Small Animal Hip Dysplasia and Pelvic/Sacrum Fx Exam 3

What is the weight bearing axis of the pelvis?

-sacroiliac joint

-ilium

-acetabulum

What shape is a pelvis?

box

What diagnostic tools should be used when assessing a pelvic fracture?

-thoracic radiographs

-abdominal imaging

-neurologic and orthopedic exam

-complete blood work and urinalysis

-ECG

-pelvic imaging (radiograph or CT)

When are pelvic fractures best repaired?

-7-10 days after injury

-bilateral repair should occur simultaneously or within a short period

What are the surgical goals of pelvic fracture repair?

-maintenance of weight bearing axis

-joint alignment

-minimization of arthritis

-prevention or repair of soft tissue damage

What are the traits of feline pelvis?

-more rectangular

-narrower

-no sacrotuberous ligament

T or F: most pelvic fractures have injured other body systems

True

What are some common secondary injuries to pelvic fractures?

-rectal tears

-herniation

-tail traction injuries

-visceral injuries

-neurologic injuries

What species may suffer from obstipation or constipation after pelvic fracture?

Cats

How to diagnose sacroiliac luxation?

-palpation

-VD imaging showing cranial displacement of ilial wing

-step between wing and sacrum

What is the treatment for sacroiliac luxation?

-conservative management

-cage rest

-oral analgesics

-surgery if severe pain

-surgery if displacement compromises pelvic canal or hip alignment

Does an open or closed approach surgery have higher risk of drilling into spinal canal?

open approach

What are the traits of sacral fractures?

-CT is best modality

-extremely painful

-common neuro deficits

How to treat sacral fractures?

lag screw fixation

Which has a better prognosis, axial or abaxial sacral fractures?

abaxial

What is the most common ilial fracture?

long oblique mid-body

What is the treatment for ilial fractures?

bone plate on lateral side of wing

T or F: ilial fractures have an excellent prognosis

True

T or F: acetabular fractures are not articular so they don't need precise reduction

False

What kind of imaging is typically required for acetabular fractures?

CT

What are the kinds of acetabular fractures?

-cranial

-caudal

-central

-comminuted

All acetabular fractures should be stabilized unless what?

-highly comminuted

-very caudal

How are the best results yielded for acetabular fractures?

-precise reduction

-rigid stability

-early controlled movement

-plates, screws with wire, and lag screws are options

T or F: ischial and pubic fractures are rarely surgically stabilized

True

What is the early disease stage of hip dysplasia?

pain from subluxation and synovitis

What is the intermediate disease stage of hip dysplasia?

improvement

What is the late disease phase of hip dysplasia?

pain from OA progression

What are the traits of mild clinical severity with hip dysplasia?

-signs after strenuous activity

-minimal discomfort

-posture and mobility are mostly normal

What are the traits of moderate clinical severity with hip dysplasia?

-signs intermittent with routine activity

-slightly altered posture and mobility

-mild to moderate discomfort

What are the traits of severe clinical severity with hip dysplasia?

-persistent signs

-markedly altered posture and mobility

-severe discomfort

Hip laxity during development leads to what?

OA

What are the clinical signs of hip dysplasia?

-calm

-unwilling to play

-tires easily

-restless at night

-difficulty rising

-vocalization

-reluctance to jump

-aggression

What are the posture abnormalities that can come with hip dysplasia?

-sploot

-sloppy sit

-hyperextended hocks

-weight shifting

What are the gait abnormalities that come with hip dysplasia?

-decreased hip ROM

-bunny hop

-sway

-choppy short strides

-hip hike

-narrow paw placement

What is the ortolani maneuver?

adduction and dorsal pressure subluxates hip

T or F: negative ortolani means no hip dysplasia

False, not always

What is the most sensitive screening tool for hip dysplasia?

radiographs

What are OFA radiographs?

-hip extended VD view

-score can only be assigned if older than 2 years

->50% of femoral head coverage is normal

-no certification needed

What are the limitations of OFA?

-view masks joint laxity due to wind up

-insensitive for early detection

What are the signs of early hip OA?

-caudolateral curvilinear osteophyte

-metaphyseal sclerosis

-circumferential femoral head osteophyte

What is PennHIP?

-hip extended, compressed, and distracted views

-requires certification

-most sensitive screening

-score can be assigned at 16 weeks

What is the most predictive measure of OA development?

distraction index

Complete luxoid hips benefit from what?

early THR

What view assesses dorsal displacement of femoral head?

lateral

What are the non surgical treatments for hip dysplasia?

-weight optimization

-exercise modification

-drugs

-diet

-supplements

What is juvenile pubic symphysiodesis?

surgical premature closure of pubic symphysis to increase femoral head coverage

What is a double/triple pelvic osteotomy?

increases femoral head coverage by cutting bone and rotating acetabulum?

Double/tribe pelvic osteotomy has a _____ morbidity that juvenile pubic symhysiodesis and is ______ reliable than a THR

higher, less

What is a THR?

femoral head and acetabulum are replaced with prosthetic implants

What is an FHO?

removal of femoral head and neck

What are the negative outcomes of an FHO?

-muscle atrophy

-decreased weight bearing

-gait abnormaility

An FHO trades ____ for _____

function, pain relief

What surgical repair has the highest change of pain free, normal function long term?

THR