THERE are some cases that, whatever your veterinary training tells you about remaining clinical and being practical, you can’t help but think ‘Ooow, that’s got to be hurting!’, writes Dominic Plumley.
Remarkably, the patient concerned was showing little sign of pain that belied the state of her right foreleg, which was, as you might have already guessed, fairly dramatic
In fact, Twiggy, a lovely six-year-old whippet, was wrapped in a blanket and lying calmly on her side, admittedly looking a little shocked but evidently unaware that, poking out of the folds, the bottom half of her leg was pointing in the wrong direction.
If you are squeamish you may want to skip this paragraph. Actually, there was no blood; in spite of the abnormal angle of the leg the skin was completely intact. However, the plantar surface of her right front foot (the bit that rests on the ground) was sitting neatly in the crook of her elbow, the 180 degree angle require to achieve this feat occurring at the carpus, the joint that is the equivalent of our wrist. I might point out that this contortion was in no way due to any talent in the double-jointed department.
Twiggy had been on the tail of a rabbit and disappeared into some trees.
Her owners heard the yelp and found her entangled in some metal bars, the lower portion of her leg apparently trapped while the rest of her body had continued at top speed in the heat of the chase. They carefully extricated her from her predicament and brought her straight to the surgery.
Having recovered from my initial ‘ouch’ moment, it was immediately apparent that, though the leg had been contorted horrendously, it was fairly fixed in its new position.
I think this probably was why poor Twiggy wasn’t howling in pain. Normally with badly broken bones the limb can be literally swinging in the wind with any movement setting the fracture ends grinding against each other triggering every nerve receptor.
We delicately moved Twiggy into the hospital taking care not to further hurt her twisted limb. We then anaesthetised her so that we could take an x-ray to assess the damage.
Fortunately, our patient was Twiggy by name alone, her skeleton made of stronger stuff with all of her bones remarkably still intact. The injury was basically a severe dislocation of her carpus (or wrist if you prefer). Now that she was asleep, I was able to gently manipulate the bones without her feeling any pain. With carefully distraction, while simultaneously un-twisting the joint, I managed to manoeuvre the bones back into place with a stomach-turning ‘clunk.’
Of course, getting the bones back into position was one thing; next I had to assess if there was any damage to the soft tissues. The foot was warm; evidently the vasculature and thus the blood supply had survived the injury, the first big problem surmounted.
In truth, I was more concerned about the disruption to the tendons and ligaments that form an integral part of the normal stability of the carpal joint.
Once again, almost miraculously, the joint was stable with no apparent significant damage.
After such a traumatic dislocation it was almost inevitable that at the very least the joint capsule would be stretched and so I decided to splint and dress the leg to provide external support to allow any damage to repair.
About an hour or so after being admitted, Twiggy was back on all four feet, albeit one of them supported by a lightweight cast.
Much to her owners’ relief, she walked back into the waiting room, even managing an enthusiastic tail wag to let everyone know that she was all right.
I guess to suffer such an injury is quite unfortunate, but in the circumstances to get away without any fractures was incredibly lucky. Her rabbit-chasing days could easily have been ended for good.