Orthopedics
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Questions and Answers

When is surgical intervention indicated for fractures?

  • When there is no neurologic involvement
  • Only for fractures in the lower extremities
  • If the fracture is stable
  • If there is significant displacement or diminished motor function (correct)

    • Which is the best approach to the cervical spine for surgery?

  • An anterior approach
  • A lateral approach
  • A dorsal approach
  • A ventral approach (correct)

    • What is a common complication monitored after surgery for fractures?

  • Seroma formation (correct)
  • Pulmonary embolism
  • Bone necrosis
  • Deep vein thrombosis

    • Which area is most frequently affected by thoracolumbar fractures?

    <p>Thoracic spine and lower lumbar-lumbosacral space</p> Signup and view all the answers

    What should be administered prior to surgery to minimize spinal cord edema?

    <p>Dexamethasone</p> Signup and view all the answers

    What is a potential postoperative concern following spinal surgery?

    <p>Hemorrhage and infection</p> Signup and view all the answers

    In the case of pelvic neoplasia, what is essential to avoid during surgery?

    <p>Preventing nerve damage and hemorrhage</p> Signup and view all the answers

    What may have occurred even if the tumor has been resected in cases of neoplasms?

    <p>Metastases</p> Signup and view all the answers

    What is a common clinical sign associated with cervical vertebral instability in dogs?

    <p>Chronic neck pain accompanied by ataxia</p> Signup and view all the answers

    Which type of compression is most commonly associated with young Great Danes?

    <p>Hourglass compression</p> Signup and view all the answers

    In which condition does compression worsen with neck extension?

    <p>Hyperextension injuries</p> Signup and view all the answers

    What typically results from hyperflexion during an injury?

    <p>Stable wedge compression fracture of the vertebra</p> Signup and view all the answers

    Which anatomical area is especially prone to fractures and luxations?

    <p>Lumbosacral junction and thoracolumbar area</p> Signup and view all the answers

    What mechanism is primarily involved in the compression related to axial loading forces?

    <p>Extrusion of nucleus pulposus into the spinal canal</p> Signup and view all the answers

    What is a likely result of rotational forces during an injury?

    <p>Disruption of both ventral and dorsal compartments</p> Signup and view all the answers

    Which breed is particularly noted for developing chronic degenerative disc disease with cervical instability?

    <p>Doberman Pinscher</p> Signup and view all the answers

    Which statement accurately describes avascular necrosis of the femoral head?

    <p>The cause of the condition is unknown.</p> Signup and view all the answers

    What can be observed in the diagnosis of coxofemoral luxation?

    <p>A shortened limb and muscle atrophy might be present.</p> Signup and view all the answers

    Which anatomical feature plays a role in the blood supply of the femoral head?

    <p>The extensive network of blood vessels.</p> Signup and view all the answers

    What radiographic finding might suggest avascular necrosis?

    <p>Decreased bone density with a widened joint space.</p> Signup and view all the answers

    In the context of avascular necrosis, what is a common symptom noted during a physical examination?

    <p>Lameness that is bilateral in about 15% of cases.</p> Signup and view all the answers

    What should be assessed to confirm a diagnosis of coxofemoral luxation?

    <p>Length comparison of the hindlimbs.</p> Signup and view all the answers

    Which of the following muscle groups is associated with the coxofemoral joint?

    <p>Major muscles of the thigh.</p> Signup and view all the answers

    Which factor plays a significant role in the deterioration of the bone in avascular necrosis?

    <p>Weight bearing leading to collapse.</p> Signup and view all the answers

    What is the anatomy included in the distal femur?

    <p>Metaphysis, condyles, trochlea, and patella</p> Signup and view all the answers

    Which grade of patellar luxation cannot be reduced manually?

    <p>Grade IV</p> Signup and view all the answers

    What is the initial postoperative care for patellar luxation management?

    <p>Apply a padded bandage</p> Signup and view all the answers

    Which breed type is most commonly affected by medial patellar luxations?

    <p>Miniature breeds</p> Signup and view all the answers

    What surgical technique involves deepening the trochlear groove?

    <p>Trochleoplasty</p> Signup and view all the answers

    Which of the following best describes the principles of stifle surgery?

    <p>Conducting an arthrotomy to examine all structures</p> Signup and view all the answers

    During which stage of patellar luxation should physical therapy begin?

    <p>On the day of surgery</p> Signup and view all the answers

    What is a potential complication of nonstable, devitalized bone fragments?

    <p>Development of draining tracts</p> Signup and view all the answers

    Which statement about tibial plateau leveling osteotomy (TPLO) is correct?

    <p>It eliminates tibial thrust due to cranial cruciate ligament laxity</p> Signup and view all the answers

    What is the objective of patellar luxation surgery?

    <p>To stabilize the patella and maintain motion</p> Signup and view all the answers

    Which characteristic does Grade II patellar luxation have?

    <p>It is characterized by clinical spontaneous luxation</p> Signup and view all the answers

    What should be limited for 6 weeks following lateral retinacular imbrication surgery?

    <p>Exercise</p> Signup and view all the answers

    What potential anatomical issue contributes to the development of patellar luxation?

    <p>Excessive femoral rotation</p> Signup and view all the answers

    Which surgical technique is usually used for dogs less than 6 months of age?

    <p>Chondroplasty</p> Signup and view all the answers

    What is the most common extracapsular technique in patellar luxation surgery?

    <p>Lateral retinacular imbrication technique</p> Signup and view all the answers

    Which condition is characterized by acute lameness and a caudal drawer sign?

    <p>Caudal cruciate ligament rupture</p> Signup and view all the answers

    What is the primary imaging modality recommended for detailed visualization of soft tissue structures in spinal assessments?

    <p>MRI</p> Signup and view all the answers

    In cases of spinal cord injury, what is the most critical factor for predicting recovery of neurologic function?

    <p>Presence of deep pain sensation</p> Signup and view all the answers

    Which of the following conditions is not typically associated with ischemic myelopathy?

    <p>Cervical pain</p> Signup and view all the answers

    What is a common diagnostic procedure used to locate spinal cord compression?

    <p>Myelography</p> Signup and view all the answers

    What imaging technique is preferred over myelography for assessing bony pathologies in the thoracic region?

    <p>CT scan</p> Signup and view all the answers

    Which surgical approach is least likely to be recommended when the fracture is stable with minimal displacement?

    <p>Decompressive surgery as an immediate step</p> Signup and view all the answers

    Which of the following is NOT considered a differential diagnosis for thoracic spinal cord issues?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What should be prioritized for immobilizing a patient with spinal issues?

    <p>Prevent additional spinal cord damage</p> Signup and view all the answers

    What is the primary goal of surgery for shear injuries?

    <p>To eliminate pain and stabilize the tarsocrural joint</p> Signup and view all the answers

    What is a common treatment option for distal intertarsal subluxation?

    <p>Arthrodesis of the distal intertarsal joint</p> Signup and view all the answers

    Which complication is often monitored postoperatively after corrective surgery for intertarsal subluxation?

    <p>Failure of bony fusion</p> Signup and view all the answers

    In what situation is joint arthrodesis considered for managing shear injuries?

    <p>If there is extensive bone and cartilage damage</p> Signup and view all the answers

    What is the main method of postoperative care after surgery for tarsometatarsal subluxation?

    <p>Use of a soft-cast splint until fusion is evident</p> Signup and view all the answers

    Which aspect of medial side injuries is noted as being more frequent compared to lateral side injuries?

    <p>More common occurrence</p> Signup and view all the answers

    During initial treatment for shear injuries, what vital procedure should be performed as soon as possible?

    <p>Performing debridement and irrigation</p> Signup and view all the answers

    What is the general recommended duration for maintaining a cast on the medial side of the tibia after external fixation?

    <p>4 to 12 weeks</p> Signup and view all the answers

    What is the recommended duration to restrict activity after a femoral head and neck excision arthroplasty in smaller dogs?

    <p>8 weeks</p> Signup and view all the answers

    What is the primary purpose of pectineal myectomy in joint pain management?

    <p>To decrease tension on the joint capsule</p> Signup and view all the answers

    What is a common complication after performing a pectineal myectomy?

    <p>Seroma formation</p> Signup and view all the answers

    What is required for total hip replacement in dogs weighing more than 40 lb?

    <p>The dog must be free of infection</p> Signup and view all the answers

    When can leash walks be started after the total hip replacement surgery if the fixation is stable?

    <p>1 to 2 days post-surgery</p> Signup and view all the answers

    What is the typical recovery time for a limb to reach functional level after a femoral head and neck excision arthroplasty?

    <p>2 to 3 months</p> Signup and view all the answers

    What type of approach is NOT mentioned for surgical techniques related to fractures?

    <p>Dorsal approach</p> Signup and view all the answers

    How long should activity be restricted following a total hip replacement?

    <p>2 months</p> Signup and view all the answers

    What is the most common location of fracture or luxation associated with the thoracolumbar junction?

    <p>Lower lumbar-lumbosacral space</p> Signup and view all the answers

    During surgical procedures for cervical fractures, what is the primary benefit of using a ventral approach?

    <p>Optimal bone structure for fixation</p> Signup and view all the answers

    What is a key factor to monitor postoperatively following spinal surgery?

    <p>Pneumothorax</p> Signup and view all the answers

    In managing pelvic neoplasia, which of the following is critical to avoid?

    <p>Nerve damage</p> Signup and view all the answers

    What should be administered prior to surgery to reduce spinal cord edema during tumor removal?

    <p>Dexamethasone</p> Signup and view all the answers

    Which of the following is NOT a primary indication for surgery in cases of unstable fractures?

    <p>Intact motor function</p> Signup and view all the answers

    What is a common clinical sign associated with fractures of L6, L7, and the sacrum?

    <p>Sciatic nerve deficits</p> Signup and view all the answers

    What should be the main focus during postoperative care for a patient recovering from spinal surgery?

    <p>Minimizing pain and monitoring; start antibiotic therapy</p> Signup and view all the answers

    What is the primary objective of surgical intervention for patellar luxation?

    <p>To stabilize the patella and maintain a full range of motion</p> Signup and view all the answers

    Which surgical procedure involves the removal of a wedge of the trochlea?

    <p>Wedge resection</p> Signup and view all the answers

    What is the recommended exercise restriction after lateral retinacular imbrication surgery?

    <p>Limit exercise for 6 weeks</p> Signup and view all the answers

    What grade of patellar luxation is characterized by the inability to reduce manually?

    <p>Grade IV</p> Signup and view all the answers

    When should physical therapy begin following trochleoplasty?

    <p>On the day of surgery</p> Signup and view all the answers

    How long should activity be restricted after performing a tibial plateau leveling osteotomy (TPLO)?

    <p>8 weeks</p> Signup and view all the answers

    What is a common clinical sign observed in dogs with caudal cruciate ligament rupture?

    <p>Presence of a caudal drawer sign</p> Signup and view all the answers

    Which is true about meniscal problems in dogs?

    <p>Meniscal problems are commonly associated with cranial cruciate tear</p> Signup and view all the answers

    What is the most significant complication resulting from mandibular symphyseal separations?

    <p>Malocclusion</p> Signup and view all the answers

    What is typically done when managing mandibular body fractures with minimal displacement?

    <p>Creating a muzzle with tape</p> Signup and view all the answers

    What is the prognosis for neurologic recovery after treatment for intracranial fractures?

    <p>Guarded</p> Signup and view all the answers

    Which technique is considered best for managing open or comminuted fractures?

    <p>External skeletal fixation</p> Signup and view all the answers

    What is an essential preoperative consideration before addressing any fractures?

    <p>Conducting a neurologic examination</p> Signup and view all the answers

    Which postoperative care measure is vital after treating a calvarial fracture?

    <p>Monitor neurologic function</p> Signup and view all the answers

    In the management of mandibular fractures, which technique involves keeping the mouth closed?

    <p>Maxillary-mandibular fixation</p> Signup and view all the answers

    What may occur as a secondary effect due to a frontal sinus fracture?

    <p>Subcutaneous emphysema</p> Signup and view all the answers

    What is a significant complication that can arise post-maxillectomy?

    <p>Infection and dysphagia</p> Signup and view all the answers

    Which of the following components is not involved in the dorsal anatomy for surgery?

    <p>Ventral spinal artery</p> Signup and view all the answers

    What is the primary goal of pain management following surgical procedures like maxillectomy?

    <p>Minimizing postoperative pain</p> Signup and view all the answers

    Which dogs typically exhibit a higher risk of being affected by wobbler syndrome?

    <p>Young Great Danes</p> Signup and view all the answers

    What is a crucial aspect of postoperative care for dogs following maxillectomy?

    <p>Use an Elizabethan collar for 2 weeks</p> Signup and view all the answers

    What surgical approach to maxillectomy is noted to have a higher success rate despite being more difficult?

    <p>Ventral approach</p> Signup and view all the answers

    During maxillectomy procedures, significant blood loss necessitates what?

    <p>A source of blood replacement</p> Signup and view all the answers

    What management technique is recommended for pain control in the immediate postoperative phase?

    <p>Use of fentanyl patches</p> Signup and view all the answers

    What is a characteristic feature of avascular necrosis of the femoral head?

    <p>Weight bearing causes the bone to collapse.</p> Signup and view all the answers

    Which diagnostic method is utilized for coxofemoral luxation?

    <p>Radiographs and physical examination are used.</p> Signup and view all the answers

    What does a widened joint space on radiographs potentially indicate?

    <p>Coxofemoral luxation.</p> Signup and view all the answers

    What anatomical feature is crucial for the stability of the coxofemoral joint?

    <p>Shape of the acetabulum.</p> Signup and view all the answers

    How does the blood supply to the femoral head contribute to its health?

    <p>It supports the bone density and prevents necrosis.</p> Signup and view all the answers

    Which of the following statements about the effects of weight bearing in avascular necrosis is accurate?

    <p>Weight bearing leads to cartilage fracture.</p> Signup and view all the answers

    Which is an unusual sign of coxofemoral luxation that may present in animals?

    <p>LLimb shortening and muscle atrophy.</p> Signup and view all the answers

    What is a common misconception regarding the causes of avascular necrosis?

    <p>It always results from a traumatic injury.</p> Signup and view all the answers

    What is the primary objective in treating mature dogs with angular deformities of the limb?

    <p>To restore joint congruity and correct angular deformity</p> Signup and view all the answers

    Which of the following statements accurately describes the mechanism behind lateral luxation of the elbow?

    <p>Lateral luxation occurs more frequently due to the size of the medial condyle</p> Signup and view all the answers

    Which ligament spans from the styloid process of the ulna to the ulnar carpal bone?

    <p>Ulnar collateral ligament</p> Signup and view all the answers

    What is a common clinical sign of traumatic luxation of the elbow?

    <p>Abduction of the foot and antebrachium</p> Signup and view all the answers

    During a closed reduction of a laterally luxated elbow, what position is recommended for the antebrachium?

    <p>Flex the elbow and inwardly rotate the antebrachium</p> Signup and view all the answers

    What additional support does the flexor retinaculum provide?

    <p>Support to the palmar part of the carpus</p> Signup and view all the answers

    What anatomical feature is used to hook the anconeal process during the reduction of a laterally luxated elbow?

    <p>Olecranon fossa</p> Signup and view all the answers

    Which anatomical feature is affected by the force exerted during a laterally luxated elbow?

    <p>Anconeal process</p> Signup and view all the answers

    What is a common issue that can arise from prolonged fixation of the leg in an extended position in dogs?

    <p>Contracture of the quadriceps</p> Signup and view all the answers

    What anatomical structures are identified as being very superficial in the femoral triangle?

    <p>Femoral artery, nerve, and vein</p> Signup and view all the answers

    What is recommended before initiating significant activity post-surgery of the proximal femur?

    <p>Reassess with repeat radiographs</p> Signup and view all the answers

    Which of the following is NOT typically associated with stifle disorders in dogs and cats?

    <p>Hip dislocation</p> Signup and view all the answers

    Which muscle groups are involved in the anatomy of the cranial stifle complex?

    <p>Quadriceps muscles and patellar tendon</p> Signup and view all the answers

    What is a significant concern following a fracture repair in the proximal femur?

    <p>Development of osteoarthritis</p> Signup and view all the answers

    What key assessment should be conducted preoperatively for stifle surgical candidates?

    <p>Complete orthopedic evaluation including patellar tendon palpation</p> Signup and view all the answers

    What anatomical feature should not deviate medially or laterally in a healthy cranial stifle?

    <p>Talocrural joint alignment</p> Signup and view all the answers

    Which breed is NOT mentioned as being predisposed to oral tumors?

    <p>Labrador retrievers</p> Signup and view all the answers

    What is the most common type of oral neoplasm in dogs?

    <p>Malignant melanoma</p> Signup and view all the answers

    Small breeds of dogs are more prone to develop which type of tumor?

    <p>Malignant melanoma</p> Signup and view all the answers

    What is the first line of therapy for all oral tumors?

    <p>Surgical resection</p> Signup and view all the answers

    Which condition is characterized by drooling, halitosis, and dysphagia?

    <p>Oral neoplasia</p> Signup and view all the answers

    Which of the following breeds is particularly noted for developing SCC?

    <p>Boxers</p> Signup and view all the answers

    Which type of carcinoma is identified as the most common in cats?

    <p>Squamous cell carcinoma (SCC)</p> Signup and view all the answers

    In the context of diagnostics, what might indicate a deformity of the muzzle?

    <p>Oral tumors</p> Signup and view all the answers

    What intervention is required for fractures involving the acromion?

    <p>Tension band or lag screw fixation</p> Signup and view all the answers

    Which of the following best describes the characteristic of scapular body fractures?

    <p>They are typically transverse or oblique</p> Signup and view all the answers

    What is commonly observed in cerebrospinal fluid evaluations during vertebral neoplasia?

    <p>Elevated protein levels and increased pressure</p> Signup and view all the answers

    What is the primary reason for using myelography and CT scans in the diagnosis of tumors?

    <p>To determine the tumor’s exact site and spinal cord compression</p> Signup and view all the answers

    What is the typical prognosis for healing and normal function after appropriate stabilization of a fracture?

    <p>Good, with successful recovery expected</p> Signup and view all the answers

    What specific surgical fixation is required for glenoid fractures?

    <p>Surgical fixation</p> Signup and view all the answers

    What type of fracture treatment is implied for scapulohumeral joint injuries?

    <p>Strict cage confinement is recommended</p> Signup and view all the answers

    Which condition necessitates a bone biopsy for diagnosis?

    <p>Histopathologic diagnosis with neoplasia suspicion</p> Signup and view all the answers

    Which of the following statements about avascular necrosis of the femoral head is true?

    <p>It leads to bilateral lameness in about 15% of cases.</p> Signup and view all the answers

    What is the correct diagnosis procedure for coxofemoral luxation?

    <p>Physical examination and radiographs.</p> Signup and view all the answers

    In cases of femoral head avascular necrosis, which finding might be observed on radiographs?

    <p>Decreased bone density and widened joint space.</p> Signup and view all the answers

    What anatomical feature is critical in the blood supply to the femoral head?

    <p>The femoral neck.</p> Signup and view all the answers

    Which condition does NOT typically exhibit a history of trauma?

    <p>Avascular necrosis of the femoral head.</p> Signup and view all the answers

    What might be a sign indicating an animal with coxofemoral luxation?

    <p>Deformity in the hind limbs.</p> Signup and view all the answers

    What is a potential long-term consequence of untreated coxofemoral luxation?

    <p>Chronic pain and progressive joint degeneration.</p> Signup and view all the answers

    Which muscle group does NOT primarily interact with the coxofemoral joint?

    <p>Pectoral muscles.</p> Signup and view all the answers

    What technique is particularly suitable for dogs weighing less than 40 lb?

    <p>Fascial strip over-the-top technique</p> Signup and view all the answers

    Which of the following is NOT typically a postoperative care measure for fractures of the tibia and fibula?

    <p>Remove small pins and wires routinely</p> Signup and view all the answers

    What is a common complication associated with rigid external fixation?

    <p>Infection at pin sites</p> Signup and view all the answers

    Which statement about the epiphyseal regions is accurate?

    <p>They serve as sites for tendon insertions and are subjected to tensile forces.</p> Signup and view all the answers

    What is the appropriate duration for maintaining an external fixator post-surgery?

    <p>3 to 4 weeks</p> Signup and view all the answers

    What is a primary reason for providing a compressive wrap after a tibia or fibula fracture?

    <p>To prevent soft tissue swelling</p> Signup and view all the answers

    Which intervention is indicated if there is chronic infection after surgical fixation?

    <p>Remove plates causing pain when cold</p> Signup and view all the answers

    What limits the holding power of fixation implants in the epiphyseal regions?

    <p>Loosely woven, trabecular bone composition</p> Signup and view all the answers

    What is the primary objective of surgery for shear injuries?

    <p>To prevent infection, stabilize the tarsocrural joint, and eliminate pain</p> Signup and view all the answers

    What is the recommended duration for maintaining a cast after external fixation in a functional standing angle?

    <p>4 to 12 weeks</p> Signup and view all the answers

    Which type of fixation is indicated when immediate stabilization of a limb is necessary?

    <p>Plate and screw fixation</p> Signup and view all the answers

    What is the common treatment approach for distal intertarsal subluxation injuries?

    <p>Perform arthrodesis of the distal intertarsal joint</p> Signup and view all the answers

    What should be done postoperatively when there is evidence of bony fusion after tendon treatments?

    <p>Remove the soft-cast splint</p> Signup and view all the answers

    In intertarsal-tarsometatarsal subluxation injuries, what is a characteristic of proximal intertarsal subluxations?

    <p>Lameness that is periodic without trauma evidence</p> Signup and view all the answers

    What is an appropriate postoperative care step for shear injuries?

    <p>Change the dressing daily and maintain a rigid splint</p> Signup and view all the answers

    What is the consequence of extensive bone and cartilage damage in shear injuries?

    <p>Increased chances of performing joint arthrodesis</p> Signup and view all the answers

    What anatomical structure is NOT included in the distal femur?

    <p>Calcaneus</p> Signup and view all the answers

    What condition is most commonly associated with medial patellar luxations?

    <p>Miniature breeds</p> Signup and view all the answers

    Which of the following is a characteristic of Grade II patellar luxation?

    <p>Can be manually luxated but reduces spontaneously</p> Signup and view all the answers

    What is typically required for the surgical treatment of scapular body fractures?

    <p>Tension band or lag screw fixation</p> Signup and view all the answers

    Which diagnostic technique is necessary for a definitive diagnosis of vertebral neoplasia?

    <p>Bone biopsy</p> Signup and view all the answers

    What anatomical feature might contribute to patellar luxation?

    <p>Shallow trochlear groove</p> Signup and view all the answers

    Which technique is gaining popularity for addressing cranial cruciate ligament laxity?

    <p>Tibial plateau leveling osteotomy (TPLO)</p> Signup and view all the answers

    How should a glenoid fracture typically be managed?

    <p>Through surgical fixation</p> Signup and view all the answers

    Which of these factors is a contributing issue in patellar luxation?

    <p>Malpositioned tibial tuberosity</p> Signup and view all the answers

    Which of the following statements regarding scapular fractures is incorrect?

    <p>Fractures involving the acromion do not require surgery.</p> Signup and view all the answers

    What potential complication might arise from excessive periosteal reaction with large callus formation?

    <p>Draining tracts</p> Signup and view all the answers

    What characterizes the fracture type that typically does not require surgical intervention?

    <p>Scapular body fractures with minimal displacement</p> Signup and view all the answers

    In which type of patellar luxation is the patella usually luxated laterally?

    <p>Lateral luxation</p> Signup and view all the answers

    What outcome is expected if rib neoplasia is treated appropriately?

    <p>Good prognosis for healing and normal function</p> Signup and view all the answers

    Which condition might present abnormal cerebrospinal fluid evaluation but is typically considered normal?

    <p>Vertebral neoplasia</p> Signup and view all the answers

    What is a potential complication following the surgical fixation of glenoid fractures?

    <p>Damage to the suprascapular nerve</p> Signup and view all the answers

    What is the primary reason that most mandibular ramus fractures do not require surgical treatment?

    <p>They usually involve minimal displacement.</p> Signup and view all the answers

    What condition may lead to condylectomy in cases of mandibular fractures?

    <p>Inability to open the mouth.</p> Signup and view all the answers

    What is a common characteristic of midline maxillary separations seen in cats?

    <p>They frequently have wide defects that should be surgically closed.</p> Signup and view all the answers

    Which statement about maxillary body fractures is accurate?

    <p>Most do not need surgical treatment.</p> Signup and view all the answers

    What type of nutritional support is recommended for postoperative care following mandibular or maxillary surgery?

    <p>Soft gruel or tube feeding to prevent discomfort.</p> Signup and view all the answers

    What is a common cause of TMJ dislocations?

    <p>Trauma.</p> Signup and view all the answers

    Which feature of the mandibular canal is important for surgical considerations?

    <p>It contains the mandibular alveolar nerve.</p> Signup and view all the answers

    During the management of mandibular fractures, what technique can be employed for stabilization?

    <p>Internal bone plating techniques.</p> Signup and view all the answers

    What is the purpose of performing an imbrication technique in cases of cruciate injury?

    <p>To tighten the lax side of the ligament</p> Signup and view all the answers

    Which sign is most consistently associated with a ruptured cranial cruciate ligament?

    <p>The cranial drawer sign</p> Signup and view all the answers

    What classification is used to describe the severity of collateral ligament disruptions?

    <p>First, second, and third degree based on tissue damage</p> Signup and view all the answers

    What conservative treatment is typically effective for first-degree collateral ligament disruptions?

    <p>Rest and restricted exercise</p> Signup and view all the answers

    What is a potential complication of a chronic cruciate ligament rupture?

    <p>Trauma to the menisci due to excessive movement</p> Signup and view all the answers

    Which surgical technique is aimed at stabilizing the joint from within rather than outside?

    <p>Patellar tendon technique</p> Signup and view all the answers

    Which condition requires acute intervention due to the risk of permanent instability if untreated?

    <p>Complete discontinuity of ligaments</p> Signup and view all the answers

    What is the procedure to assess cranial cruciate ligament laxity during examination?

    <p>Dorsi-flexing the hock while stabilizing the femur</p> Signup and view all the answers

    What is the primary objective of the surgical intervention in shear injuries?

    <p>To prevent infection and stabilize various joints</p> Signup and view all the answers

    In the context of distal intertarsal subluxation, what is a recommended postoperative care step?

    <p>Provide a soft-cast splint and remove when bony fusion is evident</p> Signup and view all the answers

    What is a characteristic observation in proximal intertarsal subluxations?

    <p>No evidence of trauma with periodic lameness present</p> Signup and view all the answers

    What type of fixation is indicated for cases where stable limb support is necessary?

    <p>F. Plate and screw fixation for immediate stability</p> Signup and view all the answers

    Which statement accurately describes the typical management approach for intertarsal-tarsometatarsal subluxation injuries?

    <p>Rigid splints should be applied for stabilization</p> Signup and view all the answers

    What is the significance of performing debridement during shear injury surgery?

    <p>To reduce infection risk and improve joint function</p> Signup and view all the answers

    In cases of medial side injuries in shear trauma, which treatment option is frequently considered?

    <p>Immediate joint arthrodesis if extensive damage is present</p> Signup and view all the answers

    What is the length of time for which a cast is typically maintained after external fixation is applied?

    <p>4 to 12 weeks, depending on recovery</p> Signup and view all the answers

    What is a suitable exercise for a dog recovering from a fracture after being placed in a Velpeau sling?

    <p>Swimming</p> Signup and view all the answers

    Which type of fixation is preferred due to its ease when dealing with large breeds?

    <p>Interlocking nails for stability</p> Signup and view all the answers

    What is essential for aligning a trochlear notch fracture to ensure proper healing?

    <p>Good alignment with rigid fixation</p> Signup and view all the answers

    In which situation would it be difficult to successfully apply plate fixation?

    <p>In large breeds due to nearby vascular and nerve structures</p> Signup and view all the answers

    What is a recommended method for stabilizing lateral luxation of the elbow?

    <p>Flex elbow, extend shoulder, and rotate humeral head</p> Signup and view all the answers

    What type of pins are most appropriate for use in condylar fractures?

    <p>Steinmann pins or double Rush pins for stability</p> Signup and view all the answers

    What is the recommended duration for removing external fixation after fracture management?

    <p>At least 4 to 6 weeks after surgery</p> Signup and view all the answers

    Which breed exhibits a heritable defect related to the ossification of the humeral condyle?

    <p>Spaniel</p> Signup and view all the answers

    What is the primary method of stabilizing a fractured styloid process of the ulna during treatment?

    <p>Use K-wires and wire in a figure-eight configuration</p> Signup and view all the answers

    What complication is associated with an unstable fracture of the ulna?

    <p>Delayed healing and nonunion</p> Signup and view all the answers

    What anatomical contribution does the proximal physis (olecranon) make to the growth of the ulna?

    <p>15%</p> Signup and view all the answers

    What is one of the primary anatomical features of the radius compared to the ulna?

    <p>The radius is the main weight-bearing bone of the forelimb.</p> Signup and view all the answers

    For a successful treatment of elbow luxations, within what time frame should closed reduction be initiated?

    <p>3 days</p> Signup and view all the answers

    What is a common complication that can occur with mid-shaft radial and ulnar fractures?

    <p>Nonunion if the fracture is not stable.</p> Signup and view all the answers

    What is the role of the radial, median, and ulnar nerves in relation to forelimb fractures?

    <p>They provide motor function to the carpal and digital joints.</p> Signup and view all the answers

    What is the main risk of premature closure of growth plates in immature animals?

    <p>Growth deformities of the radius and ulna</p> Signup and view all the answers

    Which statement is true regarding the longitudinal growth contributions of the distal radial and ulnar physes?

    <p>The distal radial physis contributes 60% and the proximal ulnar physis contributes 15%</p> Signup and view all the answers

    Which strategy is important in the surgical management of distal metaphyseal fractures in small dogs?

    <p>Maintaining neurovascular integrity during the procedure.</p> Signup and view all the answers

    Which preoperative consideration is vital for improving surgical outcomes for fracture management?

    <p>Early recognition and treatment of the fracture</p> Signup and view all the answers

    What is the purpose of using a locked plate fixation in distal metaphyseal fractures?

    <p>To align the fracture and provide stability during healing.</p> Signup and view all the answers

    What guideline should be followed when applying a fiberglass cast for closed reduction?

    <p>Flex the elbow in a functional angle during application.</p> Signup and view all the answers

    What is a significant consequence of using the tension band principle on an olecranon fracture treatment?

    <p>Converts tension into compression to stabilize the fracture</p> Signup and view all the answers

    What is a key preoperative consideration when preparing for surgery on a fractured limb?

    <p>Assess for concurrent injuries and neurologic function.</p> Signup and view all the answers

    Which surgical procedure is indicated for stabilizing the patella and maintaining a full range of motion?

    <p>Trochleoplasty</p> Signup and view all the answers

    What factor contributes to the common occurrence of open fractures in the distal radius and ulna?

    <p>High impact trauma or falls.</p> Signup and view all the answers

    What initial postoperative care is suggested after patellar luxation surgery?

    <p>Administer analgesics and apply a padded bandage</p> Signup and view all the answers

    What is a characteristic feature of Grade IV patellar luxation?

    <p>Non-reducibility of the luxation</p> Signup and view all the answers

    Which surgical technique involves creating increased depth in the trochlear groove?

    <p>Trochleoplasty</p> Signup and view all the answers

    Following lateral retinacular imbrication surgery, how long should exercise be limited?

    <p>6 weeks</p> Signup and view all the answers

    What is the recommended postoperative care for a dog that underwent trochleoplasty?

    <p>Physical therapy starting on the same day of surgery</p> Signup and view all the answers

    Which condition is characterized by acute lameness and a caudal drawer sign during examination?

    <p>Caudal cruciate ligament rupture</p> Signup and view all the answers

    For a dog less than 6 months of age with patellar luxation, which surgical technique is typically employed?

    <p>Chondroplasty</p> Signup and view all the answers

    What is typically the primary goal of surgery for shear injuries?

    <p>Prevent infection and stabilize the joint</p> Signup and view all the answers

    In the case of distal intertarsal subluxation, what is the recommended postoperative care?

    <p>Provide a soft-cast splint and remove it upon bony fusion evidence</p> Signup and view all the answers

    What is a consideration when deciding to replace ligaments during surgery for shear injuries?

    <p>Replacement should be done immediately or deferred if further debridement is needed</p> Signup and view all the answers

    Which of the following statements correctly describes intertarsal-tarsometatarsal subluxation injuries?

    <p>Proximal intertarsal subluxations show no evidence of trauma.</p> Signup and view all the answers

    What is the common treatment for distal intertarsal subluxation?

    <p>Stabilization with tension band wire</p> Signup and view all the answers

    What is true regarding joint arthrodesis in the context of shear injuries?

    <p>It is considered only when there is significant bone and cartilage damage.</p> Signup and view all the answers

    Which anatomical side is more frequently injured in shear injuries?

    <p>Medial side of the joint</p> Signup and view all the answers

    What is the typical duration for maintaining a cast after an external fixation procedure?

    <p>4 to 12 weeks</p> Signup and view all the answers

    Which of the following is considered the most significant complication of fractures related to the temporomandibular joint?

    <p>Malocclusion</p> Signup and view all the answers

    What is the primary method to stabilize mandibular symphyseal separations in cats?

    <p>Wire stabilization</p> Signup and view all the answers

    What is the common approach used for stabilizing fractures that involve significant bone loss?

    <p>External skeletal fixation</p> Signup and view all the answers

    During postoperative care for cranial fracture repair, which complication should be closely monitored?

    <p>Neurologic function</p> Signup and view all the answers

    Which of the following best describes the type of fractures most commonly encountered in the maxillofacial region?

    <p>Closed fractures</p> Signup and view all the answers

    What type of surgical intervention is performed for depressed calvarial fractures?

    <p>Elevate the depressed fractures</p> Signup and view all the answers

    Which of the following statements is true about fractures involving the frontal sinus?

    <p>Subcutaneous emphysema may occur as a complication.</p> Signup and view all the answers

    What is the most reliable method for stabilizing fracture fragments that are stable without loss of bone?

    <p>Interfragmentary wiring</p> Signup and view all the answers

    What is the primary goal of performing maxillectomies?

    <p>To completely resect the neoplasm and preserve local blood supply</p> Signup and view all the answers

    Which of the following complications is specifically associated with maxillectomy procedures?

    <p>Infection and laryngeal paralysis</p> Signup and view all the answers

    What postoperative measure should be taken to ensure a pet does not harm itself after surgery?

    <p>Use an Elizabethan collar</p> Signup and view all the answers

    What is a significant reason for obtaining a source of blood replacement during maxillectomy?

    <p>To account for potential significant blood loss</p> Signup and view all the answers

    Which type of surgical procedure is specifically mentioned as an alternative to maxillectomy?

    <p>Hemimaxillectomy</p> Signup and view all the answers

    What follow-up schedule is recommended for assessing a patient's recovery after maxillectomy?

    <p>Every three months for the first year</p> Signup and view all the answers

    Which of the following is a recommended method to manage pain in the postoperative phase after maxillectomy?

    <p>Administer NSAIDs and fentanyl patches</p> Signup and view all the answers

    Which anatomical components are essential when considering the dorsal approach for surgical intervention?

    <p>Dorsal vertebral lamina</p> Signup and view all the answers

    What procedure is performed in immature dogs to address premature closure of the distal ulnar physis?

    <p>Osteotomy of the ulna</p> Signup and view all the answers

    Which statement describes the prognosis for mature dogs with severe deformities?

    <p>The prognosis is guarded due to the severity of deformities.</p> Signup and view all the answers

    What anatomical feature does the radial bone articulate with distally?

    <p>Carpal bones C1, C2, C3, and C4</p> Signup and view all the answers

    In the context of limb alignment issues in mature dogs, what condition is characterized by cranial or medial bowing?

    <p>Carpal valgus</p> Signup and view all the answers

    What is the primary reason to reevaluate radiographically every 3 weeks in immature dogs?

    <p>To assess the effectiveness of splinting</p> Signup and view all the answers

    What complication is primarily monitored during postoperative care following the surgical correction of malformed limbs?

    <p>Infection at the osteotomy site</p> Signup and view all the answers

    What is a characteristic feature of isolated fractures of the carpus?

    <p>Rare and often associated with specific breeds</p> Signup and view all the answers

    What is crucial for the preservation of limb length following angular deformities?

    <p>Osteotomy of the radius at maximal curvature</p> Signup and view all the answers

    What is the maximum weight limit for dogs to be considered for femoral head and neck excision arthroplasty?

    <p>40 lb</p> Signup and view all the answers

    How long should activity be restricted following a total hip replacement in dogs?

    <p>2 months</p> Signup and view all the answers

    After a femoral head and neck excision arthroplasty, when is it encouraged for the dog to start using the limb?

    <p>Within 1 week post-surgery</p> Signup and view all the answers

    What is the main objective in managing angular deformity in mature dogs?

    <p>To reestablish congruity to the elbow joint</p> Signup and view all the answers

    In the context of traumatic luxation of the elbow, why is lateral luxation more common than medial luxation?

    <p>The medial condyle of the humerus is more prominent</p> Signup and view all the answers

    What is a common complication that may occur following pectineal myectomy?

    <p>Seroma formation</p> Signup and view all the answers

    What is the required aseptic condition for a total hip replacement surgery?

    <p>Strict asepsis</p> Signup and view all the answers

    What is a typical clinical sign of elbow luxation in dogs?

    <p>Abduction of the foot and antebrachium</p> Signup and view all the answers

    What is the healing time for the limb to reach a functional level post-femoral head and neck excision arthroplasty?

    <p>2 to 3 months</p> Signup and view all the answers

    Which ligament connects the styloid process of the radius to the ulnar carpal bone?

    <p>Ulnar collateral ligament</p> Signup and view all the answers

    Which surgical procedure aims to decrease tension on the medial aspect of the coxofemoral joint capsule?

    <p>Pectineal myectomy</p> Signup and view all the answers

    What is the correct action to perform for closed reduction of a laterally luxated elbow?

    <p>Flex the elbow and inwardly rotate the antebrachium</p> Signup and view all the answers

    What type of neurological assessment must be conducted prior to performing any surgical intervention on a dog?

    <p>Ligament injury evaluation</p> Signup and view all the answers

    Which structure primarily provides support to the palmar part of the carpus?

    <p>Flexor retinaculum</p> Signup and view all the answers

    What role does the radial collateral ligament play in elbow stability?

    <p>It prevents inward shifting of the elbow joint</p> Signup and view all the answers

    What anatomical feature influences the rotation of the antebrachium during elbow reduction?

    <p>Anconeal process positioning</p> Signup and view all the answers

    What is the treatment of choice for squamous cell carcinoma (SCC)?

    <p>Wide surgical resection with possible radiation therapy</p> Signup and view all the answers

    Which statement about nontonsillar squamous cell carcinoma is accurate?

    <p>It is locally invasive and slow to metastasize.</p> Signup and view all the answers

    What common symptoms may accompany tonsillar squamous cell carcinoma?

    <p>Ulceration with oral bleeding and halitosis</p> Signup and view all the answers

    Which prognosis is typically associated with squamous cell carcinoma?

    <p>Guarded prognosis with high recurrence rate</p> Signup and view all the answers

    In the context of maxillary fractures, what is a critical consideration?

    <p>Most maxillary fractures are open and thus need antibiotics.</p> Signup and view all the answers

    Which factor is the most common cause of atlantoaxial instability?

    <p>Congenital malformation of the dens</p> Signup and view all the answers

    What is the primary approach to treating fibrosarcoma?

    <p>Wide surgical excision with consideration for radiation therapy</p> Signup and view all the answers

    What characteristic differentiates tonsillar SCC from nontonsillar SCC?

    <p>Tonsillar SCC has early metastasis to lymph nodes and lungs.</p> Signup and view all the answers

    Which method is NOT recommended for treating transcondylar fractures?

    <p>Using crossed Kirschner wires</p> Signup and view all the answers

    What is a primary complication associated with intercondylar fractures of the humeral condyles?

    <p>Lameness and osteoarthritis (OA)</p> Signup and view all the answers

    What should be prioritized when stabilizing radial neck and proximal physeal fractures in immature animals?

    <p>Non-compression stabilization</p> Signup and view all the answers

    Which statement regarding Monteggia fractures is correct?

    <p>They refer to a fracture of the ulna with radial head luxation.</p> Signup and view all the answers

    When fixing a supracondylar fracture, what is the initial step to ensure proper alignment?

    <p>Fix the two condyles together before addressing the supracondylar fracture.</p> Signup and view all the answers

    What is the recommended time frame for removing K-wires used in fracture stabilization?

    <p>3 to 4 weeks post-surgery</p> Signup and view all the answers

    Which technique is preferred for the reduction of radial head luxation in Monteggia fractures?

    <p>Stabilize the ulnar fracture and then reduce the radial head luxation.</p> Signup and view all the answers

    What is the common approach used to address complications arising from radial head fractures?

    <p>Employing precise reduction with rigid fixation</p> Signup and view all the answers

    What is a primary reason for using closed reduction and cast fixation for fractures?

    <p>To ensure proper alignment and stability of the fracture</p> Signup and view all the answers

    What is a significant risk associated with nonunion of distal metaphyseal fractures?

    <p>High incidence of nonunion if the fracture is not stable</p> Signup and view all the answers

    Which of the following is correct regarding the evaluation of neurologic function prior to surgery?

    <p>It must be performed to plan optimal surgical interventions</p> Signup and view all the answers

    What is the recommended action to minimize postoperative swelling?

    <p>Apply a soft padded bandage for 3 to 10 days</p> Signup and view all the answers

    What is a common characteristic of open fractures of the distal part of the radius and ulna?

    <p>They have an increased risk of infection</p> Signup and view all the answers

    What anatomical feature is primarily responsible for weight-bearing in the forelimb?

    <p>The radius, being the main weight-bearing bone</p> Signup and view all the answers

    What is the primary objective of using plate fixation for distal metaphyseal fractures?

    <p>To align the fracture with compression and insert a cancellous bone graft</p> Signup and view all the answers

    What role do the radial and interosseous arteries play in the context of forelimb fractures?

    <p>Acting as the primary arterial supply to the forelimb</p> Signup and view all the answers

    What consequence can injuries to the physis cause in young animals?

    <p>Premature cessation of growth</p> Signup and view all the answers

    Which surgical fixation technique is appropriate for avulsion fractures of the tibial tubercle?

    <p>Pin and tension band wire fixation</p> Signup and view all the answers

    What major ligament contributes to the stability of the tarsocrural joint on the medial side?

    <p>Long medial ligament</p> Signup and view all the answers

    Which type of fracture healing is typically seen in the diaphysis of the tibia?

    <p>Slow healing requiring prolonged rigidity</p> Signup and view all the answers

    What is a critical measure in treating infection following an open fracture?

    <p>Immediate aggressive therapy</p> Signup and view all the answers

    Which joint is primarily affected by most luxations and subluxations related to the tarsus?

    <p>Tarsocrural joint</p> Signup and view all the answers

    What is one of the characteristics of the metaphysis in bone structure?

    <p>It serves as a transitional area between two regions</p> Signup and view all the answers

    Which surgical procedure is utilized for intra-articular fractures of the epiphysis?

    <p>Interfragmentary lag screw fixation</p> Signup and view all the answers

    What is the recommended postoperative care for immature dogs after surgery on the distal ulnar physis?

    <p>Apply a splint for two weeks, followed by leash walks for another two weeks</p> Signup and view all the answers

    During the evaluation of fractures of the carpus, which bones are included in the proximal row?

    <p>Radial, ulnar, and accessory carpal bones</p> Signup and view all the answers

    What is a potential consequence of performing an osteotomy at the point of maximal curvature of the radius?

    <p>Increased risk of angular deformities</p> Signup and view all the answers

    In the surgical procedure to correct premature closure of the distal ulnar physis, what method is used to prevent regrowth?

    <p>Application of a fat graft</p> Signup and view all the answers

    Prognosis following surgical correction for fractures in mature dogs with severe deformities is typically considered to be?

    <p>Guarded because of the severity of the deformities</p> Signup and view all the answers

    What anatomical feature contributes to the complexity of managing fractures of the carpus?

    <p>Articular surface involvement in fractures</p> Signup and view all the answers

    Which statement best describes the arrangement of the carpal bones?

    <p>The carpal bones are arranged in two rows</p> Signup and view all the answers

    What is the primary goal of the surgical procedure for correcting the displaced radius in mature dogs?

    <p>To correct angular deformities and maintain limb length</p> Signup and view all the answers

    Study Notes

    Spinal Fractures and Dislocations

    • Most spinal fractures and dislocations are due to trauma.
    • The thoracolumbar and lumbosacral junctions are prone to fracture and luxation.
    • Hyperextension causes direct trauma to the dorsal spine, resulting in dorsal compartment collapse.
    • Hyperflexion causes a wedge compression fracture of the vertebra, sparing the dorsal compartment.
    • Compression fractures occur with an axial load force, potentially driving fragments and extruded nucleus pulposus into the spinal cord.
    • Rotation usually occurs with hyperextension, disrupting both ventral and dorsal compartments.
    • Clinical signs can range from pain to proprioceptive deficits, progressing to paraparesis and even tetraparesis.

    Cervical Vertebral Instability

    • Most commonly occurs in Doberman Pinschers.
    • Caused by concurrent dorsal annulus and dorsal longitudinal ligament hypertrophy.
    • The caudal cervical intervertebral disc spaces are most commonly affected.

    Ligamentum Flavum Hypertrophy

    • Causes dynamic dorsal spinal canal compression.
    • Associated with vertebral arch abnormalities.

    Hourglass Compression

    • Associated with dorsal, ventral, and lateral compression.
    • Most common in young Great Danes.

    Surgical Procedures for Spinal Fractures and Dislocations

    • For cervical fractures, a ventral approach provides the best bone structure for fixation.
    • The thoracolumbar junction and lower lumbar-lumbosacral space are common locations for fracture or luxation in the thoracic and lumbar spine.
    • Common techniques include dorsal spinous process plating using plastic spinal plates and pin and PMMA fixation.
    • Fractures of L6, L7, and the sacrum are common, resulting in sciatic, femoral, and sacral nerve deficits.
    • A dorsal approach is used for fixation.

    Postoperative Care and Complications

    • Minimize pain, begin antibiotic therapy, and provide nursing care for the recumbent patient.
    • Prevent pneumothorax.
    • Monitor for hemorrhage, seroma formation, and pneumothorax. Manage pain.

    Neoplasia

    • Neoplasms are usually malignant. Consider chemotherapy if excision was not complete.
    • Metastases may have occurred even if the tumor has been resected.

    Pelvic Neoplasia

    • The ileal wing can be resected for localized tumors. Avoid hemorrhage and nerve damage.
    • Monitor for seroma formation and infection.
    • Manage pain.
    • Consider chemotherapy if the tumor is malignant.

    Vertebral Neoplasia

    • Remove as much of the tumor as possible and decompress the spinal cord.
    • Administer dexamethasone prior to surgery to minimize spinal cord edema from manipulation.
    • Subtotal colectomy may be necessary if there is obstipation.

    Avascular Necrosis of the Femoral Head (Legg-Perthes or Legg-Calve-Perthes Disease)

    • Most common in young small-breed dogs.
    • No history of trauma; lameness can be bilateral in about 15% of animals.
    • Cause is unknown.
    • Weight bearing causes bone collapse with fracture of the cartilage.

    Diagnosis of Avascular Necrosis of the Femoral Head

    • Based on physical examination and radiographs.
    • Limb may be shortened and muscles atrophied.
    • On radiographs, decreased bone density is noted with a widened joint space.

    Treatment of Avascular Necrosis of the Femoral Head

    • Obtain radiographs.

    Stifle Surgery Principles

    • Place the dog in dorsal recumbency.
    • Perform an arthrotomy to identify and examine all structures.

    Patellar Luxation

    • Commonly affects miniature breeds.
    • Medial patellar luxations are most common; lateral luxations are almost always seen in large and giant breeds.
    • Contributing factors include changes in the angle formed by the head and neck of the femur, bowing of the distal femur, a shallow trochlear groove, increased internal or external tibial rotation, and a malpositioned tibial tuberosity.

    Patellar Luxation Classification

    • Grade I: The patella lies in the trochlear groove but can be manually subluxated or luxated.
    • Grade II: There is clinical spontaneous luxation; the patella can be luxated manually but reduces spontaneously or with minimal manipulation.
    • Grade III: The patella is luxated most of the time but can be reduced manually.
    • Grade IV: Patellar luxation cannot be reduced manually.

    Diagnosis of Patellar Luxation

    • Based on a history of intermittent rear-leg lameness, particularly during exercise.

    Surgical Procedures for Patellar Luxation

    • Vary depending on the case; some require parapatellar arthrotomy and release to diminish tension on tissue, while others require arthrotomy with tightening of surrounding tissues.
    • The objective is to stabilize the patella and maintain a full range of motion.

    Surgical Techniques for Patellar Luxation

    • Trochleoplasty: Deepening of the trochlear groove. Begin physical therapy on the day of surgery; restrict activity for 1 month.
    • Chondroplasty: Used in dogs less than 6 months of age.
    • Wedge resection: Remove a piece of the trochlea, then cut a piece below to deepen, and replace the first removed wedge.
    • Imbrication: After creating increased depth in the trochlear groove, tighten the lateral retinaculum.
    • Lateral retinacular imbrication technique: The most common extracapsular technique; can be performed on any size patient.
    • TPLO (Tibial Plateau Leveling Osteotomy): This procedure is gaining popularity; designed to eliminate tibial thrust where the tibia moves forward during active weight bearing in the stifle with cranial cruciate ligament laxity. The tibial plateau is leveled to nearly perpendicular to the long axis of the tibia. An intact caudal cruciate ligament is required. It may be best suited for large or giant breeds or very active dogs. TPLO requires specialized equipment and expertise.

    Postoperative Care for Patellar Luxation Surgery

    • Administer analgesics.
    • Padded bandage for 1 to 2 days to reduce swelling.
    • With a fascial strip or lateral splint, use a leash walk for 3 months, returning to normal function after 6 to 9 months.
    • With lateral retinacular imbrication, limit exercise for 6 weeks and gradually return to normal activity over the next 2 to 4 weeks.
    • With TPLO, limit exercise for 8 weeks, then radiograph to assess bone healing.

    Caudal Cruciate Ligament Rupture

    • Extremely rare.
    • There is acute lameness and a caudal drawer sign with 90 degrees of stifle flexion.
    • Avulsion of the bony attachment is also present.

    Meniscal Problems

    • Isolated meniscal tears are rare in dogs.
    • Meniscal pathology is usually associated with partial or complete cranial cruciate tear.
    • If the meniscus is torn, it should be repaired. If it is too damaged to be repaired, it should be removed.

    Thoracic Limb

    • Muscle atrophy of the spinatus muscle is usually present
    • Ischemic myelopathy is not associated with cervical pain
    • Deep pain sensation is important for prognosis
      • If deep pain sensation is intact, there is an 85% to 90% chance of recovering normal neurologic function
      • If deep pain is absent, there is only a 15% chance of neurologic function recovery
    • MRI is the gold standard for imaging the spine because it provides the greatest detail of soft tissue structures
    • Ventral decompression using a ventral slot technique, ventral distraction and fusion, and dorsal decompression using a dorsal laminectomy are the three primary decompressive surgeries
    • Immobilize the patient to prevent additional spinal cord damage
    • If the fracture is stable with minimal displacement, and the patient has good motor function, the patient can be managed without surgery
    • Surgery is indicated if the fracture is unstable or significantly displaced, if motor function is diminished, or there is evidence of declining neurologic function

    Pelvic Neoplasia

    • The ileal wing can be resected for localized tumors
    • Avoid hemorrhage and nerve damage
    • Monitor for seroma formation and infection
    • Manage pain
    • Consider chemotherapy if the tumor is malignant

    Vertebral Neoplasia

    • Remove as much of the tumor as possible and decompress the spinal cord
    • Administer dexamethasone prior to surgery to minimize spinal cord edema from manipulation
    • Restrict activity for 8 weeks

    Femoral Head and Neck Luxation

    • The most common location of femoral head and neck luxation is the coxofemoral joint
    • Salter-Harris Type I, II, or III fractures are commonly associated with luxations
    • Grade I: The patella is occasionally luxated but can be reduced easily
    • Grade II: The patella is frequently luxated, but it can usually be reduced manually
    • Grade III: The patella is luxated most of the time but can be reduced manually
    • Grade IV: Patellar luxation cannot be reduced manually
    • Diagnosis is based on a history of intermittent rear-leg lameness, particularly during exercise
    • Surgical procedures vary; some require parapatellar arthrotomy and release to diminish the tension on tissue, and some require arthrotomy with tightening of surrounding tissues
    • The objective of surgery is to stabilize the patella and maintain a full range of motion
    • Trochleoplasty, chondroplasty, wedge resection, and imbrication are surgical techniques
    • Restrictions after surgery:
      • Trochleoplasty: restrict activity for 1 month
      • Wedge resection: restrict activity for 6 weeks, then gradually return to normal activity over the next 2 to 4 weeks
      • TPLO: limit exercise for 8 weeks, then radiograph to assess bone healing

    Stifle Joint

    • The peroneal and saphenous nerves run caudal to the femur
    • Most of the fractures are physeal fractures
    • Lateral, medial, or cranial approaches can be used for fixation
    • Restrict activity for at least 24 hours; if the fixation is stable, start leash walks 1 to 2 days after surgery

    Postoperative Care (General)

    • Administer analgesics
    • Padded bandage for 1 to 2 days to reduce swelling
    • With a fascial strip, use a lateral splint, leash walk for 3 months, return to normal function after 6 to 9 months
    • With lateral retinacular imbrication, limit exercise for 6 weeks, and gradually return to normal activity over the next 2 to 4 weeks

    Caudal Cruciate Ligament Rupture

    • Extremely rare
    • There is acute lameness and a caudal drawer sign with 90 degrees of stifle flexion
    • Avulsion of the bony attachment is also present

    Meniscal Problems

    • Isolated meniscal tears are rare in dogs
    • Meniscal pathology is usually associated with partial or complete cranial cruciate tear
    • External fixation is usually placed on the stabilized limb in a functional standing angle.
    • Maintain the cast for 4 to 12 weeks.
    • Once the cast has been removed, slowly increase activity over the next 4 to 12 weeks

    Shear Injury

    • The medial side is injured more often than the lateral side
    • Joint arthrodesis is considered if extensive bone and cartilage damage is present
    • Objectives of surgery are to prevent infection, stabilize the tarsocrural joint, eliminate pain, and maintain a functional range of motion
    • Perform debridement as soon as possible.
    • Ligaments are replaced with bone anchors or screws and figure-eight sutures
    • Stabilize with a rigid splint; change dressing daily
    • Postoperative care:
      • Minimize pain
      • Begin antibiotic therapy
      • Provide nursing care for the recumbent patient

    Distal Intertarsal (Tarsometatarsal) Subluxation with Plantar Instability

    • Less common than proximal subluxation injury
    • Usually associated with trauma
    • Treat with arthrodesis of the distal intertarsal joint
    • After surgery, provide a soft-cast splint; remove when there is evidence of bony fusion

    Intertarsal-Tarsometatarsal Subluxation Injuries

    • Proximal intertarsal subluxations:
      • No evidence of trauma
      • Periodic lameness is present
      • Treat with rigid splints
    • Distal intertarsal subluxation:
      • Valgus deformity is seen
      • Stabilize with tension band wire
    • Tarsometatarsal subluxation:
      • Stabilize with medial-lateral support and a rigid splint for 6 to 8 weeks
    • If there is evidence of bony fusion, the splint can be removed.

    Mandibular Fractures

    • Preoperative Considerations: Perform a neurologic examination prior to surgery.
    • Treatment: Most mandibular fractures are managed conservatively. Surgical intervention is necessary if displacement is severe.
    • Postoperative Care & Complications: Monitor neurologic function closely. Subcutaneous emphysema can occur following frontal sinus fractures.

    Mandibular Symphyseal Separation

    • Occurs frequently in cats.
    • Wire stabilization is the preferred treatment method.

    Mandibular Body Fractures

    • Muzzle Creation using Tape: An effective option if minimal fragment displacement is present. Difficult to apply in cats and brachycephalic breeds.
    • Maxillary-Mandibular Fixation: Involves wiring the maxilla to the mandible or using acrylic bonding to stabilize the canine teeth, keeping the mouth closed.
    • Interfragmentary Wiring: Suitable for stable fracture fragments without significant bone loss or comminution.
    • Intraoral Acrylic Splint: A viable option for fracture stabilization.
    • External Skeletal Fixation: Best suited for open, comminuted fractures or those involving bone loss. Anatomical understanding is crucial.

    Maxillectomy

    • Preoperative Considerations:
      • Ventral approach is more challenging but offers a higher success rate.
      • Requires a source of blood replacement due to significant blood loss.
    • Postoperative care:
      • Administer NSAIDs and fentanyl patches for pain management.
      • Use a cuffed endotracheal tube.
      • Provide antibiotics.
      • Place an Elizabethan collar for 2 weeks. Restrict exercise for 4 to 6 weeks.

    Caudal Cervical Spondylomyelopathy (Wobbler Syndrome)

    • Anatomy:
      • Dorsal Components: Include dorsal vertebral lamina, articular facets, joint capsule, and ligamentum flavum.
      • Ventral Components: Include vertebral bodies, dorsal fibers of the annulus fibrosus of the intervertebral disc, and the dorsal longitudinal ligament.
    • Causes:
      • Affects two distinct dog populations:
        • Young Great Danes with osseous malformations of the cervical spine (approximately 10% to 15% of cases).
        • Mature dogs with compression of the spinal cord.
    • Treatment:
      • Young Great Danes: Surgical decompression of the spinal cord, with or without stabilization.
      • Mature Dogs: Surgical ventral stabilization is frequently required.

    Traumatic Luxation of the Elbow

    • Lateral Luxation: More common due to the larger size of the medial condyle of the humerus, hindering medial luxation.
    • Clinical Signs: Acute non-weight-bearing lameness, abduction of the foot and antebrachium.
    • Treatment: Closed reduction followed by immobilization.

    Elbow Joint Disorders

    • Fractures of the Coronoid Process: Present in young dogs, affecting the elbow joint and causing chronic lameness.
    • Diagnosis: Based on radiographs and clinical signs.
    • Treatment: Surgical removal of the coronoid process.
    • Complications:
      • Fractures of the anconeal process often co-occur.
      • Subtotal colectomy may be required in cases of obstipation.

    Avascular Necrosis of the Femoral Head

    • Causes:
      • Also known as Legg-Perthes disease.
      • More common in young, small-breed dogs.
      • Typically occurs without a history of trauma.
      • Affects both limbs in approximately 15% of cases.
      • The exact cause remains unknown.
    • Diagnosis: Based on physical examination and radiographs.
    • Clinical Signs: Shortened limb, muscle atrophy.
    • Radiographic Findings: Decreased bone density, widened joint space.
    • Treatment: Femoral head ostectomy, total hip replacement.

    Coxofemoral Luxation

    • Diagnosis:
      • Animals usually bear no weight on the affected limb.
      • If pulling the hindlimbs directly caudally, they should be of equal length in a normal animal.
    • Treatment: Surgical reduction and stabilization.

    Fractures of the Femur

    • Proximal Femur: Includes the femoral head, neck, trochanters, and their attachments to the femoral shaft. The sciatic nerve and femoral artery, vein, and nerve are located in this region.
    • Treatment: Surgical stabilization, femoral head and neck ostectomy.
    • Postoperative Care:
      • Prevent weight bearing for the initial weeks.
      • Gradually transition to non-weight-bearing physical therapy.
      • Repeat radiographs before resuming significant activity.

    Orthopedic Disorders of the Stifle

    • Anatomy: Includes the patella, patellar tendon, tibial tuberosity, and associated structures.
    • Clinical Signs: Lameness, pain, instability.

    Patellar Luxation

    • Causes: Congenital or acquired.
    • Diagnosis: Physical examination, radiographs.
    • Treatment: Surgical correction.

    Cranial Cruciate Ligament Tear

    • Common Canine Disorder: Causes instability in the stifle joint.
    • Clinical Signs: Lameness, pain, swelling, joint instability.
    • Diagnosis: Physical examination, radiographs.
    • Treatment: Surgery to stabilize the stifle joint.

    Tendon Injuries of the Stifle

    • Causes: Trauma, overuse.
    • Clinical Signs: Lameness, pain, swelling.
    • Treatment: Surgical repair, rehabilitation.

    Meniscal Injuries

    • Anatomy: The menisci act as shock absorbers in the stifle joint.
    • Causes: Trauma, degeneration.
    • Clinical Signs: Lameness, pain, swelling.
    • Diagnosis: Physical examination, radiographs, arthroscopy.
    • Treatment: Surgical repair, debridement.

    Other Orthopedic Disorders of the Stifle

    • Osteochondritis Dissecans (OCD): A condition affecting the cartilage of the stifle joint.
    • Osteosarcoma: A type of bone cancer.

    Orthopaedic Disorders of the Tarsus

    • Anatomy:
      • Tarsus: Consists of seven tarsal bones.
      • Cruciate Ligaments: Essential for joint stability, spanning three joints:
        • Lateral Collateral Ligament: Extends from the styloid process of the radius to the radial carpal bone.
        • Ulnar Collateral Ligament: Spans from the styloid process of the ulna to the ulnar carpal bone.
        • Flexor Retinaculum: Supports the palmar part of the carpus.

    Tarsal Luxation and Fractures

    • Causes: Trauma, congenital conditions.
    • Clinical Signs: Lameness, pain, swelling, joint instability, deformity.
    • Diagnosis: Physical examination, radiographs, arthroscopy.
    • Treatment: Closed reduction, surgical stabilization, rehabilitation.

    Tarsal Desmotomy

    • Purpose: Performed to relieve pain and improve mobility in animals with severe tarsal joint disease.
    • Procedure: Surgical division of the tarsal ligaments.
    • Postoperative Care: Pain management, immobilization, rehabilitation.

    Neoplasia of the Maxilla and Mandible

    • Oropharyngeal region is the fourth most common site of malignant neoplasia in dogs
    • Most common oral tumors in dogs are malignant melanoma, squamous cell carcinoma (SCC), fibrosarcoma, and epulides
    • SCC is the most common oral tumor in cats
    • Boxers, golden retrievers, and cocker spaniels are predisposed to oral tumors
    • Small-breed dogs are more prone to develop malignant melanomas, while large-breed dogs are more prone to SCC and fibrosarcoma
    • Surgical resection is the first-line treatment for all oral tumors

    Diagnosis of Oral Tumors

    • Clinical signs include drooling, halitosis, and dysphagia
    • Deformity of the muzzle may be present

    Temporomandibular Joint (TMJ) Dysplasia

    • Jaw locks in the open position
    • Strict cage confinement is recommended for minimal displacement

    Scapula Fracture

    • Osteotomy of the acromion or greater tubercles may be required for stabilization
    • Scapular body fractures are often transverse or oblique.
    • Fractures of the spine of the scapula do not require surgery.
    • Fractures involving the acromion require surgery with tension band or lag screw fixation.
    • Fractures of the scapular neck require surgical fixation.
    • Supraglenoid tubercle fractures require surgical fixation.
    • Glenoid fractures require surgical fixation.

    Coxofemoral Joint Disorders

    • The coxofemoral joint is a ball-and-socket joint made up of the acetabulum and femoral head
    • The fossa of the acetabulum and the fovea of the femoral head can be mistaken for radiographic abnormalities.
    • Femoral head has an extensive blood supply.

    Coxofemoral Luxation

    • Animals typically don't bear weight on the affected limb
    • Hindlimbs should be the same length if pulled directly caudally in a normal animal
    • Treatment includes closed reduction, stabilization with tape muzzle or maxillary-mandibular fixation, or surgical correction.
    • Surgical techniques for stabilization include:
      • Intracapsular techniques: Patellar tendon imbrication, over-the-top repairs, and under-and-over repairs
      • Extracapsular techniques: Lateral imbrication technique, and tibial plateau leveling osteotomy (TPLO)
      • Fascial strip over-the-top technique: Suitable for dogs weighing less than 40 lb.

    Avascular Necrosis of the Femoral Head (Legg-Calvé-Perthes disease)

    • Most common in young small-breed dogs
    • Lameness can be bilateral in approximately 15% of animals
    • Cause is unknown
    • Weight bearing causes bone collapse and cartilage fracture
    • Diagnosis is based on physical examination and radiographs
    • Treatment includes femoral head ostectomy (FHO), triple pelvic osteotomy (TPO), or total hip replacement.

    Tibia and Fibula Fractures

    • Account for approximately 15% to 20% of long bone fractures in small animals
    • Limited soft tissue coverage makes fractures prone to becoming open

    Tibia and Fibula Fracture Treatment Options

    • Closed reduction and casting: Suitable for minimal displacement
    • External fixation: Provides stabilization when cage rest is not feasible
    • Intramedullary pin fixation: Allows for early weight bearing
    • Plate and screw fixation: Used for immediate weight bearing when other limbs are injured and restricted activity is not possible.

    Distal Intertarsal (Tarsometatarsal) Subluxation with Plantar Instability

    • Less common than proximal subluxation injury
    • Usually associated with trauma
    • Treatment involves arthrodesis of the distal intertarsal joint
    • After surgery, a soft-cast splint is provided, and removed once bony fusion evidence is observed.

    Intertarsal-Tarsometatarsal Subluxation Injuries

    • Proximal intertarsal subluxations: Have no evidence of trauma and present with periodic lameness; treated with rigid splints.
    • Distal intertarsal subluxation: Valgus deformity is present; stabilized with tension band wire.
    • Tarsometatarsal subluxation: Stabilized with medial tension band wire.

    Post-Surgical Care

    • Compressive wrap for 3 to 5 days to prevent soft tissue swelling
    • Cover external fixation connectors with tape and gauze
    • Small pins, wires, and screws generally do not need to be removed.
    • Large intramedullary pins can be removed.
    • Plates can be removed in cases of chronic infection, drainage, pain with cold temperatures, or bone atrophy.
    • In cases of subtotal colectomy, postoperative care should include pain management, minimizing inflammation, and promoting distal extremity movement.

    ### Mandibular Fractures and Dislocations

    • Mandibular Fractures: approximately 15% of all fractures in cats.
    • Mandibular Canal: Contains the mandibular artery, vein, and alveolar nerve.
    • Ramus Fractures: Typically, do not require surgical treatment due to minimal displacement.
    • Condylectomy: Might be performed for mandibular ramus fractures if the cat develops difficulty opening their mouth.
    • TMJ Dislocations: Commonly caused by trauma.
    • Midline Maxillary Separations: Also known as traumatic cleft palate, frequently occur in cats. Wide defects require surgical closure.
    • Maxillary Body Fractures: Majority do not need surgical intervention. Stabilization techniques used for mandibular fractures can be applied.
    • Postoperative Care for Maxillary and Mandibular Fractures: Ensure adequate nutrition through gastrostomy or esophagostomy feeding tubes. If a feeding tube is not used, feed soft gruel. Strict cage confinement for minimal displacement.

    Scapulohumoral Joint and Scapula Fractures

    • Scapulohumoral Joint: Requires osteotomy of the acromion or greater tubercles due to surrounding tendons and muscles.
    • Scapular Body Fractures: Commonly transverse or oblique. Cage rest is preferred due to the scapula's thin nature.
    • Spine of the Scapula Fractures: Do not require surgery.
    • Acromion Fractures: Surgical intervention with tension band or lag screw fixation is necessary.
    • Scapular Neck Fractures: Require surgery for fixation, protecting the suprascapular nerve.
    • Supraglenoid Tubercle Fractures: Surgical fixation is needed. Be cautious in immature animals because the secondary ossification center of the supraglenoid tubercle can be mistaken for a fracture.
    • Glenoid Fractures: Surgical fixation is necessary.
    • Prognosis for Scapular and Scapulohumoral Fractures: Good for healing and normal function with proper stabilization.

    Osteosarcoma

    • Commonly affects larger-breed dogs.
    • Affects appendicular skeleton, long bones (especially the radius and ulna, tibia, and femur), and flat bones such as the scapula or pelvis.
    • A malignant tumor derived from bone-forming cells.
    • Metastases occur often, particularly to the lungs, regional lymph nodes, and other bones.
    • Clinical signs: lameness, swelling, pain at the site of the tumor.
    • Diagnosis is crucial for successful treatment and determining a prognosis.
    • Diagnosis: Multiple diagnostic tools include radiographs, biopsies, and cytologic exams.

    Treatment for Osteosarcoma

    • Complete removal of the tumor with wide normal margins is mandatory.
    • Limb-sparing amputation: Involves amputating the tumor-affected limb, preserving the function of the remaining limb.
    • Amputation: An extreme measure, considering the potential for metastasis.
    • Metastases: Often found in the lungs.
    • Chemotherapy: Frequently used in conjunction with surgery to increase survival time and minimize the risk of tumor recurrence.

    General Principles of Orthopedic Surgery

    • Preoperative Considerations: Thorough physical exam, bloodwork, radiographs, and possibly CT or MRI scans.
    • Postoperative Care: Pain control, reducing post-surgical inflammation, and encouraging movement of the distal extremity. Obtain radiographs to monitor healing progress.

    Patellar Luxation

    • Common in miniature breeds (Medial luxations) and large & giant breeds (Lateral luxations).
    • Often congenital or developmental.
    • Contributing factors: Angle between the head and neck of the femurs, bowing of the distant femur, shallow trochlear groove, increased internal or external tibial rotation, and malpositioned tibial tuberosity.

    Grading of Patellar Luxation

    • Grade I: The patella is in the groove but can be manually subluxated or luxated.
    • Grade II: Clinical spontaneous luxation; the patella can be manually luxated but reduces spontaneously.
    • Grade III/IV: The patella readily luxates and stays luxated, requiring surgical correction.

    Cranial Cruciate Ligament Rupture

    • Acute onset of rear-limb lameness usually during exercise.
    • Chronic lameness may be present in older, overweight dogs.
    • Firm swelling on the medial aspect of the joint.

    Diagnosing Cranial Cruciate Ligament Rupture

    • Cranial drawer sign.
    • Tibial compression test.

    Surgical Techniques for Cranial Cruciate Ligament Rupture

    • Intracapsular: Stabilization from within the joint.
    • Extracapsular: Stabilization outside the joint

    Meniscus Tear

    • Can occur at the same time as a cranial cruciate ligament rupture.
    • Diagnosing by auditory or palpatory click during joint motion.
    • Surgery indicated to remove or repair the menisci.

    Collateral Ligament Disruptions

    • Caused by severe varus (medial) or valgus (lateral) stress to the stifle.
    • First Degree: Stretching and minor disruption of collagen fibers. Rest and restricted exercise is the treatment.
    • Second Degree: Partial tearing, requiring rest and restricted exercise.
    • Third Degree: Complete rupture, needing surgical repair.

    Stifle Luxation

    • Caused by severe trauma.
    • Usually requires external fixations.

    Tarsal Joint Injuries

    • Includes the tibia, fibula, talus, calcaneus, and the central and distal tarsal bones.

    Distal Tarsal/Tarsometatarsal Subluxation with Plantar Instability

    • Less common than proximal subluxation injury.
    • Usually associated with trauma.
    • Treated with arthrodesis of the distal intertarsal joint.

    Intertarsal-Tarsometatarsal Subluxation Injuries

    • Proximal intertarsal subluxations: No trauma, periodic lameness, treatment with rigid splints.
    • Distal intertarsal subluxation: Valgus deformity, stabilized with tension band wire.
    • Tarsometatarsal subluxation: Stabilized with medial tarsometatarsal arthrodesis.

    Postoperative Care for Tarsal Joint Injuries

    • Maintain the limb in a functional standing angle.
    • A cast is recommended for 4-12 weeks.
    • Slowly increase activity following cast removal.

    Tibial Plateau Leveling Osteotomy (TPLO)

    • A specialized procedure for cranial cruciate ligament laxity, aimed at eliminating tibial thrust.
    • The tibial plateau is leveled to almost perpendicular to the tibia's long axis.
    • Requires an intact caudal cruciate ligament and is suitable for large or giant breeds and active dogs.
    • TPLO requires specialized equipment.

    Distal Femur Fractures

    • Involve the metaphysis, condyles, trochlea, and patellar tendon.
    • Treatment depends on the location, severity, and age of the animal.

    Principles of Stifle Surgery

    • Dog positioned in dorsal recumbency.
    • An arthrotomy is performed to examine all structures.

    Treatment for Fractures

    • Surgical fixation is often required for stable fracture healing.
    • Internal fixation: Using plates, screws, wires, or pins.
    • External fixation: Using pins or wires attached to an external frame.

    Postoperative Care

    • Pain management.
    • Antibiotics to prevent infection.
    • Restricted activity to allow for proper healing.

    Prognosis

    • Depends on the nature and severity of the fracture, the age of the animal, and the effectiveness of the chosen treatment method.

    Elbow Fractures

    • Supracondylar fractures require rigid internal fixation, possible methods include Steinmann pins, double Rush pins or small bone plates.
    • Condylar fractures frequently affect the lateral portion of the condyle.
    • Spaniels and Rottweilers can have a heritable defect where the humeral condyle does not fully ossify
    • Mid-shaft radial and ulnar fractures are often the result of trauma, falling or jumping.
    • Open fractures of the distal radius and ulna are common.

    Radius and Ulna Fractures

    • The radius is the main weight-bearing bone in the forelimb.
    • Radius and ulna arteries supply blood, the radial, median and ulnar nerves supply the antebrachium and paw.
    • General surgical goals include early return to weight bearing and preserving neurovascular structures.
    • Postoperative care includes soft padded bandages and radiographic reevaluation every 3-4 weeks.
    • Olecranon fractures require the tension band principle to counteract the forces of the triceps.

    Distal Metaphyseal Fractures

    • These fractures are prevalent in small dogs and can lead to nonunion if unstable.
    • Treatment involves aligning the fracture with compression and inserting a cancellous bone graft.

    Growth Deformities of Radius and Ulna

    • Deformities arise from trauma and disruption of blood supply to the physis, resulting in synostosis of the radius and ulna.
    • The physes of the radius and ulna close at about 7-9 months old in dogs.

    Elbow Luxation

    • Elbow luxations can be treated by closed reduction within 3 days of injury.
    • Surgical reduction is difficult and requires maintaining elbow extension to maintain reduction.
    • Postoperative care includes analgesics, padded bandages, and a lateral splint.

    Caudal Cruciate Ligament Rupture

    • Caudal cruciate ligament ruptures are rare and present with acute lameness and caudal drawer sign.

    Meniscal Problems

    • Isolated meniscal tears are rare and are usually associated with partial or complete cranial cruciate tear.

    Tarsal Fractures

    • Distal intertarsal subluxation is less common than proximal subluxation.
    • Proximal intertarsal subluxations are often associated with trauma and treated with arthrodesis of the distal intertarsal joint.
    • Distal intertarsal subluxation presents as a valgus deformity and is stabilized using tension band wire.
    • Tarsometatarsal subluxation is stabilized using medial tension band wire.

    TMJ

    • Daily flushing with chlorhexidine solution can help with temperomandibular joint (TMJ) disorders.
    • The prognosis for TMJ disorders is typically good.
    • Malocclusion is a common complication associated with TMJ disorders.
    • Osteomyelitis is a rare complication.

    Extracranial Fractures

    • Can occur in the nuchal crest, sagittal crest, or frontal sinus.
    • Neurologic examination is crucial before any procedure.
    • Most extracranial fractures are managed conservatively.
    • Surgery is required for severe displacement.
    • Monitor for neurological function post-surgery.
    • Subcutaneous emphysema can result from frontal sinus fractures.

    Intracranial Fractures

    • Perform a neurological examination before surgery.
    • Most are closed fractures.
    • Calvarial fractures are often linked to central nervous system (CNS) compromise.
    • Surgical procedures include elevating depressed calvarial fractures and removing comminuted pieces.
    • Monitor for neurological function after surgery.
    • Prognosis for neurological recovery is guarded.

    Mandibular Symphyseal Separations

    • Common in cats.
    • Wire stabilization is the preferred technique.

    Mandibular Body Fractures

    • Create a muzzle using tape for minimal displacement of fragments.
    • This method is difficult for cats or brachycephalic breeds
    • Maxillary-mandibular fixation involves wiring the maxilla to the mandible or using acrylic bonding of the canine teeth.
    • Interfragmentary wiring is suitable for stable fracture fragments without bone loss or comminution.
    • Intraoral acrylic splints can be used.
    • External skeletal fixation is best for open, comminuted fractures or those involving bone loss.
    • Understanding anatomy is critical for successful treatment.
    • Complications include infection, dysphagia, laryngeal paralysis, and surgical failure.
    • Pain management, antibiotics, and an Elizabethan collar are essential for 2 weeks post-surgery.
    • Restrict exercise for 4 to 6 weeks.

    Caudal Cervical Spondylomyelopathy (Wobbler Syndrome)

    • Affects the dorsal and ventral components of the cervical spine.
    • Dorsal components include the dorsal vertebral lamina, articular facets, joint capsule, and ligamentum flavum.
    • Ventral components comprise the vertebral bodies, dorsal fibers of the annulus fibrosus of the intervertebral disc, and the dorsal longitudinal ligament.
    • Occurs in two dog populations: young Great Danes with bony malformations and older dogs with degenerative changes.

    Maxillary Neoplasia

    • The ventral surgical approach is more challenging but has a better success rate.
    • Maxillectomies involve significant blood loss, necessitating blood replacement options.
    • Administer NSAIDs and fentanyl patches for pain management.
    • Utilize a cuffed endotracheal tube during surgery.
    • Administer antibiotics.
    • The aim is to completely remove the neoplasm while preserving local blood supply.
    • Procedures include maxillectomy, hemimaxillectomy, and mandibulectomy.
    • Postoperative care includes pain control, an Elizabethan collar to prevent self-mutilation, and a diet of soft gruel for a month.
    • Flush the oral cavity after eating and maintain a healthy diet.
    • Monitor for metastasis every 3 months for the first year.
    • Complications include infection, dysphagia, laryngeal paralysis, and surgical failure.

    Premature Closure of the Distal Ulnar Physeal

    • Obtain radiographs and determine if physes are open or closed.
    • Splinting is required in immature dogs, with radiographic re-evaluation every 3 weeks.
    • Prognosis is guarded for mature dogs with severe deformities.
    • Surgical procedures aim to correct angular deformities and maintain limb length.
    • A section of the ulna is removed to allow radial growth and prevent regrowth.
    • In mature dogs, an osteotomy of the radius is performed at the point of maximum curvature.

    Premature Closure of the Proximal Radial Physeal

    • For mature dogs, the objective of surgery is to re-establish elbow joint congruity and correct angular deformities.

    Traumatic Luxation of the Elbow

    • Lateral luxation is common due to the larger medial condyle of the humerus.
    • Clinical signs include acute non-weight-bearing lameness, foot and antebrachium abduction.
    • Flex the elbow and inwardly rotate the antebrachium to reduce the luxation.
    • Restrict activity for 8 weeks.

    Hip Dysplasia

    • Most common orthopedic disorder in dogs.
    • Develops when the femoral head and acetabulum don't properly fit together.
    • Predisposing factors include: genetics, rapid growth, nutrition and exercise.
    • Evaluate puppies from 4 to 6 months old to identify hip dysplasia.
    • A lack of congruity between the femoral head and acetabulum results in degenerative joint disease.
    • Clinical signs: lameness, bunny hopping, stiffness, muscle atrophy.
    • Radiographic evaluation at 12 months.
    • Treatment options include: surgery, conservative (medication, physical therapy, weight control)
    • Surgical options include:
      • Femoral osteotomy: Performed in mature dogs, realigns the femoral head and acetabulum.
      • Triple pelvic osteotomy: Corrects the angle of the acetabulum.
      • Femoral head and neck excision arthroplasty: Removal of the femoral head and neck.
      • Pectineal myectomy: Removal of the pectineus muscle to decrease tension on the medial aspect of the joint capsule.
      • Total hip replacement: Performed in dogs over 40 lbs.

    Stifle (Knee) Injuries

    • Caudal cruciate ligament (CCL) rupture is the most common stifle injury in dogs.

    • Causes include trauma, overuse, and degenerative changes.

    • Rupture results in instability of the stifle joint.

    • Clinical signs: lameness, joint effusion, pain and instability.

    • Treatment options include:

      • Conservative: medications, physical therapy, and weight management.
      • Surgical: Repair of CCL using various techniques
      • Lateral suture: Sutures placed on the lateral aspect of the stifle to tighten the lateral joint capsule.
      • Tibial plateau leveling osteotomy (TPLO): Resects a portion of the tibial plateau to reduce joint instability.
      • Tibial tuberosity advancement (TTA): Advances the tibial tuberosity to increase the tension on the patellar tendon and stabilize the joint.
      • Partial CCL repair: Utilizes a suture technique to partially stabilize the joint.

    • Surgical Techniques:

      • Lateral suture: Utilizes sutures on the lateral aspect of the stifle to tighten the joint capsule.
      • TPLO: Requires a bone cut on the tibial plateau, which allows for realignment of the tibial plateau and reduces the joint instability.
      • TTA: Involves relocating the tibia to reduce joint instability.
      • Partial CCL repair: Uses sutures to partially stabilize the joint.

    Fractures and Dislocations of the Carpus

    • Usually caused by trauma.
    • Isolated carpal fractures are uncommon, frequently occurring in greyhounds or working dogs.
    • Articular surface involvement necessitates rigid fixation.

    Anatomy of the Carpus (Wrists)

    • Seven bones in two rows.
    • Proximal row consists of the radial, ulnar, and accessory carpal bones.
    • Distal row includes the C1, C2, C3, and C4 carpal bones.
    • The radial bone is the largest, located medially, and articulates with the radius and C1-C4.
    • The ulnar carpal bone is lateral and articulates with the ulna and C3 and C4.
    • Ligaments:
      • Radial collateral ligament: Spans from the styloid process of the radius to the radial carpal bone.
      • Ulnar collateral ligament: Spans from the styloid process of the ulna to the ulnar carpal bone.
      • Flexor retinaculum: Supports the palmar aspect of the carpus.

    Fractures of the Femur

    • Femur fractures are common, especially in large breed dogs.
    • Consider the peroneal and saphenous nerve location caudal to the femur.
    • Lateral, medial, or cranial approaches are utilized for surgery.
    • Fixation options include pins, plates, or screws.

    Anesthetic Considerations

    • Endotracheal intubation: Requires a pharyngotomy incision
    • Antibiotic administration: Essential due to open nature of many maxillary fractures

    Squamous Cell Carcinoma (SCC)

    • Second most common oral tumor in dogs, most common in cats
    • Nontonsillar SCC: Locally invasive, slow metastasis
    • Tonsillar SCC: Highly aggressive, rapid metastasis to lymph nodes and lungs
    • Treatment: Wide surgical resection, with or without radiation therapy, chemotherapy is an option
    • Prognosis: Guarded due to high recurrence rates

    Fibrosarcoma

    • Predisposes dogs to fractures
    • Treatment: Complete surgical resection, radiation therapy offers moderate success, chemotherapy is not effective

    Atlantoaxial Instability

    • Anatomy: Pivot joint allowing head rotation
    • Causes: Congenital malformations (most common), seen in young, small and toy-breed dogs
    • Diagnosis: Radiographic examination
    • Treatment: Surgery (usually necessary), stabilization with pins, wires or bone plates

    Fractures of the Radius and Ulna

    • Commonly seen
    • Causes: Trauma, falling, jumping
    • Anatomy: Radius (main weight-bearing bone, shorter than ulna), ulna (longest bone in the body), arterial supply (radial, interosseous), nerve supply (radial, median, ulnar)
    • Preoperative considerations: Evaluate concurrent injuries, neurologic function
    • General surgical objectives: Early weight bearing, neurovascular structure preservation
    • General postoperative care: Soft padded bandage for swelling reduction, radiographic reevaluation, activity restriction
    • Complications: Nonunion, malunion, infection, growth deformities

    Intercondylar Fractures of the Humeral Condyles

    • Difficult to Repair: Involve splitting of the condyles and supracondylar fracture
    • Fixation: Condyles are fixed together first followed by the supracondylar fracture
    • Complications: Lameness, osteoarthritis

    Fractures and Growth Deformities of the Radius and Ulna

    • Types of Fractures: Distal radius and ulna, proximal radial physis, distal ulnar physis, mid-shaft radial and ulnar
    • Premature Closure of Physis: Can cause growth deformities
    • Treatment: Surgical procedures for correction, may involve osteotomy and bone grafting

    Fractures and Dislocations of the Carpus

    • Causes: Trauma
    • Anatomy: Seven bones arranged in two rows (proximal and distal), radial bone (largest, medially located), ulnar carpal bone (lateral)
    • Treatment: Rigid fixation, osteotomy (corrects angular deformities)
    • Complications: Nonunion, malunion, infection, growth deformities

    Luxation, Subluxation, and Shearing Injuries of the Tarsal Joint

    • Anatomy: Tarsus (tibia, fibula, metatarsal bones, and seven tarsal bones), tarsocrural joint (tibia/fibula and talus/calcaneus), intertarsal joints (between tarsal bones)
    • Treatment: Usually requires surgery, stabilization with plates and screws
    • Complications: Chronic instability, arthritis

    General Notes

    • Growth plates (physis): Present in young, growing animals, injuries can lead to premature growth cessation
    • Metaphysis: Region between physis and diaphysis
    • Diaphysis: Shaft of the bone, subject to bending and torsional forces, fractures heal slowly
    • Infection: Aggressive treatment is crucial to prevent osteomyelitis and nonunion

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    Description

    This quiz covers the critical aspects of spinal fractures and dislocations, including the mechanisms of injury and their clinical signs. It specifically discusses the vertebrae most vulnerable to injury, especially in dogs. Test your knowledge on managing these conditions in veterinary practice.

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