Foot and miscellaneous orthopaedic conditions Flashcards
What are main conditions of the foot?
- Fractures (Mc/Mt/Phalanges)
- Luxations of joints
- Pad injuries - e.g. Corn
- FBs
- Nail injuries
- (Sesamoid disease)
What is a corn? Tx?
- Paw pad keratoma =
-focal area of hyperkeratosis, (excess keratin + thickening) - Tx = topical ointment, hulling (digging out corn), complete excision - But will recur =
Superficial digital flexor tendonectomy
What should be done with fractures of the foot? What are complications?
- Single = external coaptation
- Multiple = dowel pinning / SPIDER external fixation
- Complications = Extensive soft tissue injuries - check viability
When would you do a toe amputation?
- Single digit
- Severe luxation / fracture / neoplasia
- Can cut through joint
What are paraneoplastic bone disease?
- Marie’s disease = Hypertrophic osteopathy
What are developmental bone disease?
- Panosteitis
- Metaphyseal Osteopathy
- Craniomandibular Osteopathy
- Legg-Calve-Perthes Disease
- Slipped Capital Femoral epiphysis
- Bone Cysts
What are nutritional bone disease?
- Nutritional Secondary Hyperparathyroidism
- Renal Secondary Hyperparathyroidism
- Hypovitaminosis D (Rickets)
What is seen with panoseitis? Dx? Tx?
- Classically shifting lameness
- Varies in severity from mild to non-weight bearing
- Acute onset, no trauma
- Forelimb:hindlimb ratio 4:1
- Dx = Hx, CS + Radiography
- Tx = Self limiting, exercise restriction + analgesia
What is seen with metaphyseal osteopathy? Dx?
- Young large breed dogs (2-6m/o)
- Mild lameness to severe collapse
- Pyrexia, anorexia + depression
- Dx = History, CS, Radiographs
What is seen on radiography of Metaphyseal osteopathy? Tx?
- Distal radius + ulna = radiolucent lines in metaphysis
- Widened growth plates
- Tx = self-limiting, supportive = analgesia
What is seen with craniomandibular osteopathy?
- WHWT - 4-10m/o
- Mandibular swelling / thickening
- Inability to open mouth / prehend food
- Salivation, pain when eating
- Anorexia, weight loss
What is Dx of craniomandibular osteopathy? What is seen on radiography? Tx?
- Dx = Hx, CS, Radiography
- Radiograph = bilateral changes, palisading proliferation on mandible + tympanic bullae
- Tx = Supportive, analgesia (can be self-limiting)
- NOT SURGERY
What is seen with hypertrophic osteopathy?
- Older dogs/cats (around 9y/o)
- Lameness, single/multiple limbs
- Firm swelling along bones of distal extremities
- Pain in early stages
- Hyperthermia, weight loss + depression
How is hypertrophic osteopathy Dx / Tx?
- Dx = Hx + CS + Radiographs (thoracic + limb)
- Radiograph = increased bone density, periosteal new bone formation
- Tx = Symptomatic + remove primary cause
What causes nutritional secondary hyperparathyroidism? CS?
- Causes = Diets high in phosphorus or low in calcium
-Usually meat based diets
-Ideal Ca:P ratio 2:1 (dogs) and 1:1 (cats)
-Hypocalcaemia = increased PTH
-Induces progressive skeletal demineralisation - CS = Lameness/ inability to stand
-Skeletal pain
-Swollen metaphysis
-Pathological fracture
How is nutritional secondary hyperparathyroidism diagnosed / treated?
- Dx = Hx, CS + Radiography
- Radiograph = decreased bone density, mushroom shaped metaphysis, pathological fractures
- Tx = rest, diet correction, oral supplements, NSAIDs
What causes renal osteodystrophy?
- Impaired phosphate excretion = hyperphosphataemia = hypocalcaemia = increased PTH = bone demineralisation = rubber jaw
- Impaired vit D production = depressed enteric calcium absorption = impaired osteoid mineralisation = rickets / osteomalacia
CS of renal osteodystrophy? Tx?
- CS = Pliable mandible/maxilla (rubber jaw)
-Loose teeth
-Skeletal pain
-Pathological fractures
-Bowing of long bones - Tx = Reduce phosphate intake / phosphate binder
-Calcium / calcitriol supplement
What are the different degrees of ligament injuries?
- First degree (sprains) = minimal tearing, rapid healing
- Second degree = partial rupture associated with haemorrhage + oedema
- Third degree = complete rupture of ligament / avulsion from bony attachment
How would you treat different degrees of ligament injuries?
- First degree = 1 week restricted exercise + NSAIDs
- Second degree = Support/bandage for 3-4 weeks
-exercise controlled for up to 3 months - Third degree = surgical repair
How would you treat tendon injuries?
- In acute phase = reduce inflammation = cold compress + immobilisation
- Surgical Tx for rupture / severed / avulsed tendons
- Immobilisation for 4-6wks
- Gradual increase in exercise over 2 months
- Platelet rich plasma
What is seen with reversible contracture of the flexor carpi ulnaris muscle?
- Young dogs (6-8wks)
- Flexed carpus that cannot be extended
- Tendon of FCU is taut on palpation
Tx of contracture of flexor carpi ulnaris?
- Resolution occurs after 2-3 wks
- Carpal supports
- FCU tendinectomy = RARE
