Lecture 9 2/6/25 Flashcards
What are the differentials for disorders of the carpus?
-luxation(s)
-carpal hyperextension syndrome
-carpal laxity syndrome
-trauma/fractures
What are the differentials for disorders of the tarsus?
-OCD of the trochlear ridges of the talus
-calcanean tendon injuries
-shearing injuries/collateral ligament damage
-trauma/fractures
What are the differentials for disorders of the metacarpals/metatarsals and digits?
-joint luxations
-shearing injuries
-tendon and ligament lacerations/injuries
-hypertrophic osteopathy
-trauma/fractures
What are the characteristics of carpal hyperextension syndrome?
-damage to carpal ligaments and fibrocartilage
-NOT an injury to flexor tendons
-trauma results in damage to soft tissue structures and hyperextension of carpus during weight bearing
-can occur at any level of the carpus
How is carpal hyperextension diagnosed?
palmar stress views of the carpus to determine level(s) of involvement
What are the characteristics of hyperextension of the antebrachial joint?
-most severe
-main joint for movement in the carpus
-requires surgical fusion of joints in carpus
What is the indication for hyperextension of the middle carpal joint?
displacement of ulnar carpal bone on stress view
What is the indication for hyperextension of the carpometacarpal joint?
displacement of the distal row of carpal bones on stress view
What are the treatment steps for carpal hyperextension?
-pancarpal arthrodesis if hyperextension involves antebrachiocarpal joint (full fusion)
-partial carpal arthrodesis (spares antebrachiocarpal joint)
-removal of articular cartilage, placement of cancellous bone graft, and stabilization with plates and screws
-splint for support until initial bony union
What are the possible tarsometatarsal instabilities that can result from trauma?
-subluxation with plantar instability
-subluxation with plantar and craniomedial instability
-subluxation with cranial instability
What is the treatment for tarsometatarsal instability?
plate arthrodesis
Which muscles contribute to the common calcanean tendon?
-biceps femoris
-gastrocnemius
-gracilis
-superficial digital flexor
-semitendinosus
What is the purpose of the common calcanean tendon?
necessary for weight bearing
What are the characteristics of chronic calcanean tendinitis?
-lameness is variable
-palpable swelling proximal to tuber calcis
-palpable “thickening” over tendon
-results from chronic strain
What are the treatment options for chronic calcanean tendinitis?
-regenerative therapy
-“resting” the tendon through immobilization with controlled stress and elimination of injury-producing activity
What is happening when a patient is plantigrade or has a dropped hock?
the common calcanean tendon is damaged to the point that it is no longer keeping the hock raised
What are the steps to correcting complete failure of the common calcanean tendon?
-suture tendon with a tendon-specific suture pattern
-protect repair with external coaptation
-gradually increase loading over several months
What is the prognosis for complete failure of the common calcanean tendon?
-good with proper surgery, rehabilitation, and aftercare
-poor with improper treatment
