LET%20IT%20GO!

1
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

2
TRAUMA METHODS OF FIXATION
External fixators are pins that penetrate the
skin and bones that are attached to fixed bars or
acrylic using special clamps
3
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

4
Ligament Injury Anterior Cruciate Ligament

• ACL and PCL (posterior cruciate ligament)
  stabilize knee joint
• Intra-articular structures
• Ruptured ACL __________ common knee injury gt
  DJD
• May be complete rupture or partial tear gt
  unstable joint gt DJD

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Anterior and Posterior Cruciate Ligaments
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TRAUMA CRUCIATE LIGAMENT INJURY/RUPTURE
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TRAUMA CLINICAL SIGNS OF CRANIAL CRUCIATE
LIGAMENT INJURY/RUPTURE
Middle-aged obese dog
Highly active, athletic animals __________________
_
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TRAUMA CLINICAL SIGNS OF CRANIAL CRUCIATE
LIGAMENT INJURY/RUPTURE
Animal is non wt. bearing on the rear leg
Exercise ____________ stifle joint
Joint effusion
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TRAUMA CCL RUPTURE
Cranial drawer test ______ in CCL
Tibial compression test stabilize the dogs femur
with one hand, while flexing the ankle with the
other tibia goes _______________
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TRAUMA CRANIAL CRUCIATE LIGAMENT RUPTURE
http//www.youtube.com/watch?v9jg9E2nBt_Efeature
related
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TRAUMA CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR
Extra-articular Stabilization
Most successful in patients less than
___________ From flabella to tibial crest and
imbrication of joint
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TRAUMA CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR
Intra-articular stabilization Over-the-top
patellar tendon graft The graft is usually passed
through drill holes in the femur and tibia and,
is attached to the soft tissues of the femur or
tibia.
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TRAUMA CRANIAL CRUCIATE LIGAMENT RUPTURE
http//www.youtube.com/watch?v4nU2QZjjByg
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TRAUMA CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR
Intra-articular stabilization technique
TPLO ________________________________________
15
TRAUMA CRANIAL CRUCIATE LIGAMENT RUPTURE
http//www.youtube.com/watch?v-1pxxX4TXkofeature
fvw
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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

17
ACCEPT YOURSELF

• Theres a period of life when we swallow a
  knowledge of ourselves and it becomes either good
  or sour inside.
• - Pearl Bailey

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POOR CONFORMATION LUXATING PATELLA
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POOR CONFORMATION LUXATING PATELLA
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POOR CONFORMATION LUXATING PATELLA
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POOR CONFORMATION LUXATING PATELLA
PATELLA IN GROOVE
PATELLA OUT OF GROOVE
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POOR CONFORMATION
______________ STANCE MAY OCCUR IN MEDIAL
LUXATIONS
KNOCK-KNEED/PIGEON-TOED, OR _________________
STANCE MAY OCCUR IN LATERAL LUXATIONS
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POOR CONFORMATION TREATMENT OF PATELLAR LUXATION
____________________ RESECTION
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POOR CONFORMATION TROCHLEAR WEDGE RESECTION
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POOR CONFORMATION _______________________________
________TRANSPOSITION
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POOR CONFORMATION TIBIAL CREST TRANSPOSITION
27

• http//video.google.com/videosearch?hlenqpatell
  aluxationsurgeryum1ieUTF-8saNtabwv
• http//www.youtube.com/watch?vGfnQbIk284g

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POOR CONFORMATION HIP DYSPLASIA
YOUNG DOGS AND MATURE ANIMALS WITH CHRONIC DISEASE
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POOR CONFORMATION HIP DYSPLASIA
HX Decreased activity Difficulty
rising Reluctance to run, jump,
climb Intermittent or persistent hind limb
lameness worse after exercise Bunny hopping or
swaying gait Narrow hind limb stance
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POOR CONFORMATION HIP DYSPLASIA
Poor conformation combined with genetic,
environmental and nutritional factors
31
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

32
POOR CONFORMATION HIP DYSPLASIA
http//www.youtube.com/watch?v2rRKDheDrLsNR1
http//www.youtube.com/watch?vSHCIT87jY0Mfeature
related
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POOR CONFORMATION HIP DYSPLASIA and OFA
CERTIFICATION
Orthopedic Foundation for Animals
OFA requires animals to be gt2 yr of age
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POOR CONFORMATION HIP DYSPLASIA and OFA
CERTIFICATION
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HIP DYSPLASIA and OFA CERTIFICATION
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HIP DYSPLASIA TREATMENT
NSAIDs
NEUTRICEUTICALS
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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 - lt 20 good musculature
• Abnormal gait
• Triple Pelvic Osteotomy

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HIP DYSPLASIA TREATMENT
TRIPLE PELVIC OSTEOTOMY
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HIP DYSPLASIA TREATMENT
FEMORAL HEAD OSTECTOMY
False joint forms from scar/fibrous tissue
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HIP DYSPLASIA TREATMENT
artreality.com
www.kahalapethospital.com/yahoo_site_admin/as...
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Hip dysplasia

• http//www.youtube.com/watch?vHTwi8TRs6z8

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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