Dorso-medial ante-brachiocarpal luxation with radio-ulna luxation in a domestic shorthair

An 8-year-old domestic shorthair was admitted with non-weight bearing left forelimb lameness. Examination and radiographs revealed dorso-medial ante-brachiocarpal luxation with palmar luxation of the distal radio-ulnar joint. Primary repair was performed and stabilised using an arthrodesis wire and type Ia Kirschner-Ehmer (K-E) external skeletal fixator (ESF). The cat regained excellent pain-free limb function by 14 weeks with only minor reduction in range of movement. This is the first case report of a cat with distal radio-ulnar joint luxation associated with ante-brachiocarpal luxation. Primary repair of carpal luxation in the cat should be considered before arthrodesis.     

A novel surgical treatment of type 3 congenital elbow luxation in a dog

Congenital luxation of the ulnar and radius is a rare orthopaedic condition in the dog. This case report describes a novel surgical treatment for congenital elbow luxation in a medium-breed dog. A 6-week-old Kelpie presented for left forelimb lameness and deformity. Radiographs and computed tomography (CT) confirmed the diagnosis of unilateral ulnar and radius luxation. The surgical repair involved open reduction followed by fixation with an extraarticular pin and a transarticular external fixator. The outcome of surgery was improved leg function and weight-bearing, however, reluxation of the radial head was diagnosed 7 weeks following surgery. This technique may offer an alternative surgical option to improve clinical signs, as well as insight into improving the management of this condition.     

SURGICAL MANAGEMENT OF A TRAUMATIC ELBOW LUXATION WITH CIRCUMFERENTIAL SUTURE PROSTHESES IN A RABBIT (ORYCTOLAGUS CUNICULUS)

A 2-year-old dwarf rabbit was referred for right forelimb lameness of 1-week duration. Physical examination and radiographic findings were consistent with an elbow luxation. Manual reduction under anesthesia was unsuccessful in correcting the luxated joint. A surgical approach was recommended to repair the rabbit elbow luxation. Transcondylar, transradial, and transulnar tunnels were drilled from lateral to medial with 2 suture prostheses being placed, 1 from the radius to the humerus and 1 from the humerus to the ulna. Analgesia was provided and the patient was reevaluated on days 2, 7, and 14 after the procedure. The luxation was reduced and no recurrence was noted a year following the surgical procedure. Circumferential suture prostheses, recently described with no reported postoperative complications in cats, can be used successfully in rabbits as evidenced in this case report.     

Surgical management of suspected congenital luxation of the radial head in three dogs

Abstract

CASE HISTORIES: Three dogs, aged between 11 and 20 weeks, were presented with unilateral forelimb lameness, with an associated bony prominence on the lateral elbow.

CLINICAL FINDINGS AND DIAGNOSIS: Radiographs revealed a caudolateral luxation of the radial head in all cases, consistent with a diagnosis of suspected congenital luxation of the radial head. Surgical reduction and stabilisation involved open reduction of the radial head, and in two cases the use of a trans articular pin.

CLINICAL RELEVANCE: Congenital luxation of the radial head is an uncommon condition that has conflicting reports in the literature regarding its cause, heritability, breed predisposition, treatment and prognosis. The three cases here occurred in young dogs of English Bull Terrier, Jack Russell Terrier, and Staffordshire Bull Terrier breeds. Surgical reduction and stabilisation provided successful outcomes, in all cases. Only six cases of congenital luxation of the radial head managed surgically have previously been reported in the literature.     

Elbow joint luxation in a 1-month-old foal

This paper reports on luxation of the elbow joint without concomitant fracture in a 1-month-old foal. Conservative treatment, with closed reduction and full-limb bandaging, including caudal and lateral splints, seemed successful initially, however, failed to provide enough stability and luxation recurred, and open reduction and surgical placement of prosthetic collateral ligaments was required. Luxation of the elbow joint should be considered when acute non-weight bearing forelimb lameness occurs associated with pain and swelling in the area of the elbow in young foals. Closed reduction failed to provide sufficient joint stability.     

Unilateral congenital elbow luxation in a dachshund

Congenital elbow luxation was diagnosed in a 12-week-old, intact male, dachshund with a lateral elbow prominence and mild lameness of the right forelimb. Closed reduction of the radial head, ulnar ostectomy, and external stabilization of the joint were performed. Function was returned to the limb, but radial head and ulnar subluxation persisted.     

Unilateral congenital elbow luxation in a Cavalier King Charles Spaniel

A 7-week-old, intact female, Cavalier King Charles Spaniel was evaluated for nonweight bearing lameness of the right forelimb. Type III unilateral congenital elbow luxation was diagnosed radiographically. After surgical reduction, temporary placement of a transarticular pin, and external splinting of the joint, full weight bearing was achieved. Radial head subluxation persisted.     

Successful Management of Severe Open Metacarpophalangeal Joint Dorsal Luxation in a Horse

A 3-year-old Darreh-Shuri stallion was presented with left forelimb open dorsal fetlock luxation immediately after being hit by a motorized vehicle. The horse was in a non–weight-bearing position on the affected limb. General physical examination revealed normal vital parameters and no special concurrent abnormality. Radiographic examination in lateromedial and dorsopalmar views of the affected limb showed complete luxation of the metacarpophalangeal joint with no fractures. Ultrasonographic evaluation revealed intact collateral ligaments. Under general anesthesia and following routine preparations, forceful manual pressure was exerted on the distal part of the metacarpus and proximal part of the first phalanx to reduce the luxation. Joint capsule and skin laceration were sutured. Intraarticular amikacin (500 mg) was administered and repeated on the third and fifth days postoperatively. A palmar polyvinyl chloride, synthetic plastic polymer (PVC) splint was placed following adequate padding from the carpus to the toe. The higher and lower third of the splint was casted and the middle part left open to manage the joint and skin lesion. Intraarticular sodium hyaluronate (20 mg) was administered 10 days later. After cast removal following 5 weeks, the stallion revealed no sign of lameness. The owner was instructed to keep the stallion confined to a stall for at least 2 more months with a restricted daily short hand walk. Special casting methods for immobilization of a limb with an open joint luxation can tremendously improve the healing process.     

Successful closed reduction and conservative management with traumatic elbow luxation and medial collateral ligament rupture in an equid

A 9-year-old donkey jenny (212 kg) presented with an acute, nonweight-bearing left forelimb lameness of 24- to 36-h duration. The limb was held in flexion and abduction, with the toe above the ground, and was unable to be manually straightened. There was significant palpable swelling along the medial aspect of the elbow joint. Radiographic evaluation revealed a medial luxation of the elbow joint with rupture of the medial collateral ligament. Closed reduction was accomplished under injectable anaesthesia without complication. The patient was weight-bearing and comfortable on the limb immediately upon recovery from anaesthesia. The jenny was tied and kept standing for 60 days. Full limb bandages, splints (extending proximal to the scapula), hobbles, NSAIDs and cold laser therapy were utilised, decreased and discontinued. At 74 days, a rehab programme was initiated. At 8 months post-injury, the patient was not lame and was back to her previous level of exercise. Although elbow luxation has been described as having a guarded prognosis, there has now been success in 4/5 (80%) reported cases when treatment has been attempted. Closed reduction without surgical intervention in adult animals with elbow luxation can be successful, likely dependent on the level of associated injury.     

Ulnocarpal arthrodesis in a cat

A nine-year-old cat was presented with non-weight-bearing lameness of the right forelimb subsequent to an old fracture of the antebrachium previously treated by external stabilisation. Radiography showed severe atrophic non-union of the distal third of the radius and carpal luxation. Ulnocarpal arthrodesis was performed using a uniplanar external fixator. Follow-up radiography showed that bone fusion was slow but without complication. After 16 weeks, the external fixator was removed, and a Robert-Jones bandage was applied for one month. From postoperative week 2 onwards, the animal progressively made use of the limb in a weight-bearing capacity. At the last examination, one year postoperative, no lameness was observed.     

Bilateral hypoplasia of the minor tubercle of the humerus with medial luxation of the biceps tendon in two Quarter Horses

Two Quarter Horses were examined at the Washington State University Veterinary Teaching Hospital with forelimb lameness. Case 1 was a 4‐year‐old female with a 4 month history of intermittent forelimb lameness that had partially responded to oral anti‐inflammatories. The horse was in full training and actively competing in cutting. Case 2 was a one‐year‐old filly bred for cutting that presented with a right forelimb lameness of 3 weeks’ duration, which was not responsive to oral anti‐inflammatories. The horse was not in training. On lameness examination, Case 1 was grade 1/5 (American Association of Equine Practitioners scale) lame in the left forelimb in a straight line on a hard surface, extension and flexion of the shoulder was resented and exacerbated the lameness. Case 2 was grade 3/5 lame in the right forelimb in a straight line on a hard surface, flexion and extension of the shoulder was resented and exacerbated the lameness. Both horses had a characteristic dished appearance to the dorsal aspect of the shoulder, with prominence of the proximal aspect of the humerus. Ultrasound and proximodistal oblique (skyline) radiographic views of the scapulohumeral joints demonstrated bilateral hypoplasia of the minor tubercle of the humerus with bilateral medial luxation of the proximal biceps tendon in both cases. To the authors' knowledge this is the first report of 2 cases of bilaterally affected horses, as well as the first report of the condition in the Quarter Horse breed.     

Unusual soft tissue orthopaedic problems in the dog

Single cases of supraspinatus and infraspinatus muscle contracture in working sheep-dogs are reported. Both cases showed characteristic abnormal forelimb posture and were successfully treated by complete section of the affected muscle. Three cases of anteromedial shoulder luxation with damage to the biceps brachii tendon are also described. In two of these the tendon was completely severed. The integrity of the biceps tendon is important in maintaining shoulder joint stability and should be inspected when surgical reduction of shoulder dislocations is carried out. Repair of the tendon, if severed, is important. Three cases of lameness associated with tendon displacement are considered i.e. slipping of the biceps brachii, long digital extensor and superficial digital flexor tendons. In two cases the displacement was prevented by the insertion of mattress wire sutures to form a 'lid' over the tendon.     

CASE REPORT: Iridociliary melanoma with secondary lens luxation: distinctive findings in a long‐horned cowfish (Lactoria cornuta)

This report describes a long‐horned cowfish, which was diagnosed with buphthalmia and lens sub‐luxation in the right eye, conditions that progressed to complete anterior lens luxation and secondary keratoconus. Three months after the initial evaluation, a pigmented mass was observed protruding from the vitreous. An enucleation was performed under general anesthesia. Ocular histopathology revealed an iridociliary melanoma. Reports of intraocular melanomas are extremely rare in fish. To the authors’ knowledge, this is the first report of an iridociliary melanoma that led to buphthalmia, lens luxation, and keratoconus in a fish. Histological findings of lens luxation are also demonstrated. Due to the presence of a complex suspensory apparatus involving the teleost lens, this report speculates that lens luxation is a more devastating disease process in teleosts than in mammals.     

A case of dorso-medial luxation of the radial carpal bone in a dog

Luxation of the radial carpal bone is an uncommon injury in the dog and cat. Previous clinical cases have reported palmaro-medial luxation with injury to the short radial collateral ligament. In this study a case of dorsomedial luxation of the radial carpal bone in a 10-year-old female Gordon Setter is described. A closed reduction of the luxation was performed and a conservative treatment was carried out. Thirteen months after the reduction, the dog had a satisfactory limb function, despite the presence of degenerative joint disease of the carpus. A pathogenic hypothesis for this dorso-medial luxation of the radial carpal bone is proposed reproducing the luxation on canine cadavers.     

Inheritance of cataracts and primary lens luxation in Jack Russell Terriers

OBJECTIVE: To characterize heritability and mode of inheritance of cataracts and primary lens luxation in Jack Russell Terriers. ANIMALS: 872 Jack Russell Terriers from which buccal epithelial cells were collected and phenotypes for cataracts and lens luxation were determined and an additional 1,898 Jack Russell Terriers without phenotypic information used to complete pedigree relationships and that were included in the analyses. PROCEDURES: Narrow-sense heritabilities and genetic correlation for cataracts and lens luxation were modeled by use of threshold analysis, whereas complex segregation analysis was used to characterize mode of inheritance. For the analyses, dogs < 6 years old, unless confirmed as having cataracts or lens luxation, were classified as an unknown phenotype. The possible involvement of an HSF4 mutation in cataracts was determined by DNA sequencing. RESULTS: Cataracts and primary lens luxation were highly heritable and genetically correlated, and neither was controlled by a single gene. Cataracts were not associated with an HSF4 mutation. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis of the data indicated that concerted selection against both cataracts and primary lens luxation when choosing breeding animals can be used to improve ocular health in Jack Russell Terriers.     

Treatment of recurrent coxofemoral luxation in a calf by use of open reduction and translocation of the greater trochanter.

A 4-day-old bull calf was admitted for treatment of a coxofemoral luxation. Closed reduction of the luxation was successfully performed on 2 occasions, and the limb was placed in an Ehmer sling. On both occasions, however, the luxation recurred. The luxation was reduced a third time with open reduction and caudal and distal relocation of the greater trochanter. Luxation did not recur after this treatment, and the calf grew and developed normally.     

Latero-distal transposition of the tibial crest in cases of medial patellar luxation with patella alta

Medial patellar luxation is defined as medial displacement of the patella from the trochlear groove. In dogs, medial luxations account for 75% of all patellar luxation cases, and are frequently associated with patella alta. Common surgical treatments for medial luxation are trochleoplasty and lateral transposition of the crest to drive the patella into the correct anatomical alignment. Postoperative complications for this procedure are estimated to be between 18-29% of cases, with up to 48% of complications involving reluxation. It was previously hypothesized that in cases of medial luxation involving patella alta, the addition of a distal component to the lateral tibial crest transposition will result in repositioning of the patella into its proper position in the trochlear groove, thus reducing the recurrence of luxation. We performed this modified procedure on 14 dogs (17 limbs) that were suffering from medial luxation combined with patella alta, and our results led to favourable clinical outcomes. This modified surgical procedure places the patella into a more normal proximo-distal anatomical position, is simple to perform, and may become common practice for surgical treatment of medial patellar luxation with an alta component.     

Evaluation of risk factors for luxation after total hip replacement in dogs

OBJECTIVE: To identify risk factors for luxation after canine total hip replacement (THR). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: 256 client-owned dogs that underwent THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, prior hip surgery, implant size, intraoperative complications, and angle of lateral opening of the acetabular component. RESULTS: Postoperative complications were recorded in 20 cases (7.8%). The most common complication was dorsal luxation which occurred in 12 dogs (4.7%). The interval between joint replacement and luxation ranged from 1 to 116 days (mean, 44 days). In 1 case, luxation was attributable to failure of the repair of an intraoperative fracture of the greater trochanter. Excluding this case, the mean angle of lateral opening in those dogs that sustained luxation was 62 degrees (range, 46 degrees - 75 degrees). The mean angle of lateral opening overall was 48 degrees (range, 18 degrees - 76 degrees). The angle of lateral opening was the only factor that had a statistically significant effect on whether luxation occurred (P = .035). Acetabular revision, performed primarily to reduce the angle of lateral opening, was performed in 8 dogs and successfully prevented subsequent luxation. CONCLUSION: Luxation of the prosthesis is substantially under the control of the surgeon. It is recommended that the acetabular cup be inserted at an angle of lateral opening of 35 degrees to 45 degrees. In those cases of THR luxation in which an inappropriate angle of lateral opening is identified, acetabular revision arthroplasty generally results in a good clinical outcome.     

Coxofemoral luxation in pet rabbits: nine cases

Of the pet rabbits presented at one private practice between August 2011 and August 2016 (n=1369), 5·6% presented with a traumatic orthopaedic injury. Of these, 7·8% (n=6) presented with traumatic coxofemoral luxation, the most frequently observed type of luxation. Three cases of non‐traumatic coxofemoral luxation in pet rabbits are also discussed. Eight rabbits presented with craniodorsal luxation and one with caudoventral luxation. Five rabbits were initially treated using closed reduction and an Ehmer sling under sedation. Two rabbits responded satisfactorily to closed reduction; their bandages remained in place for 10 and 14 days, and movement was cage‐limited for 1 month after bandage placement. The bandage did not prevent re‐luxation in three cases. Therefore, two rabbits received iliofemoral nylon sutures, and three rabbits received a femoral neck and head ostectomy. One rabbit was treated directly using open reduction and an iliofemoral nylon suture due to fractures in the same limb. One rabbit was presented in shock, coxofemoral luxation was noticed as an incidental finding and euthanasia was elected by the owner. In conclusion, of the three rabbits treated via femoral neck and head ostectomy one rabbit had an unsatisfactory outcome and two rabbits have non‐assessable outcomes. The three rabbits treated with iliofemoral sutures showed satisfactory long‐term outcomes and the two rabbits treated with closed reduction and an Ehmer sling showed satisfactory medium and long‐term outcomes.