Isolated dorsal midtarsal (Chopart) dislocation: a case report.
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A case of isolated dorsal midtarsal (Chopart) dislocation resulting from blunt trauma is reported. The mechanism of injury, management, and long-term outcome are discussed. A 45-year-old inebriated man fell from a 4-m height and landed on his feet. He had immediate bilateral foot and back pain. Radiographs showed a burst fracture of the second lumbar vertebra, a left Pott's fracture, and an isolated dorsal dislocation of the right midtarsal (Chopart) joint. No neurovascular deficits or signs of compartment syndrome were noted. The image intensifier showed the unstable midtarsal joint with dorsal translation of the navicular and cuboid from the talus and calcaneum, respectively. Closed reduction of the midtarsal joint was performed with 2 transfixing 3.5-mm AO cortical screws. The right foot was immobilised in a short leg cast for 6 weeks; screws were removed 14 weeks later. At 76-month follow-up, the patient had returned to work as a construction worker, but still had right midfoot pain on prolonged walking or standing, because of persistent plantar opening up and dorsal ossification of the midtarsal joints and degenerative change at the talonavicular joint. With hindsight, open reduction may have led to a better outcome through repair of the plantar ligamentous structures, especially the plantar calcaneonavicular (spring) ligament. (+info)
The use of veterinary cuttable plates for carpal and tarsal arthrodesis in small dogs and cats.
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The objective of the study was to evaluate, retrospectively, carpal and tarsal arthrodesis in small dogs and cats by using veterinary cuttable plates in 6 animals and comparing those with arthrodesis stabilized with other implants in 9 animals. Veterinary cuttable plates were used for 1 pancarpal, 2 partial tarsal, and 3 pantarsal arthrodeses. Other implants were used to stabilize 1 pancarpal, 6 partial tarsal, and 2 pantarsal arthrodeses. In the veterinary cuttable plates group, complications included 2 cases with pressure sores and 1 case with screw loosening. One animal was lost to follow-up and 4 of the remaining 5 were always weight-bearing. In the other group, there were 2 cases with pressure sores, 1 case with dermatitis, and 2 cases with pin migration. Six out of 9 animals were always weight-bearing. The use of veterinary cuttable plates appears to be a suitable option with a good clinical outcome. (+info)
Effect of repeated arthrocentesis and single joint lavage on cytologic evaluation of synovial fluid in 5 young calves.
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The objective of this study was to evaluate the effect of repeated arthrocentesis and a single joint lavage on cytologic variables of synovial fluid. The left tarsi of 5 healthy Holstein calves were selected for the study. Samples of synovial fluid were collected daily for 4 d, then every 4 d until day 24. On day 2, joint lavage was performed with lactated Ringer's solution in all the calves. Cytologic examinations, performed by the same clinical pathologist, included the determination of total protein concentration, total leukocyte count, and differential counts (of neutrophils, lymphocytes, and monocytes). The presence of lameness or swelling and other results of physical examination were recorded regularly during the study. No clinical signs of joint disease were observed during the study. Bacterial cultures of specimens collected on day 2 were negative for all the calves. All cytologic values but 1 peaked on day 2 and progressively returned to normal. In comparison with the results for day 1, the synovial fluid total leukocyte, neutrophil, and monocyte counts were significantly increased on days 2 and 3, and the total leukocyte and monocyte counts were also significantly increased on day 4. The monocyte and lymphocyte percentages were significantly decreased until day 4, whereas the neutrophil percentages were significantly increased until day 8. The total protein concentrations were significantly increased until day 3. There were no significant differences between values for specimens taken 4 d apart. This study demonstrated that, although arthrocentesis induces a moderate inflammatory response, the joints seem to rapidly adapt. A 4-d interval between arthrocenteses is suitable when studying cellular components of the synovial fluid. However, when arthrocentesis is repeated daily, a minimal interval of 8 d should be respected. (+info)
Dislocation of the calcaneocuboid joint presenting as lateral instability of the ankle.
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A 16-year-old professional female ballet student sustained a plantar flexion-inversion injury to her left ankle while dancing. Clinical examination and MRI suggested subluxation of the tibiotalar joint. However, accurate diagnosis was hampered by a transient palsy of the common peroneal nerve. It was subsequently established that she had also sustained a dislocation of her calcaneocuboid joint, a rare injury, which was successfully stabilised by using a hamstring graft. The presentation and management of this rare condition are discussed. (+info)
Joint disorder; a contributory cause to reproductive failure in beef bulls?
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The lame sire, unsound for breeding, can cause substantial economic loss due to reduced pregnancies in the beef-producing herd. To test the hypothesis that joint disorder is a possible cause of infertility in beef sires, right and left hind limb bones from 34 beef sires were examined postmortem to identify lesions in the femorotibial, femoropatellar (stifle), tarsocrural, talocalcaneus, and proximal intertarsal (tarsal) joints. The bulls were slaughtered during or after the breeding season due to poor fertility results. Aliquots of the cauda epididymal contents taken postmortem from 26 bulls were used for sperm morphology evaluation. As a control, hind limbs (but no semen samples) from 11 beef bulls with good fertility results were included. Almost all infertile bulls (30/34) had lesions in at least one joint. Twenty-eight bulls (28/30, 93%) had lesions in the stifle joint, and 24 (24/28, 86%) of these were bilateral. Fourteen bulls (14/30, 47%) had lesions in the tarsal joint, and 10 (10/14, 71%) of these were bilateral. Four bulls (4/34, 12%) had no lesions, three bulls (3/34, 9%) had mild osteoarthritis (OA), 5 (5/34, 15%) moderate OA, 17 (17/34, 50%) severe OA and 5 (5/34, 15%) deformed OA. Almost all OA lesions (97%) were characterized as lesions secondary to osteochondrosis dissecans. All the bulls with satisfactory sperm morphology (n = 12/34) had joint lesions, with mostly severe or deformed bilateral lesions (83%). Consequently, the most likely cause of infertility in these 12 bulls was joint disease. Almost all control bulls (10/11) had OA lesions, but most of them were graded as mild (55%) or moderate (36%). None of the control bulls had severe lesions or deformed OA. We suggest that joint lesions should be taken into consideration as a contributory cause of reproductive failure in beef sires without symptoms of lameness. (+info)
Suppressive role of leukocyte cell-derived chemotaxin 2 in mouse anti-type II collagen antibody-induced arthritis.
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