Bandaging and external coaptation Flashcards
Is cold compression or bandaging more effective at decreasing limb swelling after TPLO?
Cold compression. Bandaging did not decrease postoperative swelling at 24 and 48-hours.
What breeds of dog might be more susceptible to bandage related injury?
Sighthounds, due to their thin skin.
What are some treatment options for external coaptation?
What is the function of the Ehmer sling?
Keeps the leg flexed, places internal torsion on the hip joint, and promotes abduction of the thigh.
What type of bandage is shown?
90-90 bandage. Similar to the Ehmer sling but there is no torsion on the tarsocrural joint or internal rotation of the leg.
What are the disadvantages of external coaptation?
Loss of joint motion, loss of cartilage thickness and stiffness, loss of muscle and bone mass, cartilage degeneration.
What is an orthosis?
An external device placed on the body to support or protect a body part.
What are the different types of orthoses?
Rigid, semi-rigid, mobile (hinged or flexible material).
Can by custom made if required.
Hinged orthoses restrict motion in which direction?
Perpendicular to the hinges. Should be custom made.
What device is depicted?
A tarsocrural flexion boot. Useful in patients with proprioceptive pelvic limb deficits or weak nerve function of the peroneal nerve.
Can also be used in instances of excessive tarsocrural hyperextension in dogs that shift their weight forward (secondary to joint paint in the pelvic limbs or lower-back).
Does the use of stifle orthoses eliminate cranial tibial translation in a cruciate deficient stifle?
No.
Use of orthoses for patellar luxation is also rarely successful in dogs and cats due to high skin mobility.
Exoprostheses can be used to manage partial amputations up to what level of the limb?
Proximal third of the antebrachium or mid-crus or distal. The shoulder and elbow joints or hip and stifle joints should be functional.
What are the different types of exoprostheses?
- Socket
- Hinged (passive or active)
When might a socket exoprosthesis not be appropriate?
Excessively mobile skin (makes it difficult to secure, but rarely an issue below the tarsus or carpus), moderate to severe neurologic defects, compromised joint motion, or issues with the stump (local neoplasia, infection, stump pain).
What is the difference between passively and actively hinged exoprostheses?
Passive: impart torque to return the prosthetic to a neutral position.
Active: apply torque to a joint, usually to stretch it over a long period of time.
What type of prosthetic is shown?
Surgically implanted prosthetic (or osseointegrated implant)
What are the methods of osseous fixation for a surgically implanted prosthetic?
- Plate + screws, or nail + bolts.
- Cementless (typically custom made)
- Cemented (least popular due to high likelihood of infection).
