LET IT GO! “People have a hard time letting go of their suffering. Out of a fear of the unknown, they prefer suffering that is familiar.” -Thich Nhat Hahn.

LET IT GO!“People have a hard time letting go of their

suffering. Out of a fear of the unknown, they prefer suffering that is familiar.”

-Thich Nhat Hahn

TRAUMA: METHODS OF FIXATION

External fixators are pins that penetrate the skin and bonesthat are attached to fixed bars or acrylic using special clamps

Bone Fractures – Client Info

• Restrict ____________________

• Watch for drainage, swelling, heat

• Metal (plate, pin) stronger than bone ___________ may occur

• Follow up x-rays necessary

• Metal should be removed after healing

• Metal may cause __________ sensitivity

Ligament Injury – Anterior Cruciate Ligament

• ACL and PCL (posterior cruciate ligament) stabilize knee joint

• Intra-articular structures

• Ruptured ACL – __________ common knee injury => DJD

• May be complete rupture or partial tear => unstable joint => DJD

Anterior and Posterior Cruciate Ligaments

TRAUMA: CRUCIATE LIGAMENT INJURY/RUPTURE

TRAUMA: CLINICAL SIGNS OF CRANIAL CRUCIATE LIGAMENT INJURY/RUPTURE

Highly active, athletic animals___________________

Middle-aged obese dog

TRAUMA: CLINICAL SIGNS OF CRANIAL CRUCIATE LIGAMENT INJURY/RUPTURE

Animal is non wt. bearing on therear leg Exercise: ____________ stifle joint

Joint effusion

TRAUMA: CCL RUPTURECranial drawer test ______ in CCL

Tibial compression teststabilize the dog’s femur with one hand, while flexing the ankle with the other: +tibia goes _______________

TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE

http://www.youtube.com/watch?v=9jg9E2nBt_E&feature=related

TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR

Extra-articular Stabilization

*Most successful in patients less than ___________From flabella to tibial crest and imbrication of joint

TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR

Intra-articular stabilization – Over-the-top patellar tendon graftThe graft is usually passed through drill holes in the femur and tibia and, is attached to the soft tissues of the femur or tibia.

TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE

http://www.youtube.com/watch?v=4nU2QZjjByg

TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR

Intra-articular stabilization techniqueTPLO – ________________________________________

TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE

http://www.youtube.com/watch?v=-1pxxX4TXko&feature=fvw

ACL – Client info

• Restrict activity 3-4 weeks post surgery– Cage rest– Leash walk only to urinate and defecate

• Gradually increase exercise 4-8 wks post sx• Full activity 8-12 weeks• Opposite cruciate often tears within _____________• Weight loss helps• DJD of stifle joint likely• If no surgery, joint thickens - fibrosis

ACCEPT YOURSELF

“There’s a period of life when we swallow a knowledge of ourselves and it

becomes either good or sour inside.”- Pearl Bailey

POOR CONFORMATION: LUXATING PATELLA

POOR CONFORMATION: LUXATING PATELLA

POOR CONFORMATION: LUXATING PATELLA

POOR CONFORMATION: LUXATING PATELLA

PATELLA INGROOVE

PATELLAOUT OFGROOVE

POOR CONFORMATION

KNOCK-KNEED/PIGEON-TOED, OR_________________ STANCE MAY OCCURIN LATERAL LUXATIONS

______________ STANCE MAY OCCURIN MEDIAL LUXATIONS

POOR CONFORMATION: TREATMENT OF PATELLAR LUXATION

____________________ RESECTION

POOR CONFORMATION: TROCHLEAR WEDGE RESECTION

POOR CONFORMATION: _______________________________________

TRANSPOSITION

POOR CONFORMATION: TIBIAL CREST TRANSPOSITION

• http://video.google.com/videosearch?hl=en&q=patella+luxation+surgery&um=1&ie=UTF-8&sa=N&tab=wv#

• http://www.youtube.com/watch?v=GfnQbIk284g

POOR CONFORMATION: HIP DYSPLASIA

YOUNG DOGS AND MATUREANIMALS WITH CHRONICDISEASE

POOR CONFORMATION: HIP DYSPLASIA

HXDecreased activity

Difficulty risingReluctance to run, jump, climb

Intermittent or persistent hind limb lameness; worse after exerciseBunny hopping or swaying gaitNarrow hind limb stance

POOR CONFORMATION: HIP DYSPLASIA

Poor conformation combined with genetic, environmental and nutritional factors

Hip Dysplasia – PE

• Pain on palpation of hips

• Joint laxity (positive ______________ sign) – early disease – subluxation of hip

• Crepitus

• Decreased ROM of hip joints

• Atrophy of thigh muscles

• Hypertrophy of shoulder muscles

POOR CONFORMATION: HIP DYSPLASIA

http://www.youtube.com/watch?v=2rRKDheDrLs&NR=1

http://www.youtube.com/watch?v=SHCIT87jY0M&feature=related

POOR CONFORMATION: HIP DYSPLASIA and OFA CERTIFICATION

Orthopedic Foundation for Animals

OFA requires animals to be >2 yr of age

POOR CONFORMATION: HIP DYSPLASIA and OFA CERTIFICATION

HIP DYSPLASIA and OFA CERTIFICATION

HIP DYSPLASIA TREATMENT

NSAIDs

NEUTRICEUTICALS

Hip Dysplasia – Treatment

• Surgical– Total hip replacement

• Salvage procedure in mature dogs with severed DJD unresponsive to medical Tx

• Pain free in 90% of cases• Unilateral replacement provides acceptable function in ________

of cases– Excision Arthroplasty or Femoral Head Ostectomy

• Forms _______________ joint• Removal of femoral head and neck to prevent joint pain• Salvage procedure when medical treatment not working and other

sx too expensive• Best - < 20#; good musculature• Abnormal gait

– Triple Pelvic Osteotomy

HIP DYSPLASIA TREATMENTTRIPLE PELVIC OSTEOTOMY

HIP DYSPLASIA TREATMENT

FEMORAL HEAD OSTECTOMY

“False joint” forms from scar/fibrous tissue

HIP DYSPLASIA TREATMENT

www.kahalapethospital.com/yahoo_site_admin/as...

artreality.com

Hip dysplasia

• http://www.youtube.com/watch?v=HTwi8TRs6z8

Hip Dysplasia – Client Info

• __________________ important to decrease load on painful joint

• Swimming excellent activity

• Physiotherapy – decreases joint stiffness, helps maintain muscle integrity

• Joint degeneration progressive

• May be heritable – _______________________

• Special diets designed for fast growing dogs may decrease severity