handling
- Careful hemostasis
- Respect to nervous tissue
- Closure of dead space
- Aggressive pain management
Prior to an amputation, which 2 examinations must you complete, in addition to the general physical exam?
- Orthopedic exam
2. Neurologic exam
What is a full amputation of the front limb called?
Forequarter amputation
What is a full amputation of the hindlimb called?
Coxofemoral disarticulation
A mid-femoral amputation requires a ____ of the femur.
Osteotomy
What are 4 reasons for a digit amputation?
- Neoplasia
- Trauma
- Infection
- Mutilation
Is declawing considered to be an amputation, yes or no? Why or why not?
Yes - P3 has the nail bed, so you are removing P3 and the ungual crest
What 3 analgesics might you use IV for an amputation?
- Ketamine
- Opioids (morphine, hydromorphone, fentanyl)
- Lidocaine
Describe the care for an amputation post-operatively.
- Pain management
- Weight management
- Exercise restriction
- Sling for support
- Ice/warm pack
- AND address other orthopedic conditions
What are 4 general complications associated with an amputation?
- Hemorrhage
- Seroma
- Incision site infection
- Incisional dehiscence
What are the general outcomes of an amputation? What will you tell a client?
Most dogs have excellent function and quality of life. They may be limited by other orthopedic, neurologic, or medical conditions, but the amputation will not be the life-limiting factor in these dogs!
Neoplasia limits lifespan. In this case, amputations are best used in conjunction with ____.
Chemotherapy
The risk of complications can ___ with careful patient selection and by following good surgical principles.
Decrease
