Joint instability (Yr 4)

Question 1

what are the two main directions of hip luxation?

Answer 1

craniodorsal
caudoventral

Question 2

what causes craniodorsal hip luxation?

Answer 2

trauma
hip dyplasia

Question 3

what causes caudoventral hip luxation?

Answer 3

abduction of the limb

Question 4

what is the most likely direction for hip luxation?

Answer 4

craniodorsal - weight bearing and pressure from gluteals

Question 5

what are the three clinical signs of craniodorsal luxation?

Answer 5

internal rotation of limb
non-weight bearing (usually)
greater trochanter higher than normal

Question 6

what are the three landmarks for assessing greater trochanter height in hip luxations?

Answer 6

ischiadic tuberosity
cranial dorsal iliac spine
greater trochanter
(should make triangle in normal dog but will be in a line if craniodorsal hip luxation)

Question 7

what are the clinical signs of caudoventral hip luxation?

Answer 7

history (dog does the splits)
often very painful (head sits on nerves)

Question 8

how can craniodorsal hip luxations be reduced non-surgically?

Answer 8

anaesthetise/sedate
lateral recumbency with affected limb uppermost
towel around inguinal area
externally rotate limb to release femoral head
traction caudoventrally
when femoral head distal to dorsal acetabular rim rotate the limb inwards

Question 9

what type of support is placed on craniodorsal hip luxations once replaced?

Answer 9

(ehmer sling)
keep limb inwardly rotated

Question 10

what support is used for caudoventral luxations once they have been replaced?

Answer 10

hobbles (stop legs splaying)

Question 11

what patients are mandibular physeal separations most commonly seen in?

Answer 11

cats (especially after fall/trauma)

Question 12

how are mandibular physeal separations diagnosed?

Answer 12

clinical examination - mandibular canines misaligned with excess movement
(radiographs to confirm other possible fractures)

Question 13

what treatment options are available for mandibular separations?

Answer 13

muzzle
wire (metal or PDS)

Question 14

what is the one time carpal hyperextension will correct itself?

Answer 14

young dogs that have been bandaged (due to fractures ect.) and develop weakness, this will self resolve with exercise

Question 15

can carpal hyperextension be treated conservatively?

Answer 15

no, they require surgery

Question 16

what can cause carpal hyperextension?

Answer 16

high rise falls (off walls…)
degeneration of palmar/plantar ligaments
collateral ligament injuries/ruptures
inflammatory processes

Question 17

what is the management of carpal hyperflexion and tarsal instability based off?

Answer 17

degree of lameness
dysfunction
exercises intolerance
load bearing angle
history of trauma (surgery usually indicated)

Question 18

what dogs is gastrocnemius enthesopathy seen in?

Answer 18

large breeds

Question 19

how do gastrocnemius enthesopathy present?

Answer 19

large breed dogs with thickened achilles tendon
partial/complete plantigrade stance
possible crabbed toe

Question 20

how is gastrocnemius enthesopathy treated?

Answer 20

almost always surgery (don’t bandage)

Question 21

what is an enthesopathy?

Answer 21

disorder at the site where a muscle/connective tissue connects to bone

Question 22

why do animals with gastrocnemius enthesopathy present with crabbed toes?

Answer 22

hock drops meaning the SDFT has to travel further causing the toes to curl

Question 23

how can digit luxations be treated?

Answer 23

if stable - reduce, splint, cutting nail short
if unstable - surgery required (stabilisation/amputation)

Question 24

how many digits can you amputate on a limb?

Answer 24

one (more than this will have problems, especially 3 and 4 as these are weight bearing)