Ulna is not a weight bearing bone, so it is optimal candidate for limb spare surgery.

True or false?

Bone sparing surgery will increase the survival time of the patient as compared to amputation. 

True or false?

FALSE 

It doesn't effect the survival 

Only effects one bone and no joint 

No pulmonary metastasis 

NO concurrent disease 

Limited soft tissue involvement 

Diminished bone pain

HAS NO effects on metastatis 

increases risk of pathological fracture

Dogs with osteosarcomas and micrometastasis have very poor prognosis.

True or False?

False 

the prgnosis would be lower if they were gross lesions. 

Alkaline phosphotase 

Age - younger dogs are worse off 

metastatic lesions - - gross lesions worse off than micro

Osteosarcoma - much older cats 

behaves diff from dog

NOT ELASTIC 

long collagen fiber bundles 

strongest in tension 

permenant damage after 10% elongation 

LIGAMENT 

stretching or tearing 

3 degrees of sprains 

What happens in healing of 1st degree sprains?

Hematoma forms and edema 

rapid fibrin deposition 

rapid healing 

no functional deficiet when healed 

Ice pack to reduce edema, cage rest to gradual increase in activity, NSAIDS unless not noted for patient 

Ligament still grossly intact, partial disruption 

more extensive healing = takes longer (6 months!)

long term restoration without treatment unlikely 

Tx: can be managed without surgery if no gross instability (splint - restrict activity for 12 weeks) 

instability - early surgical intervention - tighten ligament via imprication or plication

"severe" 

Transceted ligaments = will not heal without treatment 

function of ligament lost 

Common in tarsus 

splints not enough - not as strong as true ligament 

TX: surgery - ligament imbrication, fascia/tendon graft, prosthetic ligment (if will not heal directly - make near natural insertion and attachment)

Far-near-near-far (tip of needle to cut end)

Bunnell-meyer

Three loop pulley *

Locking loop * 

*more common

These are tension relieving suture patterns 

SURGICAL

this can result in continuing instability and OSTEOARTHRITIS

Ligaments do not heal well to support stress and strain required to maintain normal function if carpal and tarsal ligaments are injured.

What are some possible treatment options?

Arthrodesis

Amputation

What would be gross instability in a 3rd degree sprain?

What is the best treatment for this?

Luxation and subluxation

arthodiesis

Longitudinal stretching or tearing of muscle fibers.

musculo-tendon unit 

muscle tendon junction or tendon body 

Strain 1st degree

strain 2nd degree

1 - minimal lamness 

short lived pain and swelling

2 - obvious lameness, 

soft tissue swelling, 

point pain

Rapidly progressive pain 

significant soft tissue swelling 

obvious lameness and pain

which injuries are more likely to heal well without surgery, 

tendon or ligament?

TENDONS

they can often be treated with just ice for a few days and then heat 

MUSCLE ATROPHY 

localized pain spasm 

minimal pain on palpation of region (acute is painful)

disuse osteopenia (reabsorption of bone) 

Unable to flex or extend, 

muscle spazms and contracts 

REQUIRES SURGICAL REPAIR - muscle heals with excessive scar tissue that can interfere with function 

Aim for apposition, minimize gap and tension - - reduced non functional scar 

locking loop and three loop pulley on muscle to prevent gaping

GAP= formation of scar tissue, can cause contracture.

COntrolled loading - strengthens and improves healing 

load at 6 weeks

Irreversible shortening of a muscle - common in quadricept muscle - from distal femur injury 

many muscles feed into it sup dig flex, gastrocnemius

lameness, pain, swelling, gait abnormality 

mineralization fo tendon, periosteal reaction

Foot flat on the ground 

What tendon is ruptured?

Gastroc and sup. dig. flex

PLANTAGRADE STANCE, digit not flexed 

loss of support to the tarus completely 

Gastroc only 

NOT the sup dig flex.

Bear claw 

Young dogs with distal femur fractures 

big inflammatory response and injury to the muscle (often vastus intermedius) - dont heal, irrevesible, shortens muscle = causes extension 

BE AGGRESSIVE - reduce inflammation - NSAIDS

Shoulder strain injuries 

Hunting dogs 

difficult to diagnose - MRI best, Xrays not optimal 

biceps tenosynovitis and infraspinatous contracture 

Runs from supraglendoid tuberosity 

through biceps groove on humerus

radius and ulna distally 

INSIDE of joint capsule 

DO biceps test - flex shoulder, extend elbow, palpate tendon

Medical or surgical tx - 

Transect tendon (tendon release) 

because attached to muscle will scar down and reattach

releases tension and inflammation 

Reattach with bone screw and washer - more surgery and more complications

INfraspinatous contracture 

when contracts causes shoulder flexion,

external rotation of the shoulder joint 

TX: cut the tendon and its readily healed 

no instability 

tendon removed from insertion 

fragments fo bone 

tx: reattach tendon to bone 

pin and tenson band - 

pull of muscle causes compressive force to improve bone healing

complete or partial transcetion (Grade III STRAIN)

see if animal is standing - small wound over area of tendon, open it up and look.

tx:locking loop (flat tendons) and three loop pulley (round tendons) 

early surgical intervention = best outcome 

Proteoglycan depletion compromises lubrication.

True or false?

TRUE 

pooled synovial fluid 

decreases coeff of friction between surfaces 

Gylcoprotein LUBRICIN binds to the art cart and retains protective layer of water molecules 

displaced at high loads (jumping) 

NON infectious 

inflammatory 

degenration of cartilage 

thickening of joint capsule 

periarticular fibrosis 

Often a secondary condition 

Osteoarthritis in dogs is a primary problem.

True or false 

Osteoarthritis is curative 

t or f

false - 

once it starts it cant stop 

collagenase

interleukins 

leukotrienes

elastases

IL 1 

TNF 

Increase in MMPs (matrix ajkfsdjkf proteins)

and aggrecanase

BREAKDOWN

Articular fibrillation 

cartilage loss

subchondral sclerosi

osteophyte formation 

periarticular fibrosis 

synovitis 

PAIN, LOSS OF FUNCTION 

lineations of cartilage are normal.

t or f

Radiographs are only able to determine boney changes in joints of potential OA. They do not corrolate with clinical function.

t or f 

T. 

they may not need surgical intervention 

Weight managment

excercise moderation 

chondroprotectives 

NSAIDS 

If your OA pet becomes more sore after an activity, you should continue it to let them work through it. 

t or f 

F

DECREASE it 

Increase blood flow

minimized muscle atrophy 

prevent peroarticular fibrosis 

provide positive physcological effects

promotes vasoconstriction, muscle relax

slows nerve conduction 

analgesia

rduced edema 

improves venous blood flow - relaxed muscles 

NOT to be used in vascualr disease 

Patients with unstable fractures the passive range of motion should only be to the patients comfort.

t or f 

FALSE 

dont do this will fractures!!!!

or luxations or if skin is under tension - like still healing post op 

Glucosamine 

chondroitin sulfate 

manganese ascorbate 

MSM

precursor to GAG 

formation and repair of cartilage 

Free 02 radical scavanger

COX ind inflam

stimulates HA synthesis 

inhibits MMPs that would cause break down 

stimulates GAGs and collagen synthesis 

resilence of cartilage

MG is cofactor in making GAG 

ascorbate crosslinks collagen

made from bovine tracheal cartilage 

polysulfated glycosaminoglycans 

INJECTABLE twice weekly 

decrease infalmmatory response 

many types 

block COX1 and COX2 

but also have effects all around the body 

What NSAIDS need to inhibit 

GI upset, vomit, diar, ulcers 

inducible

NO 

never use them together 

increased complications 

7- 10 days 

anticoagulant - inhibits platelets for the life of a platelet - which is about 7 days

4-7 days - - 

dont use more than one at a time 

Use lowest effective dose 

wean patient off as soon as managable 

never use more than one at a time 

check for liver and kidney disease prior to administration, and continue to check CBC/chem

If there was an underlying primary problem

if medical treatment didnt work 

allowing blood to flow from subchondrial bed to 

encourages blood flow with cartilage fibrocartilage replacment (not AS strong as hylauronic) 

Chrondrocytes have minimal blood supply, and do not multiply in the adult

Autologous cartilage transplantation  ACI

Osteochondral transplant (from non weight bearing region) OATS

micropicking

TIBIA 

not the humerus or the femur

LATERAL side is more meaty than the MEDIAL 

The full pin will go through more soft tissue, making it more likely to have patient discomfort.

LESS STABLE - 1a

1b

2

MOST stable - 3

Fixation pin working length 

ALSO want to keep short 

limited by anatomy 

Go where there is less anatomy to shorten the length 

BUT be able to but your finger in there - - this allows room for swelling 

Diameter (OF THE THREAD, which is up higher) 

should approx 1/4 the diameter of the bone.

t or f

T 

dont go bigger than this because the hole is too big and could cause more problems 

Pins should be centered in mechanically sound bone 

t or f

TRUE 

look for fissure lines eminating from the major fractures in order to determine where to but screws 

if there is a small fissure than it may not function well. 

3

this allows the stress to be more evenly distributed 

The 0.1mm less than diameter of the SMOOTH portion of the pin

DRILL SLOWLY  

1 CM 

at EACH pin point