The Severely Abused Chihuahua-Pom
This past summer and fall my surgery schedule became quite busy at the office, forcing surgeries to be scheduled over the two-hour noon period. This is the time that I often use to catch up with the morning medical patients.
Honey’s right knee surgery would prove to be another one of these days, with an additional hour set aside in the early afternoon to allow for any unforeseen complications.
The surgery plan consisted of removing the IM pin from her right femur, the cerclage wires encircling the fractured femur, and performing a very complex reconstruction surgery to attempt to get her knee cap back to a normal position.
The patella (knee cap) is critical for the function of the hind leg, positioned in the middle of the tendon connecting the quadriceps muscle group to the top of the shin bone of the tibia, preventing the tendon from sliding to the side of the femur. This is necessary for the normal flexion and extension of the knee joint.
The pin removal was straight forward, however the removal of the cerclage wires presented some trouble as two of them had shifted position enough to interfere with complete healing of her complicated femoral fracture. These were removed along with one other wire. The other three were locked in as the boney callous had already grown around them. The use of cerclage wires were necessary with Honey’s fracture since the traumatic injury (most likely the result of a kick) resulted with her femur breaking into multiple splintered and fissured pieces.
The three cerclage wires would need to stay, but since the femur was not fully healed, I needed to replace the internal pin with a screw pin and allow the bone to complete its healing.
As I started the reconstruction of her right knee, I found a defect in the knee. I was able to correct this defect with a very complicated and lengthy surgery.
Being a perfectionist is sometimes a cross to bear, however with surgery; I believe it is absolutely crucial. Satisfied that the surgery would give Honey every chance to have a normal leg, we took her to recovery with the hope that this time she would comply with my complete restriction orders.
It is important to allow joint surgeries, especially reconstructive-type surgeries, to maintain passive range of motion, so unfortunately a restrictive type of bandage such as a cast during the healing period can be detrimental. We would do our best, with the help of medications to try to slow her down.
The first four weeks of her complete restriction were quite smooth, but by the end of that time she started back with her moments of over-activity, including jumping and running around in circles in her Pack and Play anytime she was excited – whether we were getting her food ready, anytime she saw us or heard Wrigley and Millie. Well five days of that and she cried in pain with a partially torn right cruciate ligament.
Continued next month…
William T. Carlisle, DVM