Page 383 - Canine Lameness

20.3 ­FractFres ofctrf Hip reH o 355

(A) (C) (E)

(B) (D) (F)

Figure 20.4 Pelvic fractures I: (A, B) multiple pelvic fractures including SI luxation (illustrated by black
arrow in image (A) and the cranially located tip of the ilial wing) and comminuted ilial and acetabular
fractures of the opposing side. The lack of bone dorsal to the femoral head, (illustrated by black arrow in
image (B) clearly indicates that the fractures seen on the ventrodorsal view includes an acetabular fracture.
(C, D) Minimally displaced, long-oblique acetabular fracture (black arrow, image (D) that cannot be identified
on the ventrodorsal view; however, a fracture of the ischium (black arrow, image (C) can be visualized. (E, F) HIP REGION
CT and ventrodorsal radiographs of a dog with multiple pelvic fractures. CT aided in establishing the
diagnosis of SI luxation (white arrow) in this case, which was difficult to visualize radiographically.

surgical fixation; however, this has been disputed and some recommend fixation of all acetabu -
lar fractures (Boudrieau and Kleine 1988).

20.3.3.2 Slipped Capital Femoral Physis and Femoral Neck Fractures
In young dogs, Salter-Harris Type I or II fractures of the capital femoral physis most commonly
occur secondary to trauma, with Type I being the most common (see Chapter 13 for review of the
classification system). These fractures can be challenging to diagnose, as they are often reduced
when a standard hip extended radiograph is evaluated. If there is pain on manipulation of the cox-
ofemoral joint in a young dog and a capital physeal fracture is suspected, a frog leg view of the pelvis
can help delineate such a fracture. Additionally, placing the hip through range of motion while
taking fluoroscopic (or serial digital) images can help reveal such a fracture (Figure 20.5). In some
cases, no trauma is noted, and the onset of lameness is gradual. Such atraumatic separation has
been previously reported, but is rare (Moores et al. 2004) and is sometimes referred to as a slipped
capital femoral physis based on a similar condition described in children (Dupuis et al. 1997). In
children, it is broken down further into a pre-slip, acute, chronic, and acute-on-chronic stage.