Sunday, August 6, 2017

3116. A 12-year-old Maltese fell from the bed and dislocated his right hip. A rare case of caudo-ventral luxation











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Craniodorsal luxations are common

 A cross-bred dog


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Another case - cavalier king charles




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Closed reduction with Ehmer sling - around 50% success rate
Indications for open reduction if
1. recurrence after closed reduction
2. unstable joint
3. avulsion fractures femoral head
4. other orthopedic conditions





The Ehmer Sling is used for around 2 weeks. Success rate of closed reduction is 50%. If there is recurrence, open reduction is needed.  Success rate of open reduction is 80-90%.

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CONCLUSION
Closed reduction is less expensive
Open reduction - FHO usually gives near normal function in small breeds and non-obese dogs
THR is expensive and specialised surgery. Other surgeries involve pins.





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Subluxation of Golden Retriever. Right hip




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Pre-op blood test. Blood test is normal for this 12-year-old Shih Tzu X.
Anaesthesia.   Propofol IV, intubate, isoflurane gas anaesthesia at 5% closed and open circuit.
Oximeter is used to ensure oxygen level of blood is 100%.

Surgery caudoventral is known FHO (femoral head ostectomy) or FME (femoral head excision) in which the femoral head is cut off to remove the cause of pain. A false joint is created and the dog walks almost normally.
















Conclusion.
An unusual case of caudoventral hip luxation which is found in 5% of hip luxation cases. Usually, the dog spreads out his hind leg when he falls.  The femoral head is dislocated under the pelvis into the "hole" (obturator foramen).  Most dogs fall on their paws causing craniodorsal hip luxation which is in 95% of cases.

 
  




 


DAY 3 AFTER SURGERY   Blood test showed the 12-year-old dog was in good health and fit for anaesthesia.  Femoral head ostectomy. Propofol IV and isoflurane gas 5% in closed and semi-opened circuit to effect.


Dog is able to walk a bit. The right hind limb is in normal upright position instead of being splayed outwards. Owner wanted him home on Day 4.



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