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Small Animal Surgery > Carpus and Tarsus > Flashcards

Carpus and Tarsus Flashcards

1
Q

Describe the carpal collateral ligaments

A
  • all are short ligaments

- connect adjacent bones only

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2
Q

Describe the tarsal collateral ligaments

A
  • long portion spans the entire tarsus on each sire, and is taut in extension only
  • short portion crosses the joint obliquely, provides rotational stability, and is taut in flexion and extension
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3
Q

How is collateral injury assessed?

A
  • position limb in extension
  • apply valgus and varus stress to the joint
  • examine tarsus in flexion and extension
  • abnormal motion indicates injury
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4
Q

Which views are used to assess collateral injury on radiograph?

A
  • dorsopalmar and lateral

- dorsoplamar stress views (valgus and varus)

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5
Q

How is collateral injury treated?

A
  • ESF if there is soft tissue trauma

- collateral ligament replacement

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6
Q

Describe how collateral ligament replacement is performed

A
  • screw or bone tunnel at the origin and insertion of each ligament
  • create a tunnel and thread the suture through
  • figure 8 pattern
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7
Q

What occurs in a hyperextension injury?

A
  • damage to palmar or plantar support ligament

- allows abnormal motion between rows of carpal/tarsal bones

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8
Q

What is palmar fibrocartilage?

A

the confluence of joint capsule and ligaments on the palmar surface of the carpus

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9
Q

Which breeds are predisposed to hyperextension injury?

A

shelties and collies

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10
Q

What are the possible causes of hyperextension injury?

A
  • trauma (HBC)
  • immune-mediated
  • breed-related
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11
Q

Describe the presentation of hyperextension injury

A
  • swollen, painful joint
  • less pain and swelling with chronic injuries
  • hyperextended stance (dropped hock)
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12
Q

How are hyperextension injuries treated?

A
  • splint application and rest (unhelpful alone)

- arthrodesis

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13
Q

Describe a partial carpal arthodesis

A
  • middle and carpometacarpal joints are fused using T-plate or pins
  • function is retained
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14
Q

Describe a pancarpal anrthodesis

A
  • all 3 carpal joints are fused
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15
Q

Describe a partial arthrodesis of the calcaneoquartal

A
  • lag screw placed at end of calcaneous and extended down the joint
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16
Q

What needs to be done post-arthrodesis?

A
  • coaptation (splint or ESF)

- activity restriction until bony fusion

17
Q

What components make up the common calcanean tendon?

A
  • gastrocnemius tendon
  • combined tendon of the gracillus, semitendinosus, and biceps femoris
  • SDF tendon
18
Q

How does the dog present with a partial rupture of the calcanean tendon?

A
  • SDF usually preserved
  • Partial hyperflexion of the hock
  • flexion of the digits
19
Q

How is a rupture of the calcanean tendon treated?

A
  • debride tendon ends
  • primary tendon repair with 3-loop pulley
  • immobilize tarsus in extension
20
Q

Which methods of coaptation are use post op for ruptured calcanean tendon?

A
  • eternal fixator
  • splint
  • giant lag screw
21
Q

Which breed is predisposed to tarsus OCD?

A

Rottweiler

22
Q

Where is the lesion usually located in OCD of the tarsus?

A
  • ridge of the talus
  • medial most common
  • lateral in rottweilers
23
Q

What are the clinical signs of OCD of the tarsus?

A
  • lameness, worse after rest
  • hock-extended stance
  • joint effusion/fibrosis
  • pain/crepitus on manipulation
24
Q

What is seen on radiograph of a dog with OCD of the tarsus?

A

articular flattening

lucency

25
Q

Which radiographic views are used to assess OCD of the tarsus?

A

flexed lateral - expose proximal talus

flexed craniocaudal - cranial trochlear ridges

26
Q

When is medial therapy indicated for OCD of the tarsus?

A

older dog with established osteoarthritis

27
Q

What surgical treatment is done for OCD of the tarsus?

A
  • fragment excision/debridement

- tibiotarsal arthrodesis

28
Q

What is the prognosis for OCD of the tarsus

A

guarded to poor

29
Q

When is tarsocrural arthrodesis indicated?

A
  • severe injury to tibiotarsal joint
  • failed calcanean tendon repair
  • osteoarthritis non-responsive to medical therapy
30
Q

How is tarsocrural arthrodesis performed?

A
  • fuse tibiotarsal joint at a standing angle
  • remove articular cartilage
  • pack with bone graft
  • rigid fixation (type 2 ESF or plate)

Small Animal Surgery (26 decks)

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