Injuries to the Distal Skeleton in Sporting Dogs - Tarsus

The hock is a complex joint composed of 13 bones distributed in rows and joined by several ligaments. Injuries of the tarsus are more common in the canine athletes and involve fractures of one or more bones, ligaments sprain or a combination of these.

Talus
Fractures of the talus are very rare injuries and can be associated to fracture of the CTB in sporting dogs. These fractures are generally classified as intra articular involving the lateral or medial trochlear ridges or the base, and extra-articular involving the neck and the body. Proximal intra articular fractures are usually a diagnostic challenge and they require multiple and special radiographic views for best appreciation. They are treated by open reduction and internal fixation of large fragments and excision of small chips. To increase the surgical exposure is often necessary

Medial exposure of the talocrural joint via osteotomy of the medial malleolus. (a) Exposure of the medial aspect of the tarsus. (b) Retraction of caudal tendons prior to osteotomy. (c) Position of osteotomy. (d) Distal reflection of medial malleolus to expose the medial trochlear ridge.

To perform a fibular osteotomy. Fractures of the body, neck and base can be repaired with a combination of K wires, lag screws and\or mini plates. Fractures of the talar neck with minimal displacement can be managed conservatively.

(a) Repair of a fracture of the lateral talar ridge using countersunk K-wires. The fracture is exposed via osteotomy of the distal fibula and lateral reflection of the malleolus. If possible small lag screws should be used rather than K-wires, since these provide better stability, although when used in small bone fragments there is a risk that the lag screws can cause further fragmentation. (b) The fibular osteotomy is repaired using two positional screws into the distal tibia.  [..]