Pelvis: fracture

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Introduction

Diagnosis

Differential diagnosis

  • Septic arthritis of coxofemoral neck    .
  • Fracture greater trochanter, femoral neck, femoral epiphysis    .
  • Coxofemoral luxation.

Diagnosis

Clinical signs

  • Unilateral severe hindlimb lameness  [Musculoskeletal: gait evaluation]            . (Figs. 1-2)
  • Abduction, adduction, swinging limb motion, rotation of limb.
  • Crepitus (often indicates acetabular fracture, decreases with time since injury).
  • Pelvis: asymmetry 01 - fractureFig.3 Pelvis: asymmetry 01 - fracture
    Muscle atrophy   (Fig. 3)   (in injuries of prolonged duration >2 weeks):
    • Usually gluteals.
    • Quadriceps.
    • Semimembranosus, semitendinosus.
  • Asymmetry of the pelvis    - usually due to ilial wing fracture    .
    • Soft tissue swelling over the tuber coxae or stifle/upper thigh.
    • Rectal examination:
      • Crepitus (usually associated with external crepitus).
      • Swelling (often associated with acetabular fracture) - maybe hematoma, callus formation.
    (Figs. 4-5)

Outcomes

Prognosis

  • Good - there is no relationship between fracture location and long-term survival, however horses that sustain an acetabular fracture are less likely to return to athletic function.
  • Fair - comminuted fractures involving the acetabulum or sacroiliac joint   →   prolonged weight bearing on contralateral limb   →   secondary complications, eg degenerative joint disease of the proximal interphalangeal joint    ; distortion of pelvic canal may   →   future dystocia    .
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