Lecture 7: Animal Diseases

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Dr. Nireeksha Jain

3. SYMPTOMS & SURGICAL
INTERFERENCE IN
FRACTURES AND
DISLOCATION
7
3
LECTURE
TOPIC

4. 1. Describe in detail about symptoms &
surgical management of HIP
DISLOCATION in large animals ? ( 2016)
2. What is fracture ? Give the types of
fracture (long bones). Discuss the factors
influencing fracture union & management
and treatment of fractures? (2013 )

5. ▪ A fracture is the
complete or
incomplete break in
the continuity of the
bone or cartilage with
or without
displacement of the
fragments. OR
▪ In a very simple
words “A fracture is
the break in the
continuity of hard
tissue” like bone,
cartilage etc.

6. FRACTURE
▪ After fracture, there is a soft tissue injuries of varying degree,
including blood vessels and nerves. The type of fracture and the
degree of the soft tissue damage involved are mainly depend upon
the:
 Cause of fracture
 Bone involved
 Site of fracture
 Temperament of animals
 Duration of fracture

7. ETIOLOGY
EXTRINSIC
CAUSES
DIRECT
TRAUMA
INDIRECT
TRAUMA
INTRINSIC
CAUSES
MUSCULAR
CONTRACTI-
ON
PATHOLOGICAL
FRACTURE

8. 8
ETIOLOGY
EXTRINSIC CAUSES -
1 ) DIRECT TRAUMA- RTA, hit injury, fighting
- (comminuted fracture/ multiple fracture)
2) INDIRECT TRAUMA- during running, jumping,
falling.
- Bending forces
- Torsional forces
- Compressive forces
- Shearing forces

9. ETIOLOGY
INTRINSIC CAUSES –
1) MUSCULAR CONTRACTION-
- Avulsion fracture
2) PATHOLOGICAL FRACTURE-
a. Local- bone tumor, cyst
b. Systemic disease- ostopenia, oestoporosis

10. 1) On the basis of communication of the fractured site to the
environment -
a. Simple (closed): fracture fragments do not communicate to
environment and remain covered with muscles and skin.
b. Compound fracture (open)
i. Primary compound fracture (open fracture occurs at the time of
trauma)
ii. Secondary compound fracture (initially fracture is simple but
later on become compound)
c. Complicated fracture: fracture along with injuries to neighboring
structure like blood vessels, nerves, adjacent joint, visceral or
thoracic cavity.
CLASSIFICATION OF FRACTURE

11. CLASSIFICATION OF FRACTURE
2) On the basis of the extent of the fracture line
a. Incomplete fracture: fracture line is not present throughout the bone
i. Green stick fracture: seen in young animal where mineralization has
not completed.
ii. Fissure fracture: there is a fissure in the bone which is covered by
intact periosteum.
iii. Depression fracture-seen mostly in maxilla and frontal bone.
iv. Deferred fracture: fracture is not seen at the time of trauma but it
occurs after certain period from the weak point.
b. Complete fracture: here fracture line is through and through i.e.
bone has divided into 2 or more than 2 fragments.
i. Single fracture line
ii. Double fracture line
iii. Triple fracture line

12. 3) On the basis of the direction of the fracture line
a. Transverse fracture: caused by bending force and direction of
fracture line is at right angle of longitudinal axis of the bone.
b. Longitudinal fracture: fracture line is parallel to the long axis of the
bone.
c. Oblique fracture: caused by bending force with axial or rotational
force and fracture line is present obliquely to the long axis of the bone
d. Spiral fracture: fracture line is spiral in direction and caused by
torsional, twisting, rotational forces.
CLASSIFICATION OF FRACTURE

13. e. Comminuted fracture: when there are two or more than two
fracture line and all are comminuted at one point or intersect at
one point. Such fracture is caused by high energy trauma.
f. Multiple fracture: here fracture line are two or more than two
and not interconnected to each other.
g. Impacted fracture: cortical bone end of the fracture is forced
or impacted into the cancellous bone. Noticed at the junction of
diaphysis and metaphysis of a long bone.
h. Compression fracture: it is also a type of impaction fracture,
but here a cancellous bone collapses and compresses upon itself.
Occur in vertebral bodies following trauma to the spine
CLASSIFICATION OF FRACTURE

14. i. Avulsion fracture: occur due to the distraction or pulling
force in which a part of bone is detached at the point of
insertion or attachment of a tendon at the bone. Mostly seen at
the proximal end of olecranon process, tibial crest, calcaneal
fracture etc.
CLASSIFICATION OF FRACTURE

15. FRACTURE
Trends of bone fractures in animals:
o In canine: femure>RU/tibia/>humerus> other bones
o In bovine: Tibia>MC/MT>RU>others
o In horses: external angle of ilium (tuber coxae). In
limbs: MC/MT
o In camel: mandible fracture during rut season due
to fighting

16. 1. Dysfunction: loss of function of limb i.e. lameness,
non-weight bearing etc.
2. Pain: at the site of fracture (important sign in
incomplete fracture)
3. Local trauma:
a. Swelling-most consistent signs which persist up to
24-48 hrs in untreated cases.
b. Haematoma
c. Contusion/laceration/abrasion wounds

17. 4. Abnormal posture or limb positioning: it is mostly due
to displacement of the fractured bone fragments. It could be
in form of angular, longitudinal, rotational, abduction or
adduction etc.
5. Crepitus or crepitation: crepitus is the gritting sensation
transmitted to the palpating fingers by the contact of broken
bone ends on each other
6. Abnormal mobility: in complete fracture of long bones,
an abnormal movement is noticed between two true end
joints. This sign is very difficult to locate when the fracture is
close to the joint

18. i. Fever: increased temperature seen up to 24-48 hrs
following a fracture and reflect the response to break
down of the haematoma.
ii. Anaemia: due to significant loss of blood in the form of
haematoma secondary to rupture of medullary arteries.
iii. Shock: hypovolemic shock my seen in severe fracture due
to severe blood loss into a fracture site.
iv. Nerve injuries
v. Necrosis or gangrene:.
vi. Fat in the synovial fluid.

19. General principle of fracture repair
Objective: to provide completely rehabilitated
patient as quickly as possible.
A successful fracture treatment comprises:
Perfectly aligned bone
Joint on either end should be normal with their
free range movement
Less disturbances to surrounding soft tissue,
blood vessels, nerves and skin.

20. FRACTURE UNION, MANAGEMENT ,
TREATMENT
There are 4Rs of fracture
management:
eduction
etention
igid immobilization
ehabilitation

21. REDUCTION
21
Reduction: means reconstruction or realignment of the
fracture fragments in their anatomical position with the
normal limb/joint alignment
.
Closed reduction: should be attempted in fresh cases
before swelling and haematoma formation and when
displacement is not more than ½ of the width of fractured
bone.
Closed reduction means reduction of fracture fragment
from outside the skin without making an incision. It is
mostly performed for ext. immobilization tech. e.g. splint
and bandage, casts (POP/fiberglass), Thomas splint etc

22. REDUCTION
22
 OPEN REDUCTION – STEPS :
• A traction and counter-traction is applied over bone and then bringing them into
toggling and angulation followed by reduction of fracture fragments in anatomical
position

23. REDUCTION
23
For an overriding transverse fracture: reduction can be done with the help
of periosteal elevator by depressing one end and elevating other end after
engaging in between the fracture .

24. REDUCTION
24
For oblique fracture:
By applying bone holding forceps on each fragment and pulling them in
opposite direction till their contact surface come in alignment and once it
happened a reduction forceps is applying to compress the fracture
fragment and to reduce it.

25. RETENTION
25
Retention of fracture fragments -
After reduction, it is very important that fractured
fragments are to be maintained in reduction form until an
immobilization technique applied. This step is mostly
done by keeping the bone and joint in alignment by
traction and counter-traction in the cases of closed
fracture management and by application of different
forceps in the open method of fracture management. For
e.g. during pinning, both fragments must be retained in
apposition by application of reduction forceps or bone
holding forceps and Lowman clamps during the plating
and screwing.

26. Rigid immobilization
26
External fixation
Internal fixation
External skeletal fixation
Note: however, at the same time, mobilization of all joints
involving during the process of fracture healing to prevent
joint stiffness, fracture disease and muscle atrophy.

27. Rehabilitation
27
By physiotherapy to bring the stiffed joint normal, to increase the circulation in atrophied
muscle.
Summary of fracture management:
 Closed reduction with external fixation e.g. cast and splint
 Open reduction with external fixation e.g. cast or splint
 Open reduction with internal fixation e.g. pins, plates, screws etc.
 Closed reduction with internal fixation e.g. closed pinning of stable fracture of
tibia in dog.
 External skeletal fixation: reduction may be
either open or closed and immobilization of the
bone is maintained through the use of pins,
clamps and sidebars.

28. 28

29. DISLOCATION (LUXATION)
29
Dislocation is the separation or displacement of
articular surfaces of bones in a joint.
Partial dislocation: when there is only a slight
change in the relationship of the articular surfaces of
bones also called as sub-luxation. .

30. CLASSIFICATION
30
 Complete dislocation: articular surfaces are completely separated
and one of the bone articular surface displaced completely from the
joint e.g. complete hip dislocation or shoulder dislocation
 .
 Partial dislocation (sub-luxation): when some parts of the
articular surfaces are still in contact.
 Acute luxation: when it is of recent occurrence.
 Chronic luxation-A dislocation of long standing or has been in
existence for a long time.
 Recurrent luxation: showing recurrence after correction of an
earlier occurrence .

31. CLASSIFICATION
31
 Simple luxation: when there is no open wound communicating
with the joint
 Compound luxation: when the joint communicates with the
external environment through a penetrating wound.
 Complicated luxation: when luxation is associated with other
important injuries like fracture.
 Fracture-dislocation: dislocation combined with fracture of the
related bones close to their articular surfaces.
 Pathological dislocation: a dislocation related to paralysis or
some other local pathological lesions.
 Note: Luxation of immovable joints (synarthrosis) like the
symphysis pelvis are commonly referred to as fracture.

32. Trends of dislocation in animals:
32
Bovine: femoro-patellar articulation>hip>rarely
shoulder and other joints.
Equine: hip>shoulder

33. ETIOLOGY
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• Direct violence: trauma caused by accident,
slipping, jumping (Traumatic dislocation)
• Pathological dislocation: pathological condition
affecting the joint, articular ligaments or paralysis
of certain muscles

34. CLINICAL SIGNS
34
• Deformity: due to displacement of the dislocated part in a joint.
• Dysfunction (functional interference): there is inability to use the joint or the limb
properly.
• Inflammatory swelling around the joint.
• Pain upon manipulation of the affected joint.
• Mobility of joint in abnormal direction and restricted movement in the normal
direction.
• Ruptured joint capsule, sprain of articular
ligament and/or concerned muscles.

35. General principle of treatment of
dislocation
35
Reduction: by traction and countertraction “clicking noise”
under sedation or GA as per the demand and then ,
Retention of the reduced part by immobilization for a few
days .
• For hip dislocation in dog: Ehmer sling;
• In shoulder dislocation: Velapeau sling;
• Closed dislocation of carpal/fetlock/pastern or even
hock: ext. immobilization e.g. cast and splint bandage.

36. Incidence of
certain dislocation
36
Hip dislocation: common in dog, ox, less common in sheep and goat and
rare in horses (due to presence of accessory ligament).
Shoulder dislocation: (scapula-humeral dislocation): rare in the animals and
is extremely rare in the dog.
Elbow dislocation: rare condition but seen in the dogs congenitally or during
excessive flexion of the joint.
Patellar dislocation: due to direct violence or powerful muscular contractions.
In dogs: it is mostly congenital
Sub-luxation of patella (upward fixation of the patella): common in the ox
and horse

37. HIP DYSPLASIA
37
It is a general term used to denote a badly formed hip joint due to
development abnormalities. It causes unequal wear and tear of
different components of hip joint.
Hip dysplasia can affect dogs of all breeds but is more in large
breeds. In hip dysplasia either there is a shallow acetabulum or
flattened femoral head or both
Deformity could be following:
Coxa magna: head and neck of the femur bone become broader
Coxa plana: flattened femoral head
Coxa valga: increased angle between neck and shaft of the femur
Coxa vara: decreased angle between neck and shaft of the femur

38. 38
Causes:
Exact cause is unknown and seems to be
multifactorial in origin and involved both
Hereditory and environmental factors. Heavy
weight and rapid growth during 3-8 months of age
caused disparity in the development of supporting
soft tissue and bones which leads to hip
dysplasia.

39. CLINICAL SIGNS
39
Hip dysplasia is seen mostly in giant breeds like Saint Bernard, German
shepherd and Labrador retriever, Boxer, Rottweilers etc. the sign vary with age
and disease stage. It is mostly evident when dogs are 5-10 months of age. It is
rare in cats.
Early clinical signs includes:
difficulty in rising after rest
Bunny hopping gait/waddling gait
exercise intolerance
audible clicking sound while walking
intermittent or continual lameness.

40. 40
DIAGNOSIS-
On the basis of history, clinical signs, physical examination and radiography
(ventro – dorsal).
TREATMENT
Conservative treatment: it includes
In early case
Rest for 10-14 days
Moist heat therapy
Anti-inflammatory drug
In chronic cases
Weight control
Control exercise
NSAIDs and Nutraceuticals (tab. of glucosamine
and chondroitin sulphate and manganese ascorbate
e.g. Rejoint cap./Carticare cap/HD tab. )
Bulky diet low in fat and protein

41. 41
Pectineus myectomy: removal of 1 cm of the tendon of insertion of the
pectineus muscle through a small incision in the medial mid-thigh.
Pubic symphysiodesis: done 12-16 weeks of age to prevent the hip
dysplasia
Triple pelvic osteotomy: to change the contour of acetabulum cavity. It
should be done in immature dog with pain and laxity but before development
of the osteoarthritis.
Intertrochanteric osteotomy: done to decrease the angle of coxa valga
and increase the angle of coxa vara.
Total hip prosthesis: replacement of the joint with prosthetic material. It is
very costly and done by only experienced surgeon.
Femoral head and neck ostectomy (excision arthoplasty): it is done
through cranio-lateral approach to remove the deformed femoral head and
neck to relieve from the pain by formation of a false fibrous joint. More
effective when the dog’s weight should not be more than 20 kg.

42. Canine elbow dysplasia
42
It is a most common developmental disease or syndrome of elbow joint
comprises of un-united anconeal process, osteochondrosis dissecans,
fragmentation of the medial portion of coronoid process and osteoarthritis of
elbow joint.
Elbow has three joints: humero-radial, humero-ulnar and proximal radio-ulnar
.
SYMPTOMS-
• No wt.bearing on limbs
• Abduction of elbow
• Inward rotation of forearm
• Joints in semi-flexed state.

43. TREATMENT
43
 o General treatment for osteoarthritis
 o Surgical treatment includes
 o Anconeal process excision (from lateral approach)
 o Lag screw fixation
 o Ulnar osteotomy or
 Combination of lag screw and ulnar osteotomy

44. SHOULDER DISLOCATION IN
LARGE ANIMALS
44
It generally happens when there is excessive flexion of the joint with simultaneous flexion of
the elbow joint during jumping or falling down.
SYMPTOMS-
• Shoulder lameness
• No wt.bearing on affected limb
• Shortening of the limb
• Pain on palpation
• Extensions are difficult and cause pain.
TREATMENT-
• Cast the animal with affected limb above.
• General anesthesia is advisable.
• Counter-extension provided with aropw passed around neck and thorax.
• The shoulder joint is palpated to supervise direction of traction.
• A clicking sound is heard when corrected.

45. Thank you!
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