greyhound digit dislocation

RE: greyhound digit dislocation

James Dunne — Fri, 16 Sep 2016 21:52:14 GMT

Mike is 'the man' where greyhounds are concerned. I find him very helpful and generous with his time; maybe give him a shout. If the greyhound is racing then you've to weigh up whether you can get them merely racing again or winning again - two different things! Or if it is a pet as already mentioned, then pain relief and functional pain-free limb use are the aims.

RE: greyhound digit dislocation

Martin Atkinson — Fri, 16 Sep 2016 19:21:13 GMT

[quote user="mariette asselbergs"]

I had one over the last weekend and just popped it back in and bandaged it up and thought that was job done.

Now I realise this is a challenging condition..... Or may be?

[/quote]I would stick my neck out and say Mike Guilliard is probably the foremost expert on greyhound toe injuries in the UK so his advice rocks and he never ceases to remind me of this but then he is a best friend so I can tell him to shut up and heckle him in lectures he gives!

However he is dealing with racing greyhounds and it maybe what you have done is adequate if it is a pet.

RE: greyhound digit dislocation

mariette asselbergs — Fri, 16 Sep 2016 18:53:55 GMT

Wow thanks Martin.

I had one over the last weekend and just popped it back in and bandaged it up and thought that was job done.

Now I realise this is a challenging condition..... Or may be?

Mariette

RE: greyhound digit dislocation

Lindsey Edwards — Fri, 16 Sep 2016 16:25:19 GMT

Have had great success with ESF, warn and expect infection/swelling etc but heals despite/because of inflammation

RE: greyhound digit dislocation

Gareth C. — Fri, 16 Sep 2016 12:34:04 GMT

cheers for that, esf sounds OK to do . They're in the waiting room now so good timing Martin.

RE: greyhound digit dislocation

Martin Atkinson — Fri, 16 Sep 2016 11:23:38 GMT

Here is an extract from some course notes by Mike Guiiliard CertSAO, FRCVS, maybe some help:

Phalangeal instabilities.
These can occur at any of the digital joints (metacarpal/tarsal/phalangeal,
P1/2 and P2/3) and are classified as stable or unstable. There may also be
avulsion fractures of the collateral ligaments. The principle of treatment is to
maintain the joint in normal congruity for a period of time (3 weeks) to allow
the sufficient build up of periarticular fibrosis. Stable joints can usually be
managed by external coaptation with possible nail shortening to reduce the
lever arm. The permanent surgical removal of the nail (ungual crest) is
desirable in cases of gross instability and in cases of P1/P2 subluxation
affecting the central digits.
Ungual crest removal:
The skin at the base of the nail is circumcised and using bone cutters the nail
is removed below skin level. The remnants of the nail bed can be visualised
and removed with rongeurs. Sufficient bone removal is achieved when the
skin can be easily closed over the bone stump.
In a prospective study in racing Greyhounds by the author, 21 cases of ungual
crest removal resulted in only one complication, P2/3 ankylosis, that lead to a
paw pad corn developing. Potential complications include: dorsal joint
penetration, nail regrowth and infection from insufficient nail bed removal.
P2/3 instability:
This usually responds well to ungual crest removal and only in a gross
instability is a tacking suture necessary in the remnants of the ruptured
collateral ligament. The differential diagnoses of P2/3 swelling are
osteomyelitis and septic arthritis, a joint tap will show excessive amounts of
neutrophils.
P1/2 instability:
Historically this challenging condition has been treated with a variety of
methods including pin firing, blistering, prosthetic ligament replacement and
ligament reconstruction. In the author’s experience none has given consistent
results. Prosthetic ligament replacement at best, only hold the joint in normal
congruity allowing the development of fibrosis. Accurate placement is difficult
and can not mimic the natural broad collateral ligament.
Ligament reconstruction is fraught as the damaged ligament may be avulsed
and is always badly frayed. Again at best, this technique maintains congruity
while periarticular fibrosis occurs.
The simplest way of maintaining congruity is by placing a 2:2 ESF dorsoabaxially
with 2 x 1.4mm pins into both P1 and P2 and connected with acrylic
(Guilliard 2003). Complications are common but generally not serious. Pin
tract infection leading to osteomyelitis with thickening of the digit resolves
after pin removal and prophylactic antibiosis will reduce the incidence.
Impingement of other digits can occur from poor pin placement. Some dogs
will not tolerate the frame and will bite off the acrylic connecting bar. Fracture
of P1 occurred during pin placement in a Whippet.
In a prospective study of 19 racing Greyhounds all returned to racing with
stable joints.