Clinical investigation of the lame dog

Lameness is a common clinical problem in the dog and a proportion of cases present problems in diagnosis. A systematic approach to their investigation involves history taking, observation of gait and inspection, palpation and manipulation of the suspect limb or limbs. This should allow the clinician to localise and, in many cases, characterise the problem in terms of the likely underlying disease process. This knowledge will then allow recommendations to be made as to the employment of ancillary diagnostic aids.     

Morphology and correction of distal tibial valgus deformities

OBJECTIVES: To characterise distal tibial valgus deformities in dogs through physical examination and radiographic evaluation. Methods: In a clinical study of 16 client-owned dogs, twelve unilateral and four bilateral distal tibial valgus deformities were evaluated using palpation and radiographs. The origin and amplitude of angulation, rotation and length deficits if present were measured. Radiographically, fibular length and position in relation to the tibia was compared in affected and clinically normal limbs. The dimensions of the fibular physes were also compared between clinically normal and affected limbs. RESULTS: Rottweilers and Shetland sheepdogs were overrepresented. Valgus deformities ranged from 16 degrees to 48 degrees (median, 32 degrees ) in affected and from 0 degrees to 13 degrees (median, 6 degrees ) in contralateral, clinically normal limbs. Fibular length, fibular position relative to the tibia or physeal dimensions were not statistically different between affected and clinically normal limbs. CONCLUSION AND CLINICAL RELEVANCE: Many distal tibial valgus deformities in dogs are a uniplanar deformity without concurrent craniocaudal or rotational changes or length deficits. A growth cessation in the fibula does not appear to be responsible for the development of the deformity.     

Transcutaneous tibial implants: a surgical procedure for restoring ambulation after amputation of the distal aspect of the tibia in a dog

Objective— To report surgical planning, technique, and long-term outcome of custom transcutaneous tibial implants used to restore ambulation after bilateral pelvic limb amputation in a dog.
Study Design— Case report.
Animals— A 4-year-old, 25.5 kg, female spayed, Siberian Husky.
Methods— Computed tomographic scans of the pelvic limbs were used to build sterolithographic models of the remaining tibia after bilateral amputation of the distal aspect of the tibiae. The sterolithographic models facilitated fabrication of implants that would replace the missing distal segments of the tibiae. Custom implants were surgically placed in both limbs.
Results— Assisted ambulation was restored immediately postoperatively and unassisted locomotion occurred at 7 days. At 14 months, aseptic loosening of the right implant occurred, it was removed and a 2nd transcutaneous implant was fabricated and implanted. At 26 months after initial surgery and 17 months after revision of the right implant, function is restored at a walk, trot, and run.
Conclusion— Based on over a 2-year follow-up, transcutaneous tibial implants allowed for restoration of locomotion.
Clinical Relevance— Transcutaneous tibial implants offer a potentially viable treatment option for restoring ambulation after amputation of the distal aspect of the tibiae in the dog.     

A lag-screw technique for bridging of the medial aspect of the distal tibial physis in horses

A lag-screw technique for transphyseal bridging of the medial aspect of the distal tibial physis in foals with tarsal valgus deformities and results of the technique in 11 foals (6 with bilateral tarsal valgus deformities and 5 with unilateral tarsal valgus deformities) are described. Briefly, horses were anesthetized, and a single stab incision was made through the skin to the underlying bone over the most distal aspect of the medial malleolus. A 20-gauge needle was placed in the incision to guide screw placement, and a lag screw was inserted parallel to the medial cortex of the tibia under radiographic guidance. Screws were removed when the tarsal valgus deformity was clinically assessed to have improved by at least 80%. Clinically, all horses had evidence of a tarsal valgus deformity of > 7 degrees prior to surgery. Mean age at the time of lag-screw implanation was 220 days (range, 116 to 364 days). Mean time the implant was in place was 62 days (range, 39 to 89 days). The tarsal valgus deformity resolved in all 11 horses with excellent cosmetic results.     

Treatment of fractures of the tibial tuberosity in the dog.

Of 27 dogs with fractures of the tibial tuberosity, 24 were treated by various methods of open reduction. Follow-up examination was obtained in 21 cases, and it was found that all but one fracture healed in 8 weeks. Tension band wiring and single interfragmentary screws were most commonly used; healing was similar in both groups.     

Fractures of the distal femur in the dog and cat

A series of fractures of the distal femur in the dog and cat are described and classified anatomically from radiographs. Treatment is discussed and the long-term results of surgery in twenty-four cases are described.     

Single condylar fractures of the distal femur in the dog

Nine dogs with single condylar fractures of the distal femur are described. In eight of the nine animals the medial condyle had fractured. Trauma is important in the production of this fracture as seven of the nine affected animals had a clinical history of having been suspended by the affected leg and struggling to free it. Clinically, pain and collapse of the medial compartment of the joint were the most obvious features. Confirmation of diagnosis was obtained by radiography. In the case of fracture of the medial condyle a lateral view showing caudal displacement of the condyle was most useful. Once identified the condyle was replaced surgically using combinations of pins and screws. Secure fixation allowed healing of the fracture and a successful outcome.     

An 'over-the-top with tibial tunnel' technique for repair of cranial cruciate ligament rupture in the dog

This paper describes a modification of the ‘over-the-top’ technique for cranial cruciate ligament substitution in the dog. The results are subjectively evaluated in 70 cases.