Elbow Flashcards
What are the conditions that are a part of “elbow dysplasia”?
- ununited anconeal process
- medial compartment disease
- fragmented medial coronoid process
- OCD
- joint incongruity
What is joint incongruity?
- mismatch in articular surfaces
- length/diameter discrepancy
- uneven joint surfaces
What is the typical signalment/presentation of elbow dysplasia?
- biphasic age distribution (young - joint surface defect, old - osteoarthritis) - often bilateral - large and giant breeds - GSD - males predisposed
What is the typical history of a dog with elbow dysplasia?
- chronic, progressive lameness
- aggravated by activity
Describe the characteristic posture of a dog with elbow dysplasia
“toed out”
- elbow adducted
- external rotation of limb
What is found on physical exam of a dog with elbow dysplasia?
- lameness
- elbow effusion
- pain on manipulation
- characteristic posture
- crepitus
When is pain felt during manipulation of a dog with UAP or MCD?
UAP - extension
MCD - flexion and supination
What is the proposed etiology for UAP?
radioulnar incongruity
- shortened ulna displaces humerus
- excess force on anconeal process results in failure of ossification
separate anconeal center of ossification
What is the proposed etiology for FCP?
microtrauma caused by incongruity
What is the best diagnostic method for FCP?
arthroscopy
Which radiographic view is required to diagnose UAP?
flexed lateral view
What are possible treatments for UAP?
- fragment excision (older dogs with DJD)
- osteotomy + fixation
What is incomplete ossification of the humeral condyle?
failure of union between the medial and lateral portions of the humeral condyles
Who is predisposed to IOHC?
spaniel breeds
males
How can IOHC present?
- no clinical signs
- mild lameness (weight bearing)
- acute NWB lameness
How is IOHC treated?
if no fracture - single lag screw across condyles
How is the elbow normally stabilized?
- constrained by collateral ligaments in flexion
- constrained by olecranon in extension
What occurs in traumatic elbow luxation?
rupture/avulsion of the collateral ligaments
When is a closed reduction indicated in a traumatic elbow luxation?
with an acute luxation of a normal joint
Describe the Campbells test
- elbow and carpus at 90 degrees
- supination to assess lateral collaterals
- pronation to assess medial collaterals
- compare to contralateral limb
When is an open reduction indicated for a traumatic elbow luxation?
- concurrent fractures
- unsuccessful/unstable closed reduction
- recurrent luxation
What is done post-reduction of a traumatic elbow luxation?
- leg is maintained in extension
- spica splint if closed reduction
- flexible ESF is open reduction
- after apparatus removed, exercise restriction and physical therapy
Describe the Spica splint
- maintains limb in a standing position
- splint extends from foot past dorsal midline, and is secured around thorax
What is the prognosis for reduction of a traumatic elbow luxation?
closed - good to excellent
open - fair
What is congenital elbow luxation type 1?
caudolateral luxation of the radial head
- ulna relatively intact
What is congenital elbow luxation type 2?
- lateral rotation with subluxation of the ulna
- radial head dispaced laterally
Describe the signalment and presentation of congenital elbow luxation
- small breed dogs
- seen soon after birth
- creeping gait due to incomplete extension of elbows
- partial flexion, internal rotation of antebrachium
What is the prognosis for congenital elbow luxation?
guarded to poor
- normal joint function not expected
What are the salvage procedures used for elbow diseases?
- canine unicompartmental elbow
- total elbow replacement
- arthrodesis
What is the CUE procedure, and when is it done?
- partial joint replacement
- for end-stage medial compartment disease
