Elbow

Question 1

What are the conditions that are a part of “elbow dysplasia”?

Answer 1

• ununited anconeal process
• medial compartment disease
• fragmented medial coronoid process
• OCD
• joint incongruity

Question 2

What is joint incongruity?

Answer 2

• mismatch in articular surfaces
• length/diameter discrepancy
• uneven joint surfaces

Question 3

What is the typical signalment/presentation of elbow dysplasia?

Answer 3

- biphasic age distribution
(young - joint surface defect, old - osteoarthritis)
- often bilateral
- large and giant breeds
- GSD
- males predisposed

Question 4

What is the typical history of a dog with elbow dysplasia?

Answer 4

• chronic, progressive lameness

- aggravated by activity

Question 5

Describe the characteristic posture of a dog with elbow dysplasia

Answer 5

“toed out”

• elbow adducted
• external rotation of limb

Question 6

What is found on physical exam of a dog with elbow dysplasia?

Answer 6

• lameness
• elbow effusion
• pain on manipulation
• characteristic posture
• crepitus

Question 7

When is pain felt during manipulation of a dog with UAP or MCD?

Answer 7

UAP - extension

MCD - flexion and supination

Question 8

What is the proposed etiology for UAP?

Answer 8

radioulnar incongruity

• shortened ulna displaces humerus
• excess force on anconeal process results in failure of ossification

separate anconeal center of ossification

Question 9

What is the proposed etiology for FCP?

Answer 9

microtrauma caused by incongruity

Question 10

What is the best diagnostic method for FCP?

Answer 10

arthroscopy

Question 11

Which radiographic view is required to diagnose UAP?

Answer 11

flexed lateral view

Question 12

What are possible treatments for UAP?

Answer 12

• fragment excision (older dogs with DJD)

- osteotomy + fixation

Question 13

What is incomplete ossification of the humeral condyle?

Answer 13

failure of union between the medial and lateral portions of the humeral condyles

Question 14

Who is predisposed to IOHC?

Answer 14

spaniel breeds

males

Question 15

How can IOHC present?

Answer 15

• no clinical signs
• mild lameness (weight bearing)
• acute NWB lameness

Question 16

How is IOHC treated?

Answer 16

if no fracture - single lag screw across condyles

Question 17

How is the elbow normally stabilized?

Answer 17

• constrained by collateral ligaments in flexion

- constrained by olecranon in extension

Question 18

What occurs in traumatic elbow luxation?

Answer 18

rupture/avulsion of the collateral ligaments

Question 19

When is a closed reduction indicated in a traumatic elbow luxation?

Answer 19

with an acute luxation of a normal joint

Question 20

Describe the Campbells test

Answer 20

• elbow and carpus at 90 degrees
• supination to assess lateral collaterals
• pronation to assess medial collaterals
• compare to contralateral limb

Question 21

When is an open reduction indicated for a traumatic elbow luxation?

Answer 21

• concurrent fractures
• unsuccessful/unstable closed reduction
• recurrent luxation

Question 22

What is done post-reduction of a traumatic elbow luxation?

Answer 22

• leg is maintained in extension
• spica splint if closed reduction
• flexible ESF is open reduction
• after apparatus removed, exercise restriction and physical therapy

Question 23

Describe the Spica splint

Answer 23

• maintains limb in a standing position

- splint extends from foot past dorsal midline, and is secured around thorax

Question 24

What is the prognosis for reduction of a traumatic elbow luxation?

Answer 24

closed - good to excellent

open - fair

Question 25

What is congenital elbow luxation type 1?

Answer 25

caudolateral luxation of the radial head | - ulna relatively intact

Question 26

What is congenital elbow luxation type 2?

Answer 26

- lateral rotation with subluxation of the ulna | - radial head dispaced laterally

Question 27

Describe the signalment and presentation of congenital elbow luxation

Answer 27

- small breed dogs - seen soon after birth - creeping gait due to incomplete extension of elbows - partial flexion, internal rotation of antebrachium

Question 28

What is the prognosis for congenital elbow luxation?

Answer 28

guarded to poor | - normal joint function not expected

Question 29

What are the salvage procedures used for elbow diseases?

Answer 29

- canine unicompartmental elbow - total elbow replacement - arthrodesis

Question 30

What is the CUE procedure, and when is it done?

Answer 30

- partial joint replacement | - for end-stage medial compartment disease