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RUSVM Small Animal Surgery 2017 > Joints > Flashcards

Joints Flashcards

1
Q

Arthropathy

A

any joint disease

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2
Q

Arthrosis

A

“wear and tear” degeneration

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3
Q

Arthritis

A

Inflammation within a joint

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4
Q

Polyarthritis

A

inflammation in several joints simultaneously

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5
Q

Osteophyte

A

forms at synovial or articular margins

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6
Q

Enthesiophyte

A

forms at tendon/ligament attachment

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7
Q

Joint Mouse

A

mobile fragment within a joint

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8
Q

Joint Capsule

A

the sac that encloses a joint

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9
Q

-rrhaphy

A

“to suture in place”; to close

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10
Q

imbrication

A

surgical tightening

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11
Q

-plasty

A

surgical repair or shaping of

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12
Q

arthro

A

joint

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13
Q

rhino

A

nose

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14
Q

trochleo-

A

groovelike area on a bone

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15
Q

Ankylosis

A

spontaneous fusion of joint - end stage of joint disease

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16
Q

Arthrodesis

A

surgical fusion of a joint

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17
Q

Arthrotomy

A

incision into joint

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18
Q

Types of Joints

A

Synovial
Fibrous
Cartilaginous

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19
Q

How do you differentiate between an inflammatory and noninflammatory arthritis?

A

Do a Joint Tap

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20
Q

Infectious Causes of Arthritis?

A 
Bacterial 
Fungal 
Mycoplasmal 
Erosive 
Non-erosive
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21
Q

What is the most common cause of Osteoarthritis in cats?

A

Primary Idiopathic Osteoarthritis

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22
Q

What are the types of secondary osteoarthritis?

A

Developmental

Acquired

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23
Q

What are the radiographic signs of Osteoarthritis?

A 
Osteophytes
Effusion 
Increased joint space 
Decreased joint space
Soft tissue swelling
Subchondral sclerosis
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24
Q

What is the treatment for Osteoarthritis?

A

NSAIDs

salvage procedures: Joint replacement/arthroplasty, arthrodesis, amputation

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25
Q

How do you treat septic osteoarthritis?

A

open up the joint and flush it out completely and debride it

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26
Q

What are some symptom modifying agents for Osteoarthritis?

A 
NSAIDs
Tramadol 
Gabapentin 
Amantadine
Corticosteroids
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27
Q

What are some disease modifying agents for Osteoarthritis?

A

Polysulfated glycosaminoglycan
Pentosan polysulfate
Hyaluronic acid

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28
Q

Autologous platelet therapy

A

Platelets collected and injected into involved joint

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29
Q

What are surgical salvage treatments for Osteoarthritis?

A

Joint replacement arthroplasty
Partial joint exision arthroplasty
Arthodesis
Amputation

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30
Q

Partial Excision Arthroplasty

A

Remodeling of joint without replacement

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31
Q

What are common examples of Partial Excision Arthroplasty?

A

Femoral Head and Neck exicision (FHO)

Glenoid Excision

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32
Q

What are the postoperative management options for Arthrodesis?

A

Coaptation (6-8 weeks)
Activity Restriction until bony fusion
Prolonged healing common - 3 months +

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33
Q

Osteochondrosis

A

a defect in endochondral ossification

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34
Q

What is the pathophysiology of Osteochondrosis?

A

Disruptions in anastomoses lead to cartilage necrosis

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35
Q

Where is the most common place on the shoulder for Osteochondrosis dissecans?

A

caudolateral humeral head

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36
Q

Where is the most common place on the elbow for Osteochondrosis dissecans?

A

medial humeral condyle

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37
Q

Where is the most common place on the Hock for Osteochondrosis dissecans?

A

Medial or lateral talar ridge

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38
Q

Where is the most common place on the Stifle for Osteochondrosis dissecans?

A

Medial or lateral femoral condyle

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39
Q

What are the treatments for Osteochondrosis dissecans?

A

Preventative measures - diet, energy, calcium, vitamin D restriction
Conservative
Surgical

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40
Q

What are the surgical treatments for Osteochondrosis dissecans?

A

Fragment removal and subchondral bone debridement
Replacement of articular cartilage with fibrocartilage
Osteochondral transplants (OATS)

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41
Q

What is conservative management for Shoulder OCD Treatment?

A

Rest
NSAIDs
Diet

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42
Q

What is the standard of care for shoulder OCD?

A

Surgical treatment

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43
Q

What is the surgical treatment for Shoulder OCD?

A

Flap removal and joint lavage
Debridement of bone with curette or shaver
Defect heals with fibrocartilage
Arthroscopy

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44
Q

What is the treatment for Acute Biceps Brachii Tendinopathy?

A

Confinement for 4-6 weeks
NSAIDs
Physical therapy

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45
Q

What is the treatment for Moderate Biceps Brachii Tendinopathy?

A

Intraarticular corticosteroid injection
Strict confinement 4-6 weeks
Physical therapy

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46
Q

What is seen on physical exam for Shoulder Instability?

A

Muscle Atrophy
Pain on manipulation of Joint
Medial instability: Increased abduction angle

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47
Q

What is the treatment for mild shoulder instability?

A

Rest
Physical Therapy
Hobbles

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48
Q

What is the treatment for moderate shoulder instability?

A

arthroscopic thermal “capsulorrhaphy”
Rest
Physical Therapy
Hobbles

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49
Q

What is the treatment for Severe shoulder instability?

A

Medial glenohumeral ligament reconstruction

Velpeau sling instead of hobbles

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50
Q

Contracture

A

muscle shortening not caused by active contraction

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51
Q

Infraspinatus Contracture

A

traumatic disruption of muscle fibers causing muscle shortening not caused by active contraction

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52
Q

What is the treatment for Infraspinatus Contracture?

A

Tenetomy of infraspinatus tendon

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53
Q

Incongruity

A

mismatch of articular surfaces

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54
Q

What is the characteristic posture for Medial Coronoid Dysplasia?

A

“Toed Out”
Elbow abducted
External rotation of limb

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55
Q

What is the incongruity associated with Ununited Anconeal Process?

A

Short Ulna/ Long radius

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56
Q

What is the incongruity associated with Fragmented Coronoid Process

A

short radius/ long ulna

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57
Q

Radioulnar incongruity

A

Shortened ulna displaces humerus proximally

Excess force on developing anconeal process

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58
Q

At what age does the normal ulna fuse?

A

16-20 weeks

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59
Q

What is the gold standard for diagnosing Fragmented Coronoid Process and OCD?

A

Arthroscopy

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60
Q

Long portion of the Tarsal Collaterals

A

Spans the entire tarsus

Taut in extension but not in flexion

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61
Q

Short portion of the Tarsal Collaterals

A

Taut in both flexion and extension

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62
Q

Which way does Valgus stress deviate the limb?

A

Laterally

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63
Q

Which ligament is stressed when valgus stress is applies?

A

Medial Collateral Ligament

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64
Q

Which ligament is stressed when varus stress is applied?

A

Lateral Collateral ligament

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65
Q

Which way does the limb deviate when varus stress is applied?

A

medially

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66
Q

What is conservative treatment for collateral ligament injury?

A

Splinting + rest

ESF

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67
Q

What is the surgical treatment for collateral ligament injury?

A

Reconstruct/Replace

Salvage with excessive trauma

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68
Q

Collateral Ligament Replacement

A

Screw or bone tunnel in origin and insertion of each ligament
Nonabsorbable large diameter suture placed in figure 8 pattern

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69
Q

What type of suture is used for Collater Ligament Replacement?

A

40 to 80 lb test monofilament nylon

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70
Q

What ligaments are damaged with a hyperextension injury?

A

Palmar/plantar support ligaments

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71
Q

What is the treatment for a hyperextension injury?

A

Salvage surgery

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72
Q

Palmar fibrocartilage

A

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

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73
Q

Ginglymus

A

Hinge Joint

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74
Q

What is the etiology of a Hyperextension injury?

A

Trauma (jump/fall)
Immune mediated
Breed related breakdown or weakness

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75
Q

How does a hyperextension injury present?

A

Swollen
Painful
“dropped hock”
plantigrade stance

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76
Q

What is the conservative treatment for Hyperextension injury?

A

Splint application and rest

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77
Q

What is the surgical treatment for Hyperextension injury?

A

Arthrodesis of the affected joint + joint distal

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78
Q

Post op for Arthrodesis

A

Coaptation for 4-8 weeks
Activity restriction until bony fusion
Explantation may be required

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79
Q

Carpal laxity Syndrome

A

Hyperextension, hyperflexion, flexural deformity with palpable laxity of puppies ages 5-27 weeks that spontaneously recovered in 1-4 weeks

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80
Q

What is the physical exam finding for a Common calcanean tendon rupture?

A

plantigrade stance

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81
Q

What tendon is usually preserved in a partial rupture of the common calcanean tendon?

A

Superficial Digital Flexor

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82
Q

What are the physical exam findings of a partial rupture of the common calcanean tendon?

A

Partial hyperflexion of hock

Flexion of digits

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83
Q

What is the treatment for a common calcanean tendon rupture?

A

Debride tendon ends
Primary Tendon repair
Immobilize tarsus in extension

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84
Q

Hip Dysplasia

A

Abnormal development of the coxofemoral joint resulting in hip laxity

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85
Q

What is the manifestation of Hip Dysplasia in young patients?

A

Subluxation

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86
Q

What is the manifestation of Hip Dysplasia in older patients?

A

Remodeling and OA

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87
Q

What is the etiology for Hip Dysplasia?

A

Genetics and Environmental

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88
Q

What are some nongenetic factors that contribute to Hip Dysplasia?

A

Pelvic Muscle Mass
Body weight
Nutrition

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89
Q

What is seen in the History of an animal with Hip Dysplasia?

A 
Exercise intolerance
Bunny hopping gait 
Difficulty rising/stiff after rest
Reluctant to climb stairs or jump
Bilateral Hip Lameness
Sits to the side to avoid hip flexion
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90
Q

Ortolani test

A

Push stifle proximally to subluxate then slowly abduct the stifle to hear the audible clunk

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91
Q

How do you treat Hip Dysplasia?

A 
Nutritional management
Exercise modulation 
Physical therapy 
NSAID
Weight management
92
Q

What are the surgical managements for Hip Dysplasia?

A

Juvenile Pubic Symphiodesis
Triple Pelvic Osteotomy
Salvage procedures: FHO, Total Hip Replacement

93
Q

Juvenile Pubic Symphiodesis

A

Fuse pubic symphysis with cautery to tether the growth of the pelvis to roll the acetabulum ventrally (ventroversion)

94
Q

What age is JPS useful in?

A

Less than 20 weeks

95
Q

Triple Pelvic Osteotomy

A

Osteotomy of the pubis, ischium, ilium

Fixation of the ilium with angled plates to roll the acetabulum dorsally

96
Q

What are the indications for a triple pelvic osteotomy?

A 
Clinical signs of Hip Dysplasia
Ortolani test 
Low angle of reduction 
No radiographic evidence of DJD
6-8 months of age
97
Q

Total Hip Replacement

A

Degenerative joint replaced with prostheses: Femoral Stem and Acetabular cup

98
Q

What are the two types of Total Hip Replacement?

A

Cemented

Cementless

99
Q

What type of dog is Total Hip Replacement ideal for?

A

Large Active dogs

100
Q

What are complications of Total Hip Replacement?

A 
Luxation
Infection 
Femure Fracture
Loosening
Failure of ingrowth 
Bone resorption around cement
101
Q

FHO

A

Femoral Head and Neck Osteotomy

102
Q

Femoral Head Osteotomy

A

Remove the entire Femoral Head and Neck of femur with a Osteotome or oscillating (sagittal) saw

103
Q

What supports the hip with an FHO?

A

Pseudarthrosis

Muscles and tendons provide support

104
Q

What is the most commonly luxated joint?

A

Coxofemoral joint

105
Q

What causes Coxofemoral Luxation?

A

Trauma associated with thoracic injury or other fractures

106
Q

What is the History associated with Coxofemoral Luxation?

A

Acute unilateral non weight bearing lameness

107
Q

What are the two types of Coxofemoral Luxation?

A

Caudoventral

Craniodorsal

108
Q

Caudoventral Coxofemoral Luxation

A

Luxation of the femoral head ventrally due to a fall or “splits”

109
Q

Craniodorsal Coxofemoral Luxation

A

Pull of gluteal muscles causes the greater trochanter to displace dorsally

110
Q

What is the most common Coxofemoral Luxation?

A

Craniodorsal Coxofemoral Luxation

111
Q

How is the limb held in a Caudoventral Coxofemoral luxation?

A

Leg is held abducted and internally rotated

112
Q

How do you treat a Caudoventral Coxofemoral luxation?

A

Close reduction with muscle relaxation or an epidural
Hobbles for 10-14 days
Range of Motion exercises

113
Q

What is contraindicated for a Caudoventral Coxofemoral luxation?

A

Ehmer sling

114
Q

How does the effected limb look for a Craniodorsal Coxofemoral Luxation?

A

Affected limb is held in relaxed extension and adducted and externally rotated

115
Q

What is the treatment for Craniodorsal Coxofemoral Luxation?

A

Closed Reduction

Muscle Relaxation or epidural

116
Q

What is contraindicated for Craniodorsal Coxofemoral Luxation?

A

Dysplastic hip

Fracture of the pelvis or femur

117
Q

What is the treatment Post Reduction for Craniodorsal Coxofemoral Luxation?

A

Range of Motion

Ehmer sling

118
Q

Ehmer Sling

A

Abduction
Internal rotation
Pushed femoral head away from damaged craniodorsal joint capsule

119
Q

What are the indications for an Open reduction for a Craniodorsal Coxofemoral Luxation?

A

Pelvic/acetabular fracture
Femoral fractures
Unstable closed reduction
Recurrent closed reduction

120
Q

What are the objectives of Hip Dysplasia Surgical Treatment?

A

Reconstruct joint capsule and adjacent soft tissues to hold hip in reduction
Maintain reduction temporarily with implant until soft tissues heal

121
Q

What are the surgical treatment options for correction of Hip Dysplasia?

A

Capsulorrhaphy
Prosthetic capsule
Toggle pin

122
Q

Capsulorraphy

A

closing the joint capsule torn by the trauma with heavy gauge suture

123
Q

What is a Toggle Pin/Rod used for?

A

Prosthetic Capital ligament

124
Q

What is the Post Op Management for the treatment of Hip Dysplasia?

A 
Coaptation: Ehmer sling or Hobbles
Belly Sling
Avoid slippery floors
Restrict activity X 4 weeks
Slow gradual return to activity
125
Q

Legg-Perthes Disease

A

“Aseptic necrosis of the femoral head”

Ischemia to femoral head causes necrosis

126
Q

What is the signalment for Legg-Perthes Disease?

A

Cats and small/toy breed dogs
immature (4-11 months)
Some Breed disposition

127
Q

What are the signs seen on radiographs for Legg-Perthes Disease?

A

Radiopacity of lateral femoral head
Focal bony lysis - “motheaten” “apple core”
Flattening mottling of the femoral head
Collapse thickening of femoral neck

128
Q

What is the treatment for Legg-Perthes disease?

A

Femoral Head Osteotomy

Total Hip Replacement

129
Q

What is the function of the Cranial Cruciate Ligament?

A

Prevents internal rotation
Prevents hyperextension
Prevents cranial tibial thrust

130
Q

Cranial Tibial Thrust

A

Naturally occurring weight bearing compression across the joint
Angle between compression and tibial plateau results in shear

131
Q

What opposes the shear force of Cranial Tibial Thrust?

A

Cranial Cruciate Ligament

132
Q

Cranial Cruciate Ligament Tear

A

occurs when cranial tibial thrust exceeds breaking strength of the cranial cruciate ligament

133
Q

What causes Acute Cranial Cruciate Ligament rupture?

A

Traumatic catastrophic overload of the ligament

134
Q

What causes chronic cranial cruciate ligament rupture?

A

Progressive degeneration of the Cranial Cruciate Ligament due to a lower breaking strength resulting in rupture from normal weight bearing

135
Q

Deranged Stifle

A

enough force to damage multiple ligaments in the stifle

136
Q

What other injuries of the stifle is CCL rupture associated with in cats?

A

Injuries to Menisci
Injuries to other ligaments
Deranged stifle

137
Q

What is the history of an animal with acute CCL Rupture?

A

Athletic injury
Traumatic hyperextension, limb loading or excessive internal rotation
Sudden onset of non or partial weight bearing lameness

138
Q

What is the history of an animal with chronic CCL rupture?

A

Slow degeneration of CCL leads to DJD

Fraying of ligament rather than complete rupture

139
Q

What do you see on physical exam of chronic CCL rupture?

A 
Effusion 
Rounding of limb 
Muscle atrophy 
Medial buttress - firm medial fibrosis
Crepitus - osteophyte formation 
Instability
140
Q

What are the tests for Instability and CCL Rupture?

A

Cranial drawer test

Tibial compression test

141
Q

What are the two bands of the Cranial Cruciate ligament?

A

Craniomedial

Caudolateral

142
Q

When does the Craniomedial Cranial Cruciate ligament become taut?

A

in flexion and extension

143
Q

When does the Caudolateral Cranial Cruciate ligament become taut?

A

in extension only

144
Q

What is the function of Menisci?

A

Shock absorption
Reorient load transmission “hoop stress”
improve congruency/stability

145
Q

What are the signs seen on Radiographs for Meniscus injury?

A 
Effusion of the fat pad 
Osteophytes
Subchondral sclerosis
Increased medial soft tissue 
Tibial displacement
146
Q

What is medical treatment for meniscus injury?

A

6 weeks confinement
pain management
Physical therapy

147
Q

What is the surgical treatment for meniscus injury?

A

Explore joint: debride CCL, Evaluate meniscus, arthroscopy vs. arthrotomy
Stabilize the joint

148
Q

What is the most common Meniscal tear?

A

“Bucket Handle”

149
Q

Partial Meniscectomy

A

Removal of damaged portion of the meniscus

Minimal change in contact mechanics

150
Q

What is the risk for a Partial Meniscectomy?

A

Postoperative meniscal injury

151
Q

Meniscal Release

A

Cut caudal pole of medial meniscus

Allows caudal pole to move caudally

152
Q

What is the advantage of Meniscal Release?

A

decreases risk of postoperative injury

153
Q

What is the disadvantage of Meniscal Release?

A

Worsens contact mechanics

Long Term OA

154
Q

What are the stabilization techniques for meniscal tears?

A

Intracapsular
Extracapsular
Tibial Osteotomies: TPLO and TTA

155
Q

What are the Extracapular techniques for meniscal tear?

A

Lateral suture

TightRope

156
Q

Lateral Suture

A

Heavy monofilament nylon placed in orientation similar to the native CCL
Nylon mimics function of ligament: Around lateral fabella and through hole in tibial tuberosity

157
Q

What are the complications of Lateral Suture?

A 
Infection 
Implant failure
Incomplete stabilization 
Meniscal injury 
Peroneal nerve deficit/entrapment 
Complications increase with higher body weight and younger age
158
Q

TightRope

A

Multifilament nonabsorbable fiber tape implant that is fixated with toggle mechanism

159
Q

Osteotomy Purpose

A

Alter angle between weight bearing and the tibial plateau to eliminate shear
Render cranial cruciate ligament unnecessary
Eliminates tibial thrust
Does not eliminate cranial drawer

160
Q

TPLO Mechanics

A

Force of weightbearing parallel to tibial axis
Radial cut in the proximal tibia
Rotate proximal tibial fragment
Perpendicular to force of weight bearing

161
Q

Tibial Tuberosity Advancement Description

A

Quadriceps are primary resistance to stifle flexion during weightbearing
Force of weightbearing parallel to patellar tendon
Longitudinal cut in the tibial tuberosity Advancement of tuberosity makes patellar tendon perpendicular to plateau

162
Q

What are the complications of Osteotomies?

A 
Infection 
Incomplete stabilization 
Implant failure
Meniscal injury 
Iatrogenic angular limb deformity - TPLO
Iatrogenic patellar luxation - TTA
163
Q

What is the post operative Management for Osteotomy?

A

Physical therapy 48-72 hours post op
limit exercise until radiographic healing (8-12 weeks)
Gradual return to activity over 1–2 months
6 months of recovery

164
Q

What procedures are best to perform on a small dog or cat for meniscal repair?

A

TPLO
TTA
Tightrope

165
Q

What procedures are best to perform on everything else?

A

TPLO
TTA
Tightrope

166
Q

What is the most common congenital joint deformity?

A

Patellar luxation

167
Q

What is the signalment for Patellar luxation?

A

Small and toy breeds

168
Q

What is the history for patellar luxation?

A

Intermittent weight-bearing lameness

Non-weight bearing when patella is luxated

169
Q

What is the cause of Medial Patellar Luxation?

A

Medial malalignment of quadriceps

170
Q

What is the result of Medial Patellar Luxation?

A 
Lateral bowing of distal femur 
Lateral torsion of distal femur
Medial displacement of tibial tuberosity 
Medial boring of proximal tibia 
Abnormal trochlear groove 
Hypoplasia of medial condylar ridge
171
Q

What is the result of Medial Patellar Luxation?

A 
Lateral bowing of distal femur 
Lateral torsion of distal femur
Medial displacement of tibial tuberosity 
Medial boring of proximal tibia 
Abnormal trochlear groove 
Hypoplasia of medial condylar ridge
172
Q

What do you find on physical exam of Medial patellar luxation?

A

Stifle in extension

Tibia internally rotated

173
Q

What do you find on physical exam of Lateral patellar luxation?

A

Stifle in extension

Tibia externally rotated

174
Q

What should you always assess for Patellar luxation?

A

Cranial drawer

175
Q

Grade 1 patellar luxation

A

Patella stays in the groove

but can be manually luxated but will spontaneously reduce immediately

176
Q

Grade 2 Patellar luxation

A

Patella more often reduced than luxated and luxated easily with manipulation
May luxate spontaneously
Once luxated will stay luxated until manually reduced or stifle is extended
Intermittent lameness

177
Q

Grade 3 Patellar Luxation

A

patella more often luxated than reduced
Patella can be manually reduced
Reluxates when released or with flexion
“Crouched” gait - flexed stifle and internally rotated tibia

178
Q

Grade 4 Patellar Luxation

A

Patella is fixed in luxation
Manual reduction is not possible
Anatomic abnormalities are severe - Tibia may be rotated 80-90 degrees medially, Stifle may not be able to be fully extended, or severe fibrosis and muscular contracture

179
Q

What is the most common patellar luxation?

A

MPL

180
Q

What patellar luxation is most common in large breed dogs?

A

LPL

181
Q

What are the conformational abnormalities of Lateral Patellar Luxation?

A

Mirror image of medial luxation
Femoral valgus or torsion, tibial varus
“Knock-kneed” or “Cow Hocked”

182
Q

What is more severe MPL or LPL?

A

LPL

183
Q

What is the indication for surgical management?

A 
Significant lameness regardless of grade
Episodes lasting 2-3 weeks or longer 
3 or more episodes in a short time 
Higher grade (3-4) associated with RCCL
184
Q

What are the surgical procedures for patellar luxation?

A

Soft tissue reconstruction

Bone reconstruction/realignment

185
Q

Lateral imbrication

A

Chronic stretching of lateral joint capsule, fascia

Imbrication prevents reluxation

186
Q

Medial release

A

Chronic fibrosis of medial joint capsule, fascia
Free up contracted tissue
Allows reduction of patella

187
Q

Trochleoplasties

A

Deepen femoral trochlear groove

Wedge or block recession

188
Q

Tibial tuberosity transposition

A

Osteotomy in tibial crest

Realign quadriceps

189
Q

tibial tuberosity transposition description

A

Tibial tuberosity cut from proximal to distal, leaving periosteum attached distally
Tibial tuberosity shifted laterally
Tibial tuberosity fixed in placed with K-wires

190
Q

What are the indications for ACVS referral for large breed dogs?

A

Many grade 2 luxations require surgery

require distal femoral osteotomy

191
Q

What is the post op care for surgery for patellar luxation?

A

Controlled activity
leash walking for 6 weeks
Physical therapy
Radiographs in 6 weeks

192
Q

What is the Etiology of Fragmented Coronoid Process?

A

a previous error in endochondral ossification that experience microtrauma caused by incongruity

193
Q

How do you diagnose Elbow Dysplasia?

A

Radiographs

194
Q

What view is required for diagnosis of Ununited Anconeal process?

A

flexed lateral view

195
Q

What view is required for the diagnosis of OCD of the elbow?

A

craniocaudal view

196
Q

What may be the only sign of Fragmented Coronoid process seen on Radiographs?

A

Sclerosis

197
Q

What is the gold standard for diagnosis of Elbow Dysplasia (FCP and UAP)?

A

Arthroscopy

198
Q

What is the surgical treatment of Ununited Anconeal Process?

A

Fragment excision

Osteotomy + fixation

199
Q

What occurs to the elbow joint if you excise the anconeal process?

A

destabilization

200
Q

What is the signalment of a patient that should receive a Fragment excision of the Ununited Anconeal process?

A

Older dog

201
Q

What is the goal of an Ununited Anconeal Process Osteotomy + fixation?

A

Osteotomy allows distraction of the ulna
Restoration of congruity through ulna lengthening
Encourages the union of the anconeal process

202
Q

What is the signalment of a patient who should receive an Osteotomy + fixation for UAP?

A

Young dog with no DJD

203
Q

What is the gold standard of treatment for FCP/OCD?

A

Arthroscopic treatment: Debridement and fragment removal

204
Q

What will still progress even after arthroscopy of FCP/OC?

A

Arthritis

205
Q

What is important to know about the prognosis of Elbow Dysplasia?

A

Early intervention is best chance
Early intervention does not prevent DJD
Treatment via arthotomy is worse than arthroscopy
Medical management is expected long-term

206
Q

What is Incomplete Ossification of the Humeral Condyle?

A

Failure of union between the medial and lateral portions of the humeral condyle

207
Q

When does the fusion of the humeral condyles take place?

A

12 weeks

208
Q

What is important to note about Incomplete ossification of the Humeral condyle?

A

Bilateral
In spaniel breeds
males are predisposed

209
Q

What is the presentation of Incomplete ossification of the Humeral condyle?

A

You to young adult dogs
no clinical signs
Mild lameness: Weightbearing lameness that is worse after activity
Acute Non-weight bearing lameness due to a pathologic fracture

210
Q

How do you diagnose Incomplete ossification of the Humeral condyle?

A

Craniocaudal Radiographs

211
Q

What is the treatment for Incomplete ossification of the Humeral condyle?

A

Single large lag screw

212
Q

Traumatic Elbow Luxation

A

Rupture/avulsion of collateral ligaments

213
Q

Which side do we see Traumatic Elbow Luxation to most?

A

Lateral

214
Q

Which collateral ligament is traumatized in dogs with Traumatic Elbow Luxation?

A

lateral collateral

215
Q

Which ligament is traumatized in cats with Traumatic Elbow Luxation?

A

Both collateral ligaments

216
Q

How do you diagnose Traumatic Elbow Luxation?

A

Lateral and Craniocaudal Radiographs

217
Q

What is the treatment for Traumatic Elbow Luxation?

A

Closed Reduction

Open Reduction

218
Q

When do you perform an Open Reduction on a Traumatic Elbow Luxation?

A

Concurrent fractures
Unsuccessful/unstable closed reduction
Recurrent luxation

219
Q

What procedure do you perform on a Traumatic Elbow Luxation with severe DJD?

A

Salvage procedure

220
Q

What test is used to Assess collateral ligaments of the elbow?

A

Campbell’s Test

221
Q

How do you perform the Campbell’s Test?

A

Elbow and carpus at 90 degrees
Supination to test the lateral collateral
Pronation to test the medial collateral

222
Q

In what species do you perform an open reduction normally to treat Traumatic Elbow Luxation?

A

Cats

223
Q

What procedure do you perform to stabilize the Lateral collateral ligament?

A

Suture prothesis

224
Q

What do you do Post op for a Traumatic Elbow Luxation?

A

Maintain the leg in extension
Exercise restriction for 4-6 weeks after coaptation removal
Physical therapy
Slow gradual return to activity

225
Q

What coaptation do you use for Post op treatment of Traumatic Elbow Luxation?

A

Spica Splint for 2-3 weeks (Closed reduction)

Flexible ESF for 3-4 weeks (open reduction)

RUSVM Small Animal Surgery 2017 (17 decks)

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