Veterinary Rehabilitation and Hydrotherapy

Bridie Beaumont-Terry – complex forelimb fractures

History

Bridie, a five-year-old female Boxer, was referred to Kennel & Paddock for physiotherapy treatment in September, approximately three months after surgery in May for a complex fracture to her radial carpal bone. Unfortunately there was irritation to the tissues from a part of the metal fixation and Bridie underwent a second surgery (in June) to remove a screw. Following this she was required to wear a large bandage to splint the carpus straight to reduce stress to the fracture repair for six weeks.

Assessment

On Bridie’s first physiotherapy appointment she was 4/10 lame on her affected leg in walk and showed reduced balance of the left forelimb, reduced carpal flexion to 80 degrees due to joint stiffness and soft-tissue shortening and a soft swelling over the top of the joint. Her owners were extremely concerned about her progress and their goal was to get her back to her longer walks and playing with other dogs.

Treatment

Physiotherapy treatment was started and included pulsed electromagnetic field therapy, phototherapy, joint mobilisations, muscular stretches and exercise therapy. Her owners were given a home-exercise programme that they carried out daily. It included ice application to the carpus, stretches, balance and progressive loading exercises.
During this time Bridie was on a strict exercise regime prescribed by the vet initially then prescribed by us at Kennel & Paddock. This included starting with two 5-minute walks per day, building up to 20-minute walks over four weeks. At this point we advanced her exercise regime to hills and unstable surfaces, and increased her pace (introducing trot and running free at intervals).

Outcome

On her last appointment eight weeks later, Bridie was completely sound at walk, trot and canter, and was thoroughly enjoying her walks (which were up to 40 minutes twice a day). She was back to bouncing on her forelimbs. She had achieved 90 degrees of carpal flexion and had normal strength, balance and stability to the left forelimb.

a. Transverse  CT 3D reconstruction of the fractured radial carpal bone, with the radius/ulna removed

b. Postoperative x-ray: screw fixation of the radial carpal bone

c. Postoperative x-ray (mediolateral view)

d. 2D CT reconstruction, sagitall view, fracture radial carpal bone

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