Orthopaedics (SA) Flashcards

1
Q

Where are two common sites of avulsion fracture?

A

Tibial Tuberosity

Lateral Malleolus

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2
Q

what are the 3 main methods for fixing a fracture?

A

Plate and Screw
ESF
Pins and Wires

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3
Q

What are the two major categories of plate for fixing a fracture?

A

Dynamic Compression Plate

Locking Plate

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4
Q

In which type of bone are locking plates particularly useful?

A

Poor Quality Bone - Juvenile or Oseteopenic

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5
Q

What is a disadvantage of a locking system?

A

Lag screws cannot be placed

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6
Q

What do lag screws produce?

A

Interfragmental compression

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7
Q

Name 3 advantages of a IM pin

A

Resists Bending
In Neutral axis of bone
Can use with other fixation devices

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8
Q

Name 3 disadvantages of an IM pin

A

Cant resist rotation/shear
Interferes with medullary blood supply
difficult in chondrodystrophic breeds

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9
Q

What type(s) of fracture can be fixed with an IM pin ALONE?

A

Mid diahpyseal transverse fracture

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10
Q

What type(s) of fracture can be fixed with an IM pin alongside a plate?

A

comminuted fracture

Medium-long oblique simple fracture

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11
Q

When is cerclage wire used?

A

with IM pin in long oblique fracture

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12
Q

What type of fracture are pin and tension band wires used for?

A

Avulsion fracture

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13
Q

How do pin and tension band wires fix a fracture?

A

Provide compression to avulsion fragment

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14
Q

What is a grade 1 open fracture?

A

bone end pierced skin and retracted

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15
Q

What is a grade 2 open fracture?

A

Fracture end exposed

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16
Q

What is a grade 3 open fracture?

A

major ST loss and trauma

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17
Q

What is a Salter-Harris type 1 fracture?

A

passes through entire growth plate. No bone involved.

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18
Q

What is a Salter-Harris type 2 fracture?

A

passes along GP and through metaphysis

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19
Q

What is a Salter-Harris type 3 fracture?

A

passes along GP and through epiphysis

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20
Q

What is a Salter-Harris type 4 fracture?

A

passes through GP, Metaphysis and epiphysis

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21
Q

What is a Salter-Harris type 5 fracture?

A

Crushing injury compressing GP - no displacement

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22
Q

What is a Salter-Harris type 6 fracture?

A

Injury to perichondral structures

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23
Q

Where does a healing fracture obtain its blood supply?

A

Periosteal Vessels

Surrounding Tissues

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24
Q

What are the 6 stages of # healing?

A
  1. Haematoma
  2. Granulation
  3. Connective Tissue
  4. Fibrocartilage
  5. Callus formation
  6. Callus remodelling
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25
Q

In which type of fracture healing does callus formation NOT occur?

A

Direct Healing

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26
Q

Name 6 Fracture healing + factors.

A
Young
Healthy
Closed #
Single Injury
Closed Reduction
Low Energy
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27
Q

Name 6 Fracture healing - factors.

A
Old
Systemic/local Dz
High Energy
Open
Articular
Implants present
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28
Q

What type of fracture may benefit from external coaptation?

A

simple, stable and closed

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29
Q

Which patients are suitable for external coaptation

A

small dogs

some cats

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30
Q

Where should a fracture be to be suitable for external coaptation?

A

Long Bone Diaphysis

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31
Q

How reducible should a # be to be considered for external coaptation?

A

> 50% bone contact in 2 planes

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32
Q

Name 6 indications for ESF.

A
Long bone
Highly comminuted
Open/infected
Corrective osteotomy
Immobilising a joint
Adjunct to other fixation
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33
Q

Name 5 advantages to eSF

A
Minimal invasion
Allows access to open wound
Maintains limb length
Minimal complication rate
Inexpensive
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34
Q

Which two checks may be conducted to assess CrCL integrity?

A

Cranial Drawer

Tibial Compression Test

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35
Q

Which Rx views are used to assess the stifle?

A

CrCd

ML

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36
Q

What is the most common cause of HL lameness in the dog?

A

CrCL disease

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37
Q

What is the most common cause of CrCL disease in the dog?

A

Degeneration (+/- minor trauma)

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38
Q

What may cause CrCL Dz in predisposed breeds?

A

Inc collagen metabolism
Sloping angle of tibial plateau
IM disease

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39
Q

How may the affected leg be positioned in a standing dog with CrCL Dz?

A

Toe Touching

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40
Q

What may be noted on Cx of a dog with CrCL Dz? (2)

A

Stifle Effusion

Medial Buttress

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41
Q

What are 3 Rx signs of CrCL disease?

A

Osteophyte Formation
Effusion (Compression of IP fat pad)
Cr Translation of Tibia

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42
Q

Which dogs with CrCL Dz may be managed conservatively?

A

<15kg

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43
Q

What does conservative management of CrCL Dz involve?

A

Restrict rest 6-8w

Analgesia

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44
Q

Name 3 surgical techniques used in a patient with CrCL Dz.

A

TPLO
TTA
Lateral Suture

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45
Q

Which ligament is most commonly affected in meniscal tears?

A

Medial Meniscus

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46
Q

How long should conservative management be undertaken for meniscal injury?

A

4-6w

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47
Q

How should a meniscal injury non-responsive to conservative management be treated?

A

Surgical Removal

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48
Q

Which type of patellar luxation is most common?

A

Medial

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49
Q

What is developmental patellar lunation caused by?

A

Malalignment of the quadriceps complex

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50
Q

What is grade 1 patellar luxation?

A

Intermittent, immediate reduction

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51
Q

What is grade 2 patellar luxation?

A

frequent, self-reduction

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52
Q

What is grade 3 patellar luxation?

A

Permanent - can be replaced

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53
Q

What is grade 4 patellar luxation?

A

Permanent non-reducible

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54
Q

When should surgical Tx be undertaken for patellar luxation?

A

Recurrent Cx

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55
Q

What are the 3 different surgeries which may be performed for patellar luxation?

A

TTT
Trochlear Groove Deepening
Medial Retinaculum Release/Reinforcement

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56
Q

Where are OCD lesions found?

A
  1. Caudal aspect humeral head
  2. Medial part humeral condyle
  3. Lateral femoral condyle
  4. Medial trochlear ridge talus
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57
Q

3 Cx of OCD are…

A

Lame from 5m
Bilateral Crouching Gait
Join Effusion and discomfort

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58
Q

How is collateral ligament rupture diagnosed?

A

Abnormal joint movement in M or L direction

Stressed Rx vs CL limb - widened joint space

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59
Q

How is Collateral ligament rupture treated?

A

Parapatellar surgery - repair ligament and re-attach

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60
Q

Which dogs commonly suffer form multiple ligament injury?

A

Working dog

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61
Q

how are multiple ligament injuries fixed?

A

Trans-articular external skeletal fixation

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62
Q

Name the most common SECONDARY disease of the stifle.

A

Osteoarthritis

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63
Q

Which animals are most susceptible to hip dysplasia?

A

Large Breed Dog

Devon Rex Cat

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64
Q

What causes the pain associated with hip dysplasia?

A

Femoral head hitting dorsal acetabular rim

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65
Q

Describe the aetiopathogenesis of hip dysplasia.

A

poor ST cover > Laxity/instability of CF joint > OA

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66
Q

Which are the two groups of dogs that commonly present with hip dysplasia?

A

Immature <12m

Adult dog with OA 2e to Hip Dysplasia

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67
Q

How do young dogs with hip dysplasia present? (4)

A

HL lame (uni/bilateral)
Bunny-hopping gait
Reluctant to exercise
+ ortolani test

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68
Q

How do adult dogs with hip dysplasia present? (4)

A

Stiff after exercise/rest
“bunny hop”
bilateral lameness
reduced ROM + pain

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69
Q

Which Rx views should be taken to check for hip dysplasia?

A

VD extended

LM view

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70
Q

What are the 1e changes seen on Rx of Hip Dysplasia? (3)

A

wide joint space
medial divergence
Centre of FH lateral to dorsal acetabular edge

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71
Q

What are the 2e changes seen on Rx of Hip Dysplasia? (3)

A

Bone formation on femoral neck (morgan line)
Remodelling of FH/N
Remodelling of acetabular rim

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72
Q

What is the success rate for conservative management of Hip Dysplasia?

A

75-80%

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73
Q

Which surgical Tx may be appropriate for a young dog with Hip Dysplasia?

A

TPO

Juvenile Pubic Symphisiodesis

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74
Q

Which surgical Tx may be appropriate for any dog with Hip Dysplasia?

A

FHNE

Total Hip Replacement (>9m)

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75
Q

What is the principle behind JPS for Hip Dysplasia?

A

Electrocautery causes arrest of chondrocytes
Shorter Pubic bones
VL rotation of acetabulum = better congruity

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76
Q

Over what age does a JPS no longer work?

A

> 22w

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77
Q

Which rare disease can be treated with a FHNE?

A

Legg-Calve-Perthes

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78
Q

Which dogs are most suitable for FHNE?

A

Small dogs <15kg

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79
Q

Which is the most appropriate surgical Tx for Hip Dysplasia in MOST dogs?

A

Total Hip Replacement

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80
Q

What is a common CI for Total Hip Replacement?

A

Chronic systemic illness

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81
Q

Which breeds are predisposed to LCP disease?

A

WHWT and Manchester Terrier

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82
Q

What is LCP Dz?

A

Ischaemia of the femoral head > deformity/collapse

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83
Q

How does LCP Dz present?

A

<5m
Unilateral lameness
pain on hip manipulartion

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84
Q

Which Rx should be taken to diagnose LCP?

A

Frog Leg
Vd Extended
ML

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85
Q

What is the best Tx approach for LCP?

A

Surgical (FHNE or Total Hip Replacement)

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86
Q

Which age of animal most commonly suffers capital physical #s?

A

4-7mo, 2e to trauma

Pain on manipulation

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87
Q

How are capital physeal #s treated?

A

3 diverging/parallel K wires

Craniolateral or dorsal approach!

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88
Q

Which animals are commonly affected by CF luxation?

A

Small
Following RTA
<12m

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89
Q

Which direction of CF luxation is most common?

A

Craniodorsal

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90
Q

How is the leg carried in a case of CF luxation?

A

Flexion

Stifle Out, Hock in

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91
Q

Which anatomical landmark is more prominent in the affected leg during CF luxation?

A

Greater Trochanter

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92
Q

Which Rx views are important to diagnose CF luxation?

A

VD

Lateral

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93
Q

Common Ddx for CF Lux?

A

Hip Dysplasia

Capital Physeal #

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94
Q

How should CF lux be initially Tx?

A

CLOSED reduction - followed by Ehmer sling & rest 7-10d

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95
Q

What are 2 common CIs of closed reduction for CF luxation?

A

Hip Dysplasia

Avulsion # of femoral head

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96
Q

How long after CF luxation can closed reduction be performed?

A

48h

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97
Q

How should a CF lux patient be prepared for closed reduction?

A

GA

TIE to table

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98
Q

How long should a dog be cage rested for post closed reduction of CF lux?

A

7-10d

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99
Q

Which approach is taken in open reduction of hip luxation?

A

Craniolateral

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100
Q

What is the first step of CF lux surgery?

A

Remove haematoma and bone fragments + lavage

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101
Q

Name 3 surgical options for open reduction of CF lux?

A

Toggle Fixation
Transarticular Pinning
Iliofemoral Suture

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102
Q

What is the most appropriate Tx for a single MT #?

A

External Coaptation

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103
Q

What is the most appropriate Tx for multiple MT #s?

A

Internal fixation

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104
Q

Two complications of MT # are…

A
  1. ST injury

2. Synostosis

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105
Q

Which breed commonly sufffers from interphalangeal luxation?

A

Greyhounds

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106
Q

Name the 3 Tx options for interphalangeal luxation.

A

Reduce & wire collateral ligaments
Small ESF
Amputation

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107
Q

Name 3 indications for toe amputation

A

Neoplasia
Severe #
Severe IP luxation

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108
Q

Where are OCD lesions commonly found?

A

Medial/Lateral Trochlear Ridge

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109
Q

How do OCD lesions appear on Rx?

A

Flattened Trochlear Ridge

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110
Q

What si the best Tx for OCD?

A

Surgery

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111
Q

What is the most common type of # to the central tarsal bone?

A

Dorsal Slab

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112
Q

What is the best Tx for central tarsal bone #?

A

Lag screw

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113
Q

What is the underlying cause of talocrural instability?

A

Damage to medial/lateral collateral ligaments OR malleolar #

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114
Q

In Talocrural instability, what are the first-line and second-line Tx?

A

Surgery

If fails - Pantarsal arthrodresis

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115
Q

How should open luxations of the tarsus treated?

A

Extensive lavage

ESF

116
Q

What is the main cause of calcaneoquartal instability?

A

Trauma or Degeneration (collie)

117
Q

Where is calcaneoquartal instability located?

A

Between calcaneus and 4th TB

118
Q

Degeneration of which ligament causes calcaneoquartal instability?

A

Plantar ligament

119
Q

Where should an autogenous bone graft be taken from in dogs?

A

Proximal Humerus

120
Q

Where should an autogenous bone graft be taken from in cats?

A

Ilium

121
Q

Which approach should be taken for carpal arthrodesis?

A

Dorsal

122
Q

Describe the POC for pan tarsal arthrodesis

A

Splint for 6-12w
Check weekly
Re-Rx after splint
ANALGESIA!!

123
Q

What is the most common cause for achilles tendon rupture in dogs?

A

Trauma (RTA, severing)

124
Q

What is the most common cause for AT rupture in Dobermans?

A

Gastrocnemius enthesiopathy - BILATERAL

125
Q

How is AT rupture treated?

A

Attach loop pulleys to exposed tendon end and bone screw back in place with hock in extension
Cast 6w.

126
Q

What is a unique sign of AT rupture in dobermans?

A

Toe Clenching - “crab” toes

127
Q

What is the most common pelvic problem in dogs/cats?

A

Pelvic #

128
Q

What should your first 4 priorities be when presented with a pelvic # patient?

A

ABC
Control Haemorrhage
Fluids/Shock Therapy
Analgesia

129
Q

What nerve deficiency ould be present with an ilial #?

A

Sciatic

130
Q

Which Rx view(s) should be taken to assess a pelvic #?

A

Lateral and DV

131
Q

How many pelvic # cases would recover if managed conservatively?

A

75%

132
Q

Which animals are better candidates for conservative Tx of pelvic #?

A

Smaller animals with # in NON weight-bearing axis

133
Q

What is the conservative management for pelvic #?

A
Cage rest 4-6w 
Turn often
Soft Bed
Check and manage bladder
Analgesia (opioid +NSAID)
134
Q

What Tx is necessary for sacroiliac separation?

A

Surgical!

Lag Screw OR Trans-ilial Pin

135
Q

Which animals commonly suffer sacroiliac separation and why?

A

Cats - post RTA

136
Q

What Tx is necessary for iliac shaft #?

A

Internal fixation

137
Q

What Tx is necessary for acetabular #?

A

CONTROVERSIAL

Sx - plate fixation possible. If small then FHNE.

138
Q

Describe the post-op care for pelvic #s. (4)

A

Cage rest 4-8w
Short walk 5-10m.
Analgesia
Soft Bed

139
Q

When should re-visits occur for Post-op pelvic #?

A

3d
7-10d
4-8w

140
Q

What are the 3 Rx projections for assessment of the shoulder?

A

Mediolateral
Craniocaudal
Cranioproximal-Craniodistal

141
Q

Which Rx view allows you to visualise the humeral head, glenoid and osteophytes of the shoulder joint?

A

ML view of the shoulder

142
Q

What are the bony landmarks for should arthrocentesis?

A

Acromion

Greater Tubercle

143
Q

What are the 3 samples that should be taken for shoulder arthrocentesis?

A

Smear
EDTA
Blood Culture Medium

144
Q

What needle & syringe should be used for shoulder arthrocentesis?

A

1-2” 21-23G needle

5ml syringe

145
Q

How much Iohexol is injected for a low volume arthrography of the shoulder?

A

1ml

146
Q

How much Iohexol is injected for a high volume arthrography of the shoulder?

A

5-8ml

147
Q

Which lesions of the shoulder may be observed using arthrography?

A

Biceps Lesions

Capsular Tears

148
Q

What does US of the shoulder allow you to view?(5)

A

Infra/Supra-spinatus tendons
Teres minor
Caudal Humeral Head
Biceps Tendon

149
Q

What are the 3 diseases of the shoulder a CT can detect?

A

OCD
Tendon calcification
OA

150
Q

Which 3 anatomical landmarks may be visualised with arthroscopy of the shoulder?

A

Caudal humeral head
Glenohumeral ligaments
Bicipital Tendon

151
Q

What age/breed predilections exist for shoulder OCD?

A

4-8m

Giant Breed

152
Q

When is shoulder OCD painful on Cx?

A

Extreme extension/flexion

NOT palpation

153
Q

Describe conservative treatment of shoulder OCD

A

Exercise until flap detaches.

NB: inferior to Sx.

154
Q

How is shoulder OCD managed surgically?

A

Best Tx!

Flap Removal and stimulation of fibrocartilage formation

155
Q

What dogs commonly present with biceps tendinopathy?

A

Middle Age

Medium-Large breed

156
Q

Describe the lameness associated with biceps tendinopathy.

A

Progressive TL lameness.

Worse after exercise.

157
Q

When is biceps tendinopathy painful on Cx?

A

Shoulder flexion WITH concurrent elbow extension.

check elbow to rule out Ddx

158
Q

How may biceps tendinopathy be managed conservatively?

A

NSAIDs - usually helps

159
Q

What medical management is available for biceps tendinopathy?

A

Intra-articular methylprednisolone

160
Q

What surgical intervention is possible for biceps tendinopathy?

A

BEST Tx. Tenotomy +/- Tenodesis to proximal humerus

161
Q

What is the long-term Px for surgical Tx of biceps tendinopathy?

A

Good

162
Q

How may biceps brachia rupture be diagnosed on Cx?

A

Hyperextension of elbow when shoulder is in FULL flexion.

163
Q

How many carpal bones does a dog have?

A

7

164
Q

Which dogs are more high-risk for Radoiocarpal bone #?

A

Males

Boxer, Springer, Pointer

165
Q

Which are the two most common type of Radoiocarpal bone#?

A

Dorsal slab
Midbody sagittal
Communited

166
Q

What is the Sx management for a Radoiocarpal bone #?

A

Lag screw & immobilise
OR
Carpal Arthrodesis

167
Q

Which animals are prone to accessory bone #s?

A

Racing Greyhounds

168
Q

What is the Sx management for an accessory bone #?

A

Lag screw OR remove if small fragment

169
Q

What structure is damaged in a carpal hyperextension injury?

A

Flexor Retinaculum OR Palmar Fibrocartilage

170
Q

Which Rx view is MOST useful in carpal hyperextension injury?

A

Stressed ML (compare with CL limb!)

171
Q

What surgical Tx is most common for carpal hyperextension injury?

A

Pancarpal arthrodesis - Dorsal plate

172
Q

Where is the plate most commonly placed for pancarpal arthrodesis?

A

Dorsally

173
Q

Which location is biomechanically best for plate application in pancarpal arthrodesis?

A

Palmar - but more technically challenging than dorsal, so less common

174
Q

What is the most common complication following pancarpal arthrodesis?

A

SSI (loosening second)

175
Q

What are the 3 mainstays for postoperative management following pancarpal arthrodesis?

A
Analgesia
Exercise restriction (2w min)
External Coaptation (RJB 5-10d)
176
Q

What is the most sensitive modality for diagnosing elbow disease? What does this allow us to visualise which is not possible with other techniques?

A

Arthroscopy

Cartilage

177
Q

What is the advantage of using arthroscopy over CT or Rx in cases of suspected elbow disease?

A

Concurrent Dx and Sx

178
Q

what needle should be used for arthrocentesis of the elbow?

A

21-23G 1-1.5” needle

179
Q

What are the anatomical landmarks for elbow arthrocentesis?

A

Distal to M/L epicondyle

Caudolaterally along anneal process

180
Q

What 3 samples can be taken following elbow arthrocentesis?

A

Smear
EDTA
Blood Culture

181
Q

How does synovial fluid present in a patient with elbow OA?

A

Low cellularity

Mononuclear cells

182
Q

How does synovial fluid present in a patient with IMPA/BIA?

A

Highly Cellular

Neutrophilic inflm

183
Q

Which two bones may be short, leading to elbow incongruency?

A

Radius - premature closure of GP

Ulna - premature closure of ulna physis

184
Q

A shortening of which bone may contribute to UAP?

A

Ulna

185
Q

How may elbow congruency be improved in short ulna syndrome?

A

Osteotomy to induce bone lengthening

186
Q

Which 3 dog breeds are most commonly affected by elbow dysplasia?

A

Labradors
Rottweilers
Burmese Mountain Dogs

187
Q

Which 4 diseases are covered by the term “developmental elbow disease”?

A

FCP/Medial Coronoid Disease
OCD of medial humeral condyle
UAP
Elbow incongruity

188
Q

What are the 4 factors predisposing to medial coronoid disease?

A

Genetics
Nutriton
Biomechanics
Gender (M>F)

189
Q

Which is more common in MCD - short radius or short ulna?

A

Short radius (45% vs 14%)

190
Q

How does mechanical overload cause MCD?

A

Disturbs EC ossification Weak points between cartilage and subchondral bone
Fissure and # as a result

191
Q

How is MCD diagnosed?

A

CT/Scope - not likely to see on std Rx views

192
Q

How can MCD be managed conservatively?

A

Analgesia
Neutrceuticals
WEIGHT control
Phsyio

193
Q

What is the issue with surgical management of MCD?

A

Can remove # but numerous procedures for cure.
None particularly effective and all case-specific.

REFER!!!

194
Q

What is the OATS procedure for OCD?

A

Transfer host osteochondral graft from unaffected site

195
Q

Which breeds are commonly affected by UAP?

A

Basset
GSD
BMD
Mastiff

196
Q

Is UAP more common in males or females?

A

Males

197
Q

How often is UAP bilateral?

A

20-35% of cases

198
Q

What causes UAP?

A

2e centre of ossification or joint incongruency

199
Q

Characterise the lameness commonly associated with UAP.

A

Thoracic limb
Chronic
Worse after exercise
(+ LARGE EFFUSION)

200
Q

Which Rx view is best for Dx of UAP?

A

Flexed ML

201
Q

At what age does UAP become apparent on Rx?

A

16-20w

Greyhound 14-15w

202
Q

Why would a CT > Rx for UAP diagnosis?

A

Allows assessment of concurrent Dz

203
Q

What is the most appropriate Tx for UAP?

A

CONSERVATIVE - if mild lameness

204
Q

What are three common surgical approaches for UAP?

A
Anconeus Removal (if reattachment fails)
Anconeus reattachment
Ulnar osteotomy (+/- reattachment)
205
Q

Which breeds commonly suffer from IOHC? (3)

A

Springers
Cocker Spaniels
Labradors

206
Q

What may IOHC lead to if left untreated?

A

Fracture of humeral condyle

207
Q

What may be seen on Rx of IOHC?

A

CrCd: Large fissures

208
Q

Which is the most sensitive Diagnostic tool for IOHC?

A

CT

209
Q

How may condylar #s be prevented in IOHC?

A

Prophylactic placement of transcondylar screw +/- lateral condylar plate

210
Q

What are two surgical indications for IOHC?

A

Persistent lameness

Early remodelling on lateral epicondylar crest

211
Q

Characterise the lameness seen with panosteitis. (4)

A

Shifting
Varied Severity
Acute onset w/o trauma
FL >HL

212
Q

At what point in the Dz process can panosteitis be appreciated on Rx and how?

A

10d + increased medullary radiodensity. Periosteal thickening
70-90d: medullary remodelling - normal again.

213
Q

What is the most appropriate Tx for panosteitis?

A

analgesia

SELF-limiting. will resolve.

214
Q

Which dogs commonly present with metaphyseal osteopathy?

A

YOUNG (2-6m)

Medium-large breed

215
Q

How do dogs with metaphyseal osteopathy present clinically?

A

Mildly lame to severe collapse (pyrexia, anorexia, depression).
Swollen metaphysis present!

216
Q

Where is metaphyseal osteopathy most common?

A

Distal Radius/Ulna

217
Q

How can metaphyseal osteopathy be appreciate on Rx?

A

Band of inc radio density parallel to physis.

Possibly widened GP.

218
Q

How is metaphyseal osteopathy Tx?

A

Supportive care and analgesia.

Self-limiting

219
Q

Which breeds commonly suffer from craniomandibular osteopathy?

A

WHWT
Scottish Terrier
Cairn Terrier

220
Q

At what age do dogs suffering from craniomandibular osteopathy present?

A

4-10m

221
Q

What are the Clinical signs of craniomandibular osteopathy?

A
Mandible swelling
Inability to open mouth
Salivation
Weight loss
Pain when eating
222
Q

What are the Rx changes associated with craniomandibular osteopathy?

A

Bilateral

Proliferation on mandible/tympanic bulla

223
Q

How is craniomandibular osteopathy treated?

A

Analgesia + support

224
Q

What is the Px for craniomandibular osteopathy?

A

Self-limits around 1yo.

Euthanasia may be required before this.

225
Q

Which dogs are commonly affected by Legg-Calve-Perthes Disease?

A

4-11mo

Mini Poodle, WHWT, Cairn/Manc/Yorkie

226
Q

Characterise the lameness associated with L-C-P disease.

A

Varies: Mild intermittent lameness to acute non-wb lameness
+/- PL atrophy
+/- pain on hip manipulation

227
Q

What is the aetiopathogenesis of L-C-P Dz?

A

Vascular Supply to femoral head from epiphyseal vessels compromised

228
Q

How does L-C-P appear on Rx?

A

“apple-core” bone lysis of femoral head

229
Q

What are the 3 Tx options for L-C-P Dz?

A

Conservative Tx
FHNE
THR

230
Q

Which disease causes a slipped capital femoral epiphysis?

A

Feline Metaphyseal Osteopathy

231
Q

Which cats are most likely to suffer from Feline Metaphyseal Osteopathy?

A

MN
Overweight
<2yo

232
Q

What are the clinical signs of Feline Metaphyseal Osteopathy?

A

Subtle lameness prog to NWB.
Inability to jump.
Pain and crepitus on hip manipulation.

233
Q

What are the EARLY Rx changes in Feline Metaphyseal Osteopathy?

A

Widening and lateral displacement of capital femoral growth plate

234
Q

What are the LATE Rx changes in Feline Metaphyseal Osteopathy?

A

Displacement of proximal femoral metaphysis.

Resorption/Sclerosis of femoral neck.

235
Q

How is Feline Metaphyseal Osteopathy treated? (2)

A

FHNE

THR

236
Q

What is the colloquial name for Hypertrophic Pulmonary Osteoarthropathy?

A

Marie’s Disease

237
Q

Which animals are most commonly affected by Hypertrophic Pulmonary Osteoarthropathy?

A

Older dogs AND cats

mean age 9yo

238
Q

What is the aetiopathogenesis of Hypertrophic Pulmonary Osteoarthropathy?

A

Calc of periosteum and CT.
Due to vast congestion in periosteum.
Secondary to intrathoracic/abdominal neoplasia.

239
Q

What are the clinical signs of Hypertrophic Pulmonary Osteoarthropathy?

A

Prog lameness over several months.

Firm swelling over distal extremities - initially painful.

+/- hyperthermia, WL, depression

240
Q

What are the Rx changes associated with Hypertrophic Pulmonary Osteoarthropathy?

A

New periosteal bone formation - laid down at right angles to periosteum.

241
Q

How is Hypertrophic Pulmonary Osteoarthropathy treated?

A

Remove Primary Tumour.

+ Symptomatic relief

242
Q

What are the 3 categories of bone cyst?

A

Simple
Aneurysmal
Subchondral

243
Q

Where are subchondral bone cysts found?

A

Adjacent to synovial membrane

244
Q

What do aneurysmal bone cysts contain?

A

Blood sinusoids

245
Q

What are the Rx changes characteristic of bone cysts?

A

Expansile, locally aggressive lucency.

Minimal periosteal reaction.

Metaphysis/diaphysis with eccentric location.

Thin cortex.

246
Q

What are the 4 Tx options for bone cysts?

A

Surgical Drainage/Graft
Radiation Therapy
Excision
Amputation

247
Q

Which dogs are most susceptible to Infraspinatus contracture?

A

Medium sized working dogs

248
Q

How do dogs with infraspinatus contracture stand?

A

Shoulder abducted
Elbow adducted
External rotation of lower limb

249
Q

What is the Tx for Infraspinatus contracture?

A

Infraspinatus tendinectomy

250
Q

Which dogs are most susceptible to gracilis contracture?

A

GSD 3-7yo

251
Q

How do dogs with gracilis contracture walk?

A

Affected limb jerk-like movement.
Hyeprflexion of tarsus.
Internal rotation of metatarsus.

252
Q

Which dogs are predisposed to quadriceps contracture? (2)

A

Young, fast-growing.
OR
2e to femoral #.

253
Q

What are the clinical signs of quadriceps contracture?

A

Extended stifle/tarsus.
Pain over Femur.
Difficulty walking.

254
Q

What is the most appropriate Tx for gracilis contracture?

A

None

255
Q

What is the most appropriate Tx for quadriceps contracture?

A

amputation

256
Q

Following debridement and anastomosis, how long should a tendon be immobilised for?

A

3w

257
Q

How many tendon ends foes the SDFT have?

A

4

258
Q

How many tendon ends does the DDFT have?

A

4

259
Q

What nutritional derangement(s) cause(s) Nutritional Secondary Hyperparathyroidism?

A

High P or Low Ca: Meat based!

260
Q

What is the ideal Ca:P ratio for dogs?

A

1.2 : 1

261
Q

What is the ideal Ca:P ratio for cats?

A

1 : 1

262
Q

How does Nutritional Secondary Hyperparathyroidism cause lameness?

A

HypoCa > inc PTH > inc resorption.

BUT normal production.

so progressive skeletal demineralisation.

263
Q

How does Nutritional Secondary Hyperparathyroidism present on Rx?

A

Decreased bone density.

Thin cortices.

“mushroom” metaphysis.

Pathological #.

264
Q

how is Nutritional Secondary Hyperparathyroidism treated?

A

Rest
Change Diet + Ca supplements
NSAIDs

265
Q

How does Hypovitaminosis D lead to osteopenia?

A

Low Vitamin D > Low Ca/P > cannot form bone.

266
Q

What are the Cx of hypovitaminosis D?

A

Pathological #/bowed long bones.
Large costochondral jct.
Delayed dental eruption.

267
Q

What changes may be notes on Rx of a dog suffering from hypovitaminosis D?

A

Thick GPs
Cupped metaphysis.
Osteopenia
Bowed Diaphysis

268
Q

How does Renal osteodystrophy cause osteopenia?

A

Renal impairement > lack of P excretion.

HyperP –> HypoCa.

Inc PTH –> bone demineralisation.

ALSO impairs vit D production.

269
Q

What are the clinical signs of Renal Osteodystrophy?

A
Pliable jaw.
Loose Teeth
Skeletal Pain
Pathological #s
Bowed long bones
270
Q

Which patients are commonly affected by hypervitaminosis A?

A

Cats

2-9yo

271
Q

What are the common clinical signs of a patient with hypervitaminosis A?

A
Scurfy Coat
Malaise
Neck paincervical stiffness
Abnormal posture
Lameness
272
Q

What Rx changes may be noted on a patient with hypervitaminosis A?

A

Extensive exostoses of cervical/thoracic vertebrae.
Ankylosing spondylopathy of cervical/thoracic vertebrae.
DJD shoulder/elbow.

273
Q

How is hypervitaminosis A treated?

A

CANT RESOLVE DAMAGE.

Balanced diet to halt progression.

274
Q

What is the best way to evaluate ST injuries of the shoulder?

A

US

275
Q

What are the 4 indications for myelography?

A
  1. Localisation of spinal lesion
  2. Surgical planing
  3. Rule out surgrey
  4. Asses dynamic SC lesion
276
Q

What is the 1e site of osteochrondrosis?

A

Lateral or Medial Femoral Condyle

277
Q

how is feline cruciate/patellar Dz fixed?

A

Transarticular pin across stifle joint for 4 weeks (+ taESF)

278
Q

Which Tx is reccomended for articular site fractures?

A

Fixation with pins

279
Q

What is Juvenile Pubic Symphisiodesis?

A

Thermal arrest of pubic chondrocytes by electrocautery/staples - results in ventrolateral rotation of acetabulum and better congruity

280
Q

Which dogs should undergo Juvenile Pubic Symphisiodesis?

A

<20w old - diagnose at 14-16w

281
Q

Which dogs should undergo Juvenile Pubic Symphisiodesis?

A

<20w old - diagnose at 14-16w

282
Q

How is a calcaneal avulsion # treated?

A

Pin and Tension Band wire

283
Q

What is the best Tx for calcaneoquartal instability?

A

calcaneoquartal arthrodesis - dorsal approach, remove all cartilage and apply bone graft from proximal humerus

284
Q

What should the post-op management be for calcaneoquartal arthrodesis?

A

Splint/cast 6w - Rx. Rest and analgesia.

Check weekly

285
Q

What can be visualised with low volume arthrography of the shoulder?

A

OCD lesions of the humeral head

286
Q

What are the clinical signs of carpal bone fractures?

A
NWB thoracic limb lameness
Abnormal stance
Effusion, swelling
crepitus and pain on ROM
Ml or CrCd instability
287
Q

What are the signs of Carpal Hyperextension?

A

Palmigrade stance - pain and progression