Page 382 - Canine Lameness

354 20 Hip Region

(A) (B)

(C) (D)

Figure 20.3 The pelvis can be considered a rigid box-like structure and for any substantial displacement
to occur, at least three fractures have to be present (unless an SI luxation is also present). (A) Typical
appearance of a dog with multiple fractures of (red arrows) pubis and ischium and an (black arrow) SI
luxation; the green arrow illustrates the distal aspect of the sacrum, the location where the articular
HIP REGION surface of the ilium should be located. This allows for (white arrow) displacement of the ilium (i.e. it is
located further cranial than the tip of the ilium of the contralateral side). (B) Example of an iliac fracture
illustrating the concept of the “pelvic box.” Note that while the (white arrow) wing of the ilium itself is not
displaced, the fractured (black arrow) body of the ilium can be seen cranial to the tip of the wing of the
ilium. Also note the location of the obturator foramina indicating the displacement. (C) The fracture itself is
best visualized on the lateral radiograph (white arrow); (D) note restoration of the structural integrity of the
pelvis, including the symmetric location of the obturator foramina and tips of the ilial wings, after surgical
repair of the fracture illustrated in (B, C).

20.3.3 Fractures of the Coxofemoral Joint

With fracture of the coxofemoral joint there will be pain and crepitus with range of motion of the
joint. This can sometimes be difficult to assess given the patients generalized discomfort, or with
fractures of the ilium near the coxofemoral joint. These are intra-articular fractures and surgical inter-
vention is generally recommended to achieve the best outcome for the patient. Even with surgical
intervention, such injury predisposes the patient to develop osteoarthritis (OA) in the joint over time.

20.3.3.1 Fractures of the Acetabulum
In cases of possible acetabular involvement, a CT scan can be useful to determine exact loca -
tion and extent of the fracture. If CT is not available for imaging, oblique lateral views can be
useful to remove some of the superimposition of the pelvis aiding in assessment for acetabular
involvement and comminution. Caudal acetabular fractures may not necessarily require