Angular limb deformity in a 2 year old boxer

[Guest guest]

I have a 2½ year old boxer that came in to me for a wellness exam. On exam she has a valgus deformity of the stifle that is related to an old tibial fracture that occured in 2009 which resulted in a medial patellar luxation and internal tibial rotation. The patellar luxation was repaired early in 2010 and the old tibial fracture had been managed with external coaptation. The first time I've seen the dog is today for the wellness exam.

On exam she is significantly muscle wasted in the affected quadricepts and walks with her hip externally rotated, and the tibia internally rotated. She also walks with her sacrum tucked, thus giving her a rounded appearance to her lumbar spine. She will fully weightbear if forced, but at a walk only toe touches the leg. She is not painful on manipulation through range of motion exercises.

At this point I have only completed the first module of the course, and headed to Coral Springs this week for the therapist module. Are there any suggestions I can give to this owner for things we can do to strengthen the leg and try to work on a more normal limb position?

Any input would be helpful as I really have minimal thoughts on where to start given I'm just starting my therapist journey.

Thanks.

a

[Guest guest]

a,

Could you post some radiographs? MPL is a problem of limb alignment. From your

description I would be concerned with both a femoral varus and femoral rotation

deformity. On the lateral radiographic view, with the coxofemoral, stifle and

hock all in the same plane (flat surface), femoral condyles should be

superimposed. If one appears longer than the other then varus or valgus, if

one is behind the other then rotational deformity. If either of these are

pronounced then the standard deeping of intercondylar groove, TTT, medial

release and lateral imbrication will not adequately correct the MPL and could

lead to further complications.

Rick Wall, DVM

[Guest guest]

Rick

The issue with the leg is complex in that all of the issues started with a

poorly handled tibial fracture when the dog was a pup. At this point the

only radiographs I have are those from a couple of years ago when the dog

was evaluated for MPL. I can talk to the clients about current radiographs

but as of right now I don't have any.

Re: Angular limb deformity in a 2 year old boxer

> a,

>

> Could you post some radiographs? MPL is a problem of limb alignment.

> From your description I would be concerned with both a femoral varus and

> femoral rotation deformity. On the lateral radiographic view, with the

> coxofemoral, stifle and hock all in the same plane (flat surface), femoral

> condyles should be superimposed. If one appears longer than the other

> then varus or valgus, if one is behind the other then rotational

> deformity. If either of these are pronounced then the standard deeping of

> intercondylar groove, TTT, medial release and lateral imbrication will not

> adequately correct the MPL and could lead to further complications.

>

> Rick Wall, DVM

>

>

>

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