<h2>Elbow Dysplasia 1</h2> <h4>Fragmented Coronoid Process (FCP) = Medial Coronoid Disease (MCD)</h4> <h6>What are the treatment options?</h6> <p>MCD/FCP constitutes a spectrum of disease and there are many treatment options. The best treatment option for each dog can only be recommended following thorough assessment of the severity of disease, particularly on clinical examination, x-rays, CT scan and arthroscopy.</p> <h6>1.Non-surgical management</h6> <p>Non-surgical management may allow some improvement in lameness or pain in the short term, particularly in patients with only very limited disease development. It may be the best option in some cases. Four basic methods are usually recommended:</p> <ul> <li>Body weight management</li> <li>Exercise modification and physical therapy</li> <li>Anti-inflammatory / pain relief medications (e.g. NSAIDs, pentosan polysulphate)</li> <li>Nutraceutical supplements (e.g. glucosamine, chondroitin sulphate, Green-lipped Mussel extract, etc)</li> </ul> <p>However, we recognize in our case population that surgical treatment can carry a better long-term prognosis than non-surgical treatment in many dogs affected by MCD/FCP.</p> <h6><br /></h6> <h6><img src="../../pictures/0000/0453/elbow_displasia_img_002.jpg" alt="http://www.fitzpatrickreferrals.co.uk/pictures/0000/0453/elbow_displasia_img_002.jpg" />&nbsp;&nbsp;&nbsp; <img src="../../pictures/0000/0451/elbow_displasia_img_005.jpg" alt="http://www.fitzpatrickreferrals.co.uk/pictures/0000/0451/elbow_displasia_img_005.jpg" /></h6> <h6><br /></h6> <h6>2.Biceps Ulnar Release Procedure (BURP)</h6> <p>This involves cutting the tendon of the biceps brachii &ndash; brachialis complex, a large muscle that attaches onto the ulna immediately next to the coronoid process and can exert a large rotational force on it, contributing to conflict between the humerus and ulna and therefore MCD/FCP in some dogs. We believe that this procedure is only appropriate for a limited population of dogs with a specific pattern of disease identified on arthroscopy, and it is currently only performed in a handful of veterinary hospitals worldwide.</p> <h6>3.Subtotal Coronoid Ostectomy (SCO)</h6> <p>In animals with more serious damage, we can improve lameness and pain in most dogs by surgical removal of the damaged part of the coronoid process. Most arthroscopists nowadays remove the fragment(s) and an additional portion of the remaining damaged coronoid process in an effort to ameliorate frictional abrasion due to humero-ulnar conflict.</p> <p><a onclick="window.open(this.href,'Picture','height=500,width=700');return false;" href="../../pictures/0000/0447/elbow_displasia_img_004.jpg"><img src="../../pictures/0000/0447/elbow_displasia_img_004.jpg" alt="http://www.fitzpatrickreferrals.co.uk/pictures/0000/0447/elbow_displasia_img_004.jpg" /><img src="../../pictures/0000/0449/elbow_displasia_img_003.jpg" alt="http://www.fitzpatrickreferrals.co.uk/pictures/0000/0449/elbow_displasia_img_003.jpg" /></a></p> <h6>4.Proximal Ulnar Osteotomy&nbsp; (PUO)</h6> <p>The radius and the ulna (the two fore-arm bones) make up the lower part of the elbow joint, and should share the weight-bearing forces transmitted through the joint. If the radius grows to a shorter length than the ulna, a &ldquo;step&rdquo; is formed within the elbow joint or if the ulnar notch doesn&rsquo;t fit the humerus properly, either scenario can cause an increased proportion of the weight-bearing forces to be transmitted to the coronoid process of the ulna, and can result in MCD/FCP. In such circumstance, cutting the bone of the ulna below the joint allows the ulnar alignment to correct and may limit ongoing humero-ulnar conflict.</p> <p><img src="../../pictures/0000/0443/elbow_displasia_img_001.jpg" alt="http://www.fitzpatrickreferrals.co.uk/pictures/0000/0443/elbow_displasia_img_001.jpg" /></p> <h6>5.Sliding Humeral Osteotomy (SHO)</h6> <p>In some dogs with advanced MCD/FCP, the cartilage across the medial (inner) half of the elbow joint may already have been fully eroded away, while the lateral (outer) half of the joint remains relatively healthy. SHO is an advanced surgical procedure and is currently only offered in a few veterinary hospitals worldwide. It involves cutting the humerus and fixing it in a new position using a special stepped bone plate and screws. This transfers weight away from the diseased medial joint to the healthier lateral joint surface.</p> <h6>6.Total Elbow Replacement (TER)</h6> <p>In some dogs elbow osteoarthritis may be extremely severe with little healthy cartilage. The procedures above may be unable to restore comfort or function. TER is a &ldquo;salvage&rdquo; procedure (i.e. it is performed as a last resort where other treatments will be ineffective) and involves replacing the entire elbow joint surface with metal and plastic implants. We are one of the few practices in the UK able to provide this procedure routinely.</p> <p><a class="pdf" href="../../documents/0000/0028/elbow_displasia_001_client_handout.pdf">Download Client Handout Sheet for this Surgery</a></p> 2009-08-27T14:55:16Z Just to say thank you. Cassie the Boxer is back running at top speed after her elbow operation. It's great to see her running around again. Thank you so much!... Elizabeth and Alec 34 2 1 25,45 1 treatments_and_sugeries Treatments & Surgeries 2009-09-04T13:05:12Z