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LIFE

LIFE. “We must be willing to get rid of the life we’ve planned, so as to have the life that is waiting for us.” -Joseph Campbell. DISEASES OF THE MUSCULOSKELETAL SYTEM. FUNCTIONS OF THE MUSCULOSKELETAL SYSTEM. Support (skeletal system) structural support/framework for the entire body

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LIFE

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  1. LIFE “We must be willing to get rid of the life we’ve planned, so as to have the life that is waiting for us.” -Joseph Campbell

  2. DISEASES OF THE MUSCULOSKELETAL SYTEM

  3. FUNCTIONS OF THE MUSCULOSKELETAL SYSTEM • Support (skeletal system) • structural support/framework for the entire body • Storage • Minerals (calcium) and lipids. • Blood cell production. • site of formation for all types of blood cells. • Protection • vital organs of the body • ribs surround the visceral organs • central nervous system is encased within the skull and spinal cord. • Leverage • Many of the joints of the body act as levers therefore assisting with movement. • Provides a place for muscles, tendons, ligaments to attache

  4. REVIEW - Bone anatomy Epiphysis is the enlarged area at either end of the bone Diaphysis is the long shaft in the middle portion of the bone Metaphysis is the joining point between the epiphysis and diaphysis The periosteum is the fibrous covering around the outside of the bone not covered with articular cartilage. The endosteum is the fibrous and cellular tissue lining the medullary cavity of the bone

  5. REVIEW – Shapes of Bones vertebrae and certain facial bones humerus, radius, femur, tibia, metacarpals, and metatarsals patella, and proximal and distal sesamoid bones of the digits. carpal and tarsal bones sternum, ribs, scapula, and certain skull bones

  6. MUSCULOSKELETAL SYSTEM Flexible articulations form joints The skeleton is the rigid frame Muscles, tendons, and ligaments form a system of pulleys

  7. MUSCULOSKELETAL SYSTEM FUNCTIONS MOVEMENT SHAPE

  8. MUSCULOSKELETAL SYSTEMDISRUPTION: POOR CONFORMATION TRAUMA DEGENERATIVE DISEASE INFLAMMATION NEOPLASIA

  9. TRAUMA: CLINICAL SIGNS OF LONG BONE FRACTURES Lameness, swelling, hx of abuse lameness Deformity of bone, swelling

  10. TRAUMA: CLASSIFICATION OF FRACTURES • Open (compound) – broken skin • Closed – intact skin • Simple (1 break): oblique, transverse, incomplete fractures • Comminuted –multiple pieces • Stable – ends opposed and fixed (ie. greenstick) • Unstable • Compression: vertebrae

  11. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES Oblique fracture Transverse fracture

  12. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES Greenstick fracture Comminuted fracture

  13. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES Fissure fractures

  14. TRAUMA: DIAGNOSIS OF LONG BONE FRACTURES Spiral Fractures

  15. TRAUMA: DIAGNOSIS OF FRACTURES COMPRESSION FRACTURE SALTER-HARRIS FRACTURES OF THE EPIPHYSIS

  16. TRAUMA: OPEN VS. CLOSED FRACTURES In open fractures bone is exposed through the skin

  17. TRAUMA: METHODS OF FIXATION OF LONG BONE FRACTURES SPLINTS It is critical that the splint support both the joint above and below the injury !

  18. TRAUMA: METHODS OF FIXATION OF LONG BONE FRACTURES Splints ROBERT JONES BANDAGE METASPLINT

  19. TRAUMA: METHODS OF FIXATION ON FRACTURES SCHROEDER-THOMAS SPLINT Immobilize any fracture Distal to midhumerus or midfemur

  20. CASTS • Casts can be made for the entire body, as for spinal injuries, for any portion of the body (spica cast), or for just the extremities.

  21. TRAUMA: METHODS OF FIXATION OF FRACTURES IM (Steinmann) pins with cerclage wires

  22. TRAUMA: METHODS OF FIXATION • Advantages of IM pins • Prevent bending forces • Disadvantages • Do not prevent rotation or compressive (axial) forces • Should be combined with other methods such as cerclage wire to prevent other forces

  23. TRAUMA: METHODS OF FIXATION OF LONG BONE FRACTURES Bone plates and screws http://www.youtube.com/watch?v=Wls_Pyop-D0

  24. 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: Kirschner-Ehmer apparatus

  25. TRAUMA: CLIENT INFO • Restrict activity • Watch for drainage, swelling, heat • Metal (plate, pin) stronger than bone – refracture may occur • Follow up x-rays necessary • Metal should be removed after healing • Metal may cause cold sensitivity

  26. Ligament Injury – Anterior Cruciate Ligament Rupture • ACL and PCL (posterior cruciate ligament) • stabilize knee joint • Intra-articular structures • Ruptured ACL – most common stifle injury and leads to DJD • May be complete rupture or partial tear => unstable joint => DJD

  27. TRAUMA: CRUCIATE LIGAMENT INJURY/RUPTURE

  28. TRAUMA: CLINICAL SIGNS OF CRANIAL CRUCIATE LIGAMENT INJURY/RUPTURE Middle-aged obese dog Highly active, athletic animals

  29. TRAUMA: CLINICAL SIGNS OF CRANIAL CRUCIATE LIGAMENT INJURY/RUPTURE Animal is acutely non wt. bearing on the rear leg after hyperextending the stifle joint Joint effusion

  30. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE Cranial drawer test Tibial compression test

  31. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE http://www.youtube.com/watch?v=9jg9E2nBt_E&feature=related

  32. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR Extra-articular Stabilization *Most successful in patients less than 15kg

  33. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR Intra-articular stabilization – Over-the-top patellar tendon graft

  34. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE http://www.youtube.com/watch?v=4nU2QZjjByg

  35. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE REPAIR Intra-articular stabilization technique TPLO – Tibial Plateau Leveling Osteotomy

  36. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE http://www.youtube.com/watch?v=-1pxxX4TXko&feature=fvw

  37. TRAUMA: CRANIAL CRUCIATE LIGAMENT RUPTURE – 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 1 yr • Weight loss helps • DJD of stifle joint likely • If no surgery, joint thickens - fibrosis

  38. POOR CONFORMATION: LUXATING PATELLA

  39. POOR CONFORMATION: LUXATING PATELLA

  40. POOR CONFORMATION: LUXATING PATELLA

  41. POOR CONFORMATION: LUXATING PATELLA PATELLA IN GROOVE PATELLA OUT OF GROOVE

  42. POOR CONFORMATION BOW-LEGGED STANCE MAY OCCUR IN MEDIAL LUXATIONS KNOCK-KNEED/PIGEON-TOED, OR COW-HOCKED STANCE MAY OCCUR IN LATERAL LUXATIONS

  43. POOR CONFORMATION: TREATMENT OF PATELLAR LUXATION TROCHLEAR WEDGE RESECTION

  44. POOR CONFORMATION: TROCHLEAR WEDGE RESECTION

  45. POOR CONFORMATION: TIBIAL CREST TRANSPOSITION

  46. POOR CONFORMATION: TIBIAL CREST TRANSPOSITION

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