Hock Fracture in a 2 Month Old Heifer Mandy Gutliph 2/19/2014
Advisors: Dr. Hayley Lang Dr. Ruth Van Hatten Slide 2 Signalment: 2
month old Holstein Heifer Valuable History: Weaned December 31 st
New pig wire pen Non-weight bearing lameness left hind limb on
January 1 st Swollen hock No improvement with 2 days of flunixin
meglumine and 5 days of penicillin Slide 3 Physical Exam Bright,
Alert, Responsive TPR WNL Large, Clean Calf Small amount of
perineal staining Umbilicus WNL Non weight bearing left hind limb
Left tarsus swollen, especially caudally Rest of physical
unremarkable Slide 4 Problem List Swollen Left Tarsus Non Weight
Bearing Lameness Differential Diagnosis Degenerative Joint Disease-
osteochondrosis, osteoarthritis Developmental Abnormality-
Anomalous- serous tarsitis Metabolic- Neoplastic/Nutritional-
Idiopathic/Inflammatory- septic arthritis, lyme disease
Trauma/Toxic- fracture Vascular- hematoma Slide 5 Plan Radiograph
the Left Tarsus -Typical Equine Views 1. Lateralmedial (Lateral) 2.
Dorsoplantar (DP) 3. Dorsolateral-plantaromedial oblique (DLPMO) 4.
Dorsomedial-plantarolateral oblique (DMPLO) Also we did 5. Flexed
Dorsal Plantar Image 1 Slide 6 Dorsal View Medial Side to Right of
Screen Distal Trochlea of Talus Fused Central and 4 th Tarsal Bones
Fused Metatarsal 3 and 4 BOVINE EQUINE Slide 7 2 Medial View
Cranial to Left of Screen BOVINE EQUINE Tuber Calcanei
Sustentaculum Tali Fused Tarsal 2 and 3 Sesamoid Bone Slide 8
Lateral View Cranial to Right of Screen Body of Calcaneus
BOVINEEQUINE Talocalcaneal Joint Slide 9 Lateral Views Cranial to
the Left of Screen RIGHT TARSUS LEFT TARSUS Slide 10 Dorsal Plantar
Lateral Slide 11 Flexed Dorsal Plantar Cranial Lateral Slide 12
Diagnosis Radiographs show: Comminuted fracture of Calcaneus Tuber
Calcanei Body Sustentaculum tali Fracture Line in Talus (?)
Luxation of Talocalcaneal Joint Soft Tissue Swelling Slide 13
Updated Plan Computed Tomography- including normal tarsus General
Anesthesia Slide 14 Computed Tomography Radiographs: 1890s CT:
1970s Veterinary CT: 1989 in Paris Gantry X ray tube with cathode,
anode and detectors Sliding Table Console Slide 15 Sagittal Slices
Cranial to Left of Screen Moving Lateral to Medial within limb from
Left to Right Image Slide 16 Transverse Image Through Talus
Incomplete Fracture DORSAL LATERAL Slide 17 Slide 18 Surgery Slide
19 Post Operatively Slide 20 Prognosis Bristol Retrospective Study
of Traumatic Hock Fractures 7/13 horses returned to work 6
euthanized Depends on fracture site Auyer and Stick on Equine
Surgery Non-displaced talus fractures- increased prognosis Closed
calcaneus fractures- increased prognosis Likely to develop
Osteoarthritis Good Prognosis for full fracture healing and full
function as dairy cow Slide 21 Recheck Exam Slide 22 Cost Initial
Exam Radiographs$160 CT$420 Anesthesia$500 Surgery$750 Total$2,300
First Recheck Exam Including radiographs, anesthesia, cast change
$500 Slide 23 References Auer, Jo rg A, and John A. Stick. Equine
Surgery. St. Louis, Mo: Saunders Elsevier, 2006. Jakovlevic S,
Gibbs C, Yeats J.J. Traumatic fractures of the equine hock: A
report of 13 cases. Equine Veterinary Journal. 1982; 14:2042-3306.
Blackwell Publishing Ltd Meagher D, and Mackey V. "Lag Screw
Fixation of a Sagittal Fracture of the Talus in the Horse." Journal
of Equine Veterinary Science. 10.2 (1990): 108-112. Merck Manual:
Disorders of the Bones and Joints in Cattle:
http://www.merckmanuals.com/vet/musculoskeletal_system/lameness_in_cattle/disorders_of_the_bones_and_
joints_in_cattle.html Raes, E. V., Bergman, E. H., van,. V. H.,
Vanderperren, K., Van,. V. E., & Saunders, J. H. (January 01,
2011). Comparison of cross-sectional anatomy and computed
tomography of the tarsus in horses. American Journal of Veterinary
Research, 72, 9, 1209-21. Schwarz, T., & Saunders, J. (2011).
Veterinary computed tomography. Chichester, West Sussex, UK:
Wiley-Blackwell. Image 1:
http://www.3d-it.vet.ed.ac.uk/xrayhandbook/webpages/other/Hindlimb/Tarsus.html
Slide 24 Thanks! My Patient Dr. Hayley Lang Dr. Ruth Van Hatten
Rotation Mates Imaging Department Class of 2014
