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Farm > Bovine Musculoskeletal Dz > Flashcards

Bovine Musculoskeletal Dz Flashcards

1
Q

Main muscles affected in spastic pariesis

A

Gastrocnemus primarily (BSP-G)

Quads or mixed muscle involvement also possible

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2
Q

Spastic pariesis - age at onset and clinical sigsn

A

Usually presents before 6month old

CSs = hyperextension of the hock and stifle. Rx in swinging limb gait and limb held caudally. NO resistance to passive manual flexion

Main ddx is UFP - cannot manually flex the limb with UFP

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3
Q

Tx of spastic pariesis

A

No effective medical treatments

2 sx options

1) Partial tibial neurectomy
2) Transection of the gastroc tendon insertions (2)

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4
Q

Spastic pariesis px

A

Hopeless w conservative tx

Good with sx if gastroc only affected - approx 85% for either tx

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5
Q

Treatment complications for spastic pariesis

A

Gastroc rupture

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6
Q

Vertebral formula of cattle

A

C7, T13, L6, S5, Ca 18-20

(similar to horse except for thoracic

equine = C7, T18, L6, S5, Ca 15-21)

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7
Q

Vertebral formula of sheep

A

C7, T13, L6(7), S4, Ca16-18

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8
Q

Vertebral formula of goats

A

C7, T13, L6(7), S5, Ca 16-18

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9
Q

Vertebral formula of pigs

A

C7, T14-15, L6-7, S4, Ca 20-23

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10
Q

Vertebral formula of llamas

A

C7, T12, L7, S5, Ca 16-20

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11
Q

Treatment and prognosis for lateral radial luxation in cattle reported by Devaux (VS 2019)

A

Closed reduction followed by 9-12wk confinement

Reduction UGA achieved with elbow and carpus in maximal flexion, and medial rotation of the forearm in combo with strong lateral pressure on the radial head

All 3 cases had good outcome

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12
Q

What type of external coaptation is this

A

Thomas Splint Cast

2 metal side bars at the front and back connect to a ring which the limb is placed through

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13
Q

Describe the normal anatomical relationship between greater trochanter of the femur, and tuber coxae/tuber ishii

How can this be used to aid in dx of musculoskeletal problems?

A

GT sits ventral to both tubera. The 3 structures form a triangle, with the distance between GT & TC approx 2x more than GT & IT.

GT palpable on a level with TC/IT = dorsal coxofemoral luxation.

GT not palpable = ventromedial coxofemoral luxation

Excessive limb abduction is also possible with ventral hip luxations - normally shouldn’t be able to abduct >45degrees. This incr upto 90degrees w luxations

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14
Q

List 3 non-fatal musculoskeletal causes of downer cow syndrome, & 4 fatal causes

A

NON-FATAL

1) Peroneus tertius rupture
2) Muscle damage
3) Brachial/radial nerve paralysis

FATAL

1) Ventral coxofemora luxations (most present down vs dorsal where present w lamaness)
2) Gastroc rupture - usually at MT junction & complete if cow down
3) Femoral fracture
4) Vertebral trauma

Other causes incl

1) Acute systemic inflammatory conditions (metritis/mastitis)
2) Electrolyte imbalances

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15
Q

Clincal apprearance of ruptured gastroc in a cow?

Give 2 ddx

A

Tarsal hyperflexion/plantigrade stance. Can’t extend tarsus to WB normally

Ddx = calcaneal fx, schiatic nn injury

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16
Q

Dx features of ventral coxofemoral luxation

A

Lamaness (NWB)

Crepitus in region of the hip (per rectum & precutaneously)

Abnormal relationship between GT, TC & IT; w ventral luxations, GT usually not palpable (whereas w dorsal luxations will be locatd dorsal to normal, in line w TC)

Limb abduction >45° - assessed in lateral w limb up.

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17
Q

Indications for digit amputation in cattle

What weight of cow is it most appropriate for?

A

Indications = pedal osteitis, luxation, or fracture of P3, deep sepsis of the digit, & septic arthritis of the DIP or PIP joint

Adv = rapid & inexpensive, all infected tissues are resected, & cattle usually return rapidly to prev level of production

Disadv; expected production life reduced, heavy animals do poorly, & cosmetic result is poor.

Cattle weighing >680 kg have a short production life w digit amputation.

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18
Q

List 2 surgical treatment options for DIPj sepsis. What are the advantages & disadvantages of each?

A
  1. Digit amputation: +quick & easy (esp if not closing stump as in septic processes)

+radpidly return to prev production level

  • poor cosmesis
  • long term px poor; shortens productive lifespan, esp >680kg
    2. Ankylosis of the DIP joint: + longer productive lifespan

+ more cosmetic rx

+success rate approx 80%

+ more appropriate (longer span) in heavy animals, esp if hind lateral or FL medial digit involved

  • more difficult to perform
  • longer PO care
  • slower return to production levels PO; more PO pain during slow porcess of ankylosis
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19
Q

Which 2 approaches are available for ankylosis of the DIPj?

What are advantages & disadvantages of each?

A

Adv of arthrodesis (generally over digit amputation) incl longer production life, better outcomes in heavy animals, or when hind lateral or front medial digit is affected, better cosmetic rx & mechanically more stable vs digit amputation.

Disadv; more expensive & technically demanding, more PO care is needed, slower return to previous production dt PO pain during long process of ankylosis

1) Solar approach:

+ good access & visualisation w

+good outcomes

  • Approach to the joint is hard
  • Even if not affected by the septic process, DDF & distal sesamoid bone—must be resected; can create joint instability
    2) Dorsal approach:

+can be used if the navicular bone & DDFT are unaffected.

+ easy to perform

+less invasive,

+superior more joint stability as DDFT remains intact

  • limited visibility vs solar approach
  • can be hard to know if you have removed adequate cartilage.
  • Drainage less efficient
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20
Q

2 main sx tx for CCL tears/rupture in cattle

A

1) Extra-articular imbrication
2) Intra-articular stablilisation
a) Gluteobiceps tendon repair of CCL
b) synthetic CCL

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21
Q

Hallmark radiographic feature of CCL rupture in cattle

A

Tibial intercondylar eminences located cranial to femoral condyles - ordinarily would be completely superimposed on one another

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22
Q

What are the 2 broad sx tx options for CCL rupture in cattle

A

1) Stifle imbrication (extra-articular)
2) Intra-articular stabilisation
a) gluteobiceps graft
b) synthetic ligament graft

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23
Q

Briefly describe stifle imbrication for tx of CCL rupture.

A
  1. S-shaped skin incision starting 5cm proximal to the patella extending 1st medially on the cranial aspect of the stifle joint, until 5 cm distal to tibial crest
  2. Aspirate joint fluid
  3. W limb in almost full extension; 1st row of imbricating Lembert sutures placed w nonabsorbable suture (No. 5 polyester or polyblend) at the level of the lateral femoropatellar ligament, extending from the dorsal aspect of the patella to the tibial crest
  4. Repeat on medial side centred over medial femoropatellar ligament
  5. Place 2nd/3rd layers on either side if fascia strong enough to hold
  6. Close approach in 3 layers
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24
Q

Briefly describe the procedure for graft repair of a ruptured CCL

A
  1. Skin incision from greater trochanter → lateral aspect of patella , then curved distally → parallel to LPL → tibial crest
  2. Incise fascia lata over plane between vastus lateralis & gluteobiceps
  3. Full-thickness strip of fascia 2cm wide sharply dissected from cranial margin of medial GB mm, continued distally through fibrocartilaginous thickening over lateral epicondylar bursa & distally stillby dividing LPL parallel to its fibres down to tibial crest (maintaining 50% of LPL in a normal position)
  4. Graft is therefore attached distally to the tibial crest, containing lateral half of LPL, a portion of suprabursal fibrocartilage, & approx 20 cm of gluteobiceps mm fascia
  5. LFTj approached by arthrotomy between lateral & middle PLs & transection of lateral femoropatella lig - inspect joint digitally & remove any injured bine/meniscus
  6. Curved graft passer passed through intercondylar space in crania→caudal direction, directed through caudal joint capsule & popliteus mm to exit lateral gastroc origin @ lateral epicondyle
  7. 120cm 8mm wide umbilical tape threaded into graft passer & brought out through arthrotomy. Cutting umbilical tape at the graft passer eye leaves 2X 60cm lengths of tape in the route of the graft passer; 1 is a spare incase 1st attempt fails.
  8. Widen tissue tunnel by passing lubricated gauze through attached to umb tape multiple X
  9. Graft then inserted into lumen of 10mm sterile braided nylon rope (length, 2 ft [60 cm]), secured to graft w interrupted sutures. Other end of rope secured to gauze in the tissue tunnel.
  10. Rope & graft are lubricated w CMC &, w stifle in 100° flexion, rope leader & attached graft are pulled through the passageway; entrance is best with the joint in 100° flexion whereas exit is best in partial extension.
  11. Then attach graft proximally to lateral epicondylar area w elevation of 6cm strip periosteum & sucure graft - bone w bone staple, fold end & staple again (or can place plate/screws)
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25
Q

Briefly describe procedure for synthetic CCL repair

A
  1. 40cm incision from mid femur, lateral to patella, along to tibial crest
  2. Incise fascial lata & cutting lateral femoropatellar ligament → medial luxation of patella to gain articular access
  3. Make 3 bone tunnels w 6.2mm drill bit; 1st just proximal to lateral femoral epicondyle & aims toward intercondylar space approx where CCL originates, w stifle in flexion
  4. 2nd - from medial tibial crest, exiting at insertion site of CCL.
  5. 3rd - from previous medial tibial crest bone hole, aimed laterally.
  6. Many synthetic materials been used: eg threaded caprolactam or polyester to fishing lines or custom-made nylon cable
  7. Synthetic implant passed through tunnels similarly to the graft. Difficult to do
  8. Implant is passed through the femoral tunnel first, then through the tibia from proximal to distal, & finally from medial → lateral through tibial crest tunnel
  9. Distal implant then tunnelled under mm proximally → tightened over lateral epicondylar area
  10. If heavy-duty nylon cables (500-1000 lb) are used, can’t tie knot so use 5-hole stainless steel plate to withstand & secure the tension. Adv of cable →easy to thread through bone holes.
  11. Joint capsule, femoral patellar ligaments, & fascia lata are sutured as for graft technique. Lateral imbrication is performed as well & a stent is applied over skin incision
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26
Q

Expected px following CCL repair in cattle

A

Return to breeding function depends on size, degree of DJD pre-op, & behaviour (lying down on a good leg, etc.

Of 14 bulls (≥900 kg), 6 → incisional failure (4 → fatal septic arthritis) & 2 → graft failure, makes total success rate of 43%.

Of 13 cows, 11 (85%) were successful, but 2 had residual lameness.

CCL rupture observed in contralateral limb in 2 cows a few months after repair.

Similar rx obtained w prosthetic ligaments.

27
Q

Whats the likely dx? - pathognomonic limb posture

How is it treated?

A

PIT joint luxation.

Ddx = IA tarsal fx (eg calcaneous, small tarsal bones)

Limb held flexed, inability to manually straighten. Should X-ray hock

Tx - Closed reduction - lateral recumbency with distal traction. No ext coaptation required (vs TCj luxation = 8-12wk RJB +/- splint)

28
Q

What are the layers of physeal cartilage?

Which is the weakest?

A

Zones from epiphysis to metaphysis

  1. resting
  2. differentiation
  3. proliferation
  4. hypertrophy

5 zone of provisional calcification (zone of hypertrophy)

Zone of hyperttrophy is the weakest & prone to fx

29
Q

Diagnostic features of CCL rupture in cattle?

A

Swollen stifle w POP.

+ve draw test - stand behind the cow with limbs around the front feeling prx tibia Firm caudal pressure on tibia then release. Crepitus after release = positive rx

Rads - tibial eminences and condyles usually superimposed - with CCL rupture, the tibial eminences will be cranial to the femoral condyles. This is diagnostic

30
Q

Which claw is most commonly affected with foot lesions in cattle?

A

Hind foot, lateral claw

31
Q

Treatment of distal phalynx fractures

A

Immobilisation - block on the unaffected digit, then wire the affected digit to the block in slight flexion to decrease pull of DDF - which will displace the fragment. Maintain block for 6-8weeks. Tx should be guided by clinical progression vs radiographic (long time to union as in horses).

Consider facillitated ankylosis or digit amputation if failure to improve, or in fx 2ary to septic processes.

32
Q

Treatment options for pedal osteitis

A
  1. Debridement - remove infected sole/chorium, then debride/curette bone. Block opposite claw. Repeated tx usually necessary
  2. Digit amputation - for severe/ non-responsive cases
33
Q

Tx options for acute & chronic DIPj sepsis.

A

Acute - (less common presentation); needle lavaage 500ml on 3 consecutive days. ABx 2 weeks (Truperella, E coli, Staph most common isolates)

Chronic (more common presentation);

  1. Digit amputation - Biers block. Incise from interdigital skin, aiming 45° abaxially to the proximal digit. Osteotomy then performed in same way w foetotomy wire. Bandage 10d ABx 3-5d

Usually don’t close anything - drainage. In non-septic dz - can preserve skin flap to close over stump.

  1. DIPj arthrodesis / facillitated ankylosis.
    a) solar approach - horizontal skin incision along plantar aspect 2cm proximal to coronary band, through whcih DDF is transected distally, reflected & transected again proximally & remove distal sesamoid bone. Debride/lavage joint through sole or dorsal hoof wall. Block opposite digit & wire affected digit in sl flexion.
    b) Dorsal approach - 2X dorsal arthrotomy with trephines, debride/lavage and block as above
34
Q

Advantages and disadvantages of digit amputation & facillitated ankylosis for tx of DIPj sepsis in cattle

A

Digit amputation + quick & easy

+cheap

+ removes all infected tissue

+ cows rapidly return to prev production levels

  • shortens productive life significantly overall
  • poor cosmesis
  • poor outcomes in heavy animals >680kg

DIPj arthrodesis: +longer overall production lives

+better outcomes in heavy animals, or when hind lateral or fore medial claw is involved.

+ better cosmetic outcomes

+mechanically more stable Vs digit amputation

  • take longer to achieve previous levels of production
  • longer PO care
  • more painful PO
35
Q

Advantage/disadvantages of dorsal approach vs solar approach for DIPj facillitated ankylosis

A

Solar: +good drainage

+good visibility

Dorsal: + less invasive; better mechanical stability vs solar as DDF remiains intact

+easier

+ can be used if navicular bone/DDF not involved

  • worse drainage & visibility
36
Q

Describe the modified abaxial approach for digit amputation described by Amstel et al (JAVMA 2018)

A
  1. Sedated on tilt table w Biers block
  2. 2x2cm cut in abaxial hoof wall, 1cm distal to coronet from 5cm abaxial to dorsal midline; & removed
  3. Navicular bone attachments incised and bone removed, preserving flexor tendons
  4. Articular surface debrided with 3/8” drill bit & tunnel created w drill through dorsal hoof wall
  5. Curettes inserted through drill tracts to debride joint
  6. Hoof window packed w iodinated gauze & block unaffected claw +/- distal limb cast
37
Q

What factors were assoc with a dx of DIPj sepsis in lame cattle described by Chamorro et al (TVJ 2019)

A

Increased lameness severity >/= 4/5

Asymmetric swelling above coronory band of affected digit

Both were assoc w DIPj sepsis as the cause of lameness in cattle

38
Q

Main underlying reason for haematogenous septic arthritis in calves? And adults?

Common bacterial isolates

A

Calves - umbilical infection

Adults - septic endocarditis

Common isolates incl Truperella pyogenes & E coli

39
Q

Constant et al - JAVMA 2018 - clincial findings in calves with septic arthrities

A

Key Points

  1. Most frequently isolated pathogens were Streps and Mycoplasma bovis. Fluoroquinolones, tetracyclines, and macrolides have the best distribution into synovial structures and fluid and are active against Mycoplasma (which lack a cell wall and are therefore naturally not susceptible to B-lactams)
  2. The px for calves < 6 months old with septic arthritis is fair following hospitalisation and treatment at a referral hospital - 83% were discharged from the hospital and 59% positive outcome at 12 months
  3. Positive association between synovial fluid TNCC and a positive outcome; thus, synovial fluid TNCC may be a useful prognostic indicator and help guide treatment decisions for calves with septic arthritis.
  4. Carpal joints were most frequently affected, followed by stifle and tarsi
  5. Negative outcome assoc with incr. no of affected joints, infection of the stifle joint, neutrophil count, and plasma fibrinogen concentration, although generally these factors not retained in multivariable
40
Q

What were negative prognostic factors associated with haematogenous septic arthritis in calves reported by Constant et al VCOT 2018

A

Neg px indicators incl. reduced joint space height on rads, & subchondral lysis on weight bearing surfaces of the affected joint.

Increased severity of radiographic changes were documented in older calves, longer duration of clinical signs before admission & positive synovial culture for Truperella pyogenes

41
Q

Expected outcomes following CCL repair in cattle?

A

For gluteobiceps repair(synthetic repairs similar rx)

Bulls >900kg - 43% success rates

Cows (<900kg) - 85% success rate

Stifle imbrication technique most successful in those <400kg

42
Q

What surgical tx options are availble for stifle collateral ligament injuries?

A

1) MENISCOPEXY

Suitable for medial CL/meniscal injuries

Horizontal skin incision over MCL, dorsal & parallel to meniscus. Most medial aspect of meniscus sutured to MCL & joint capsule - starting extra-articular, entering joint capsule, through abaxial meniscus, then exiting & tied extra-articular.

2) MCL stabilistion
a) 5.5mm cortex screws/washer at MCL origin & insertion. Then 2-3 USP 5 polyester sutures placed in figure 8 between the screws.
b) Imbrication of medial peri-articular tissues - as for extra articular stabilisation of CCL injuries

43
Q

Tx options for gastroc rupture

A

Ypund animals that can stand - immobilisation (RJB +/- splint, TFPC) 6-8weeks, 2-3mo overall confonement, Good long term px

Adults with plantigrade stance or unable to rise should be euthanised

44
Q

Management of scapulohumeral luxations

A
  1. Closed reduction w stall confinement (GA lateral)
  2. Open reduction & internal fixation - open joint, debride/lavage, replace & close. Place 5.5mm cortex screw + washer in greater tubercle, & several 3.2mm drill holes in distal scapula (Xra in the book shows screw in scapula rater than GT). Several USP 5 fibrewire sutures placed around screw head & through bone tunnels in figure 8 fashion to maintiain.

Can manage in Velpeau sling PO (maintains limb non-WB with carpal flexion)

45
Q

Tx options for coxofemoral luxations

A

Most appropriate for craniodorsal luxations (ventral usually recumbent, unable to stand & req PTS)

1) Closed reduction - limb traction/rotation - rarely succussesful in all but the most recent of injuries & re-luxation rates high esp if chronic. Mainly as the fibrocartilagenous rim of the dorsal acetabulum gets folded & stuck between acetabulum & femoral head

Px 43-75% if performed within 12hours of injury, otherwise v poor

2) Open reduction - allows proper seating of femoral head + reinforcement

Open approach for debridement/replacement. Thenreinforce w 2 screws w washers in craniodorsal acetabular rim, & 1 in the greater trochanter. Additional drill hole through rostral greater trochanter. Multiple USP 5 sutures,placed between screws & tied to restrict ROM t 30° flexion. 3 mo PO confinement

75% success rates for calves, 50% for adults.

46
Q

Which fractures can be treated with Thomas splint/cast combination?

A

Best suited to fractures of the radius or tibia.

Made with a metal ring measured to the axilla or groin with metal side bars front & back, incorporated into a cast from the distal metatarsus to proximal tibia (as high as poss). Then place limb through the splint. Wires through hoof wall to attach foot to the base of the splint.

47
Q

Tx for UFP in cattle. What is the main clinical ddx?

A

Tx = medial patella ligament desmectomy - similar to horses but a section of MPL is removed vs desmotomy alone in horses. 99% success rate with this procedure

Main ddx for holding limb in extension is spastic pariesis (gastroc) - but this usually occurs <2yr vs UFP >2 years.

48
Q

How many layers of casting material are req. for a typical cast?

How often should casts be changed?

A

4 MINIMUM.

Usually 4-6 layers <150kg. 8-12 layers for adults.

<1mo old - change cast q3 weeks

1-6mo - change q 4 weeks

6-12 mo change q 6 weeks

6-8 weeks in adults

49
Q

What features of an ESF can be altered to maximise its stability?

A
  1. Increasing pin number per fragment
  2. Increasing pin size (except beyond >10% diameter - weakens bone)
  3. Angling pins slightly divergenty
  4. Increasing number & size of connecting bars
  5. Decreasing distance between bone and connecting bars (working length)
  6. Using positive profile threaded pins (vs neg profile or smooth)
50
Q

What fracture types are best suited to ESF

A
  1. Generally the more distal the fx, the better suited to ESF
  2. Open fx
51
Q

What methods can be used to approach a humerus for ORIF

A
  1. Lateral approach - for plate application in young calves (deltoid tuberosity gets in the way beyond 1 yr) & placement of IM pins/interlocking nails
    1. Skin incision from greater tubercle of humerus to lateral humeral epicondyle
    2. Dissect unde back of brachiocephalicus & reflect cranially. Then elevate deltoideus & retract brachiocephalicus caudally for proximal humerus
    3. For distal humerus, brachialis separated from ECR - retracted caudoventral & brachialis cranially.
  2. Canial approach - from cranial humeral head distally
    1. dissect between brachiocephalicus & omotransversarius, & brachial fascia
    2. Insertion of brachiocephalicus transected to expose brachialis & MS groove.
  3. Combined: craniolateral approach - curvilinear skin incision from cranial humeral head, laterally over ECR ending cranially over ECR
52
Q

Methods of fixation for humeral fractures

A
  1. IM pins - better for short oblique or transverse fx w significant interdigitation as lacks rotational stability. Will need cerclage wires in addition if using in longer oblique fx. Inserted normograde (from proximally); from greater tubercle to medial condyle, avoiding olecranon fossa. Stacked pinning improves rotational stability.
  2. IIN - placed from normograde. More technically demanding but improved rotational stabilty
  3. Plates - single <200kg, double >200kg. Either laterally or cranially (or both). Care re radial nerve and olecranon fossa with distal screws in the lateral plate.
53
Q

Methods of fixation for radius/ulna fractures

A

Usually neonatal calves w cortical bone too weak to rely on implants, so need to combine w external coaptation <6mo old

1) Cast +/- Thomas splint - +/- selected internal fixation, eg lag screws +/- cerclage wires
2) Plate fixation - single cranial or 2 cranial & lateral or medial (>200kg)

NB dont use full limb cast following plate repair of radial fx - shifts the tension side of the bone from cranial to caudal so cycles implants & incr risk of implant failure

3) ESF - esp open fx
4) TFPC - 2 above, 2 below. Care re pin loosening rapid in neonates

54
Q

Fixation methods for MC/MT III/IV fractures

A
  1. Adults - oblique diaphyseal fx best managed w plate fixation - 2 plates in adults.
  2. Neonates - usually SHII fx of the distal metaphysis. Usually ext coaptation sufficient.
  3. TFPC for open, comminuted fx
  4. NB unstable physeal, all diaphyseal, & proximal metaphyseal fx of MC/MT require full limb cast extending to proximal radius/tibia
55
Q

Tx options for sacral fractures

A

1) Conservative - NSAIDS, confinement
2) Tail amputation - rubber ring at tail base (leaving enough to cover vulva), or sx amputation with the skin incision 2-3cm caudal to vertebral transection to cover over the stump
3) Repair - LCP via dorsal midline incision. Care re penetration of vertebral canal

56
Q

Tx of slipped capital femoral physes

A
  1. Stacked IM pins - 55% good outcomes (better <12mo)
  2. Cortical or cannulated screws in lag fashion; 70% servicable, mild lameness in 80% of these

Approach - curvilinear skin incision made just cranial to the greater trochanter, extended distally to the proximal 1/3 to 1/2 of the femur. Dissect between tensor fascia lata & gluteobiceps, retracting the latter caudally. Vastus lateralis incised along fibres to access its origin on greater trochanter. Joint needs to be open so can feel the femoral head. Pins/screws inserted from greater trochanter or femoral neck into femoral head. Confirmed digitally or w intra-op rads

57
Q

Uses of FHNE in cattle

Briefly describe the approach

A

Used for avascular necrosis of the femoral head

Approach

  1. Curvilinear skin incisiod from craniodorsal to greater trochanter to proximal 1/3 femur
  2. Dissect beteen TFL & GB mm. VL origin re. partial tenotomy to access greater trochanter.
  3. Pre-drill 2 holes in GT & then osteotomy w Gigli wire
  4. Femur then rotated & osteotomy of femoral head w wire
  5. Re-attach GT w screws & wires placed around screws & through holes in diaphysis
58
Q

Methods of repair of femur fx

A
  1. Plates - dorsally & laterally
  2. IM pins/stack pins +/- lateral unilateral ESF. Good px for stacked pins in middiaphyseal fx in neonates, poor for metaphyseal.
  3. IIN
59
Q

Methods of repair for tibial fx

A
  1. Coaptation - cast/Thomas or Walker splint, TFPC or type 2 ESF
  2. Double plating - anything >2mo. Lateral and craniomedial plate via same incision
  3. IIN
  4. Proximal physeal fx - as for foals. Medial plates
  5. Selective internal fixation combined w coaptation also works well
60
Q

Management of FLD in calves

A
  • No oxytet - often nephrotoxic w single dose
  • Splints etc as for foals
  • Sx - fetlock FLD; sequential transection until resolution; SDF & SL branches first (mid-metacarpal branches that join the SDF), then DDF, SL until corrected
  • Carpus - UL& FCU as in foals
61
Q

Grades of patella luxation

A

Almost exclusively lateral in calves

I: intermittent. Easily manually luxated but returns to normal after

II: Intermittent. Easily manually luxated, doesn’t readily return to normal

III: Permanent - can return to normal position manually but doesn’t readily remain there

IV: Permanent - can’t return to normal position manually.

62
Q

Treatment options for patella luxation

A

Grade I/II conservative - usually retain productive life

Greade III/IV surgical

1) Lateral patella release (transect gluteobiceps insertion on lateral stifle & lateral femoropatella ligament), & medial imbrication (sutureing heavy fascia as for extra-articular imbrication of CCL rupture, with limb in full extension).
2) May req. recessive trochleoplasty in addition to the abive depending on depth of groove in grade 4s. Can do wedge resecrtion, rectangular resection or curettage (latter if there is overlying chondromalacia meaning preservation of cartilage not req (care re trachlear ridge fractures after). Wedge & rectangular involve removing cartilage/SCB segment, curetting underneath & replacing it to preserve cartilage.
3) Re-allignment of tibial crest can also be performed but not recommended for heavier animals

63
Q

Briefly describe 2 surgical procedures to treat spastic pariesis (elso heel).

What is the expected prognosis with medical & surgical management

A

1) Partial tibial neurectomy - 15-20cm incision midway between greater trochanter & tibial crest centred over caudal gastroc/caudal femoral condyles. Separate gluteobiceps longitudinally to expose tibial nn - note at this level, peroneal branches from sciatic & runs dorsally. Brnaches of tibial nn supplying medial & lateral heads of gastroc ID w nerve locator. Cut the 2 brnaches that stimulat strongest contraction of those mm bellies. Resect 2cm portion of each & place ligature around proximal cut ends to prevent ‘re-growth’ Hobble for recovery. Expect improvement or resolution in 80%. Most common complication is gastroc rupture.
2) Gastroc tenotomy/tenectomy - 7cm incision over craniolateral gastroc tendon. 2 tendons of gastroc are inceised & 2cm segment of each removed. SDF preserved. No nerve locator needed. Care re gastroc rupture.

Hopeless px w medical management

Farm (17 decks)

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