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Elbow Luxation in Cats

By: Dr. Nicholas Trout

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Elbow luxation is usually associated with trauma causing the lower portion of the joint, the radius and ulna, to move laterally (away from the body) relative to the upper bone of the joint, the humerus. This condition is also known as a dislocated elbow.

A history of trauma, fighting with another animal, or falling from a height can be associated with elbow luxation. There is no specific age, sex or breed predeliction. Younger animals tend to fracture at the growth plates of their bones rather than developing a luxation.

Affected animals are unable to bear weight on the leg. If untreated your pet would lose useful function of the front leg.

What to Watch For

  • Sudden onset of front leg lameness
  • Carrying the elbow flexed
  • Significant elbow swelling

    Diagnosis

    Most pets present to the veterinarian with a history of trauma and a sudden onset of profound front leg lameness. The limb is carried, held out from the body and typically is outwardly rotated. There is swelling and pain at the elbow joint. Diagnostic tests may include:

  • Radiographs of the elbow that show that the radius and ulna have moved lateral to the humerus. This is best appreciated on a front to back view of the elbow. Radiographs should be carefully scrutinized for fractures of the bones of the joint and avulsion injuries where torn ligaments have fractured off small pieces of bone at the contact points from which they originate or insert.

  • There is no specific laboratory test for elbow luxation. Blood tests may be suggested as part of a pre-anesthetic work up and in cases where trauma may have caused injury to other body systems.

  • Pre-anesthetic chest x-rays may be part of a work up for any animal that has sustained trauma prior to anesthesia.

    Treatment

    Many luxations of the elbow can be treated medically, that is putting the elbow back into the correct alignment without surgically approaching the joint. This "closed" reduction requires general anesthesia. This conservative approach may be more difficult or even impossible if the injury is more than a few days old or the damage to the collateral ligaments that stabilize the elbow are so severe that the elbow joint remains unstable even after the bones have been restored to their normal position (reduction).

    Once the elbow has been reduced, radiographs are taken to confirm that the elbow is in place. If the elbow looks right on the X-ray and feels stable, the elbow is placed in an extended (straight) position in a splint and soft padded bandage for about two weeks.

    When the medical approach is not feasible or the results are unacceptable, a surgical repair of the elbow is undertaken. This can involve using screws and washers, or even pins to either hold the joint in the correct alignment or to replicate the ligaments that held the elbow in the appropriate position. After surgery the elbow is supported in an extension splint for two weeks.

    Home Care

    The bandage needs to stay clean and dry. The toes will extend from the base of the bandage and can be checked daily for swelling, cold or pain.

    Your veterinarian will remove the bandage and will ensure that the joint is still in the correct alignment. He will demonstrate physiotherapy in the form of passive range of movement of the joint.

    Restriction is necessary for an additional four weeks. This means there is no going up or down stairs, no jumping on/off furniture, and no rough-housing.

    Preventative Care

    Most elbow luxations occur secondary to significant trauma and so appropriate fencing and leashing of your pets should help to reduce the risk of this and many other traumatic injuries.

    Range of motion following elbow luxation is usually fair to good. There is often joint thickening and some arthritis. The more unstable the elbow prior to surgery, and the larger the dog, the poorer the overall outlook, although acceptable limb function can usually be achieved.

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