Laurie's Blogs.

Over the last week and a half I have had a run on sesamoid bone fractures!  How many is a run?  TWO!  Yes, I have recently seen two.  Over the course of my career (now 25 years), I have only seen 4 in total.  So, seeing two so close together is a ‘run’!

In all cases, they were diagnosed by a physio / PT (3 by me and 1 by another physio).  All had been to a vet who was unable to localize the source of the lameness.  Here’s the scoop: A sesamoid fracture lameness is severe.  It looks like a foot lameness.  Each part of the body (or condition) has a different look to the kind of lameness it creates.  A foot lameness is dramatic.  In both of the recent cases, not only was the dog lame, but after walking a few steps they would hold up the affected paw (looking very woe-be-gone too, I might add).

How did I find the problem?  In every foot case, I start by clearing the neck (i.e. check it out for signs of problems), then the shoulder, then the elbow, then down to the carpus and finally I go through each digit.  I flex and extend each digit at each joint (MCP, PIP, DIP).  I squeeze each toe joint and each phalanx.  I test MCLs and LCLs for each of the interphalangeal joints.  Then I palpate the sesamoids, coming at them from the distal edge of the main carpal pad and pushing into the palmar (or plantar) aspect of each MCP (or MTP) joint.  And when you get the “Voila!  Pain!” then you know you’ve found it!

Now I don’t want to go into the diagnosis or anatomy of sesamoid bones more than that.  There’s a whole video on sesamoids on the Members side of FourLeg.  So, members should check that out if they’ve not yet watched it!  Instead I want to talk about the super simple treatment.

PADDING!  There you go, I could end the blog right there!  These dogs need some padding under their foot, and they need to wear that padding likely for several weeks until the bone heals.  As well, the owner needs to be aware of fracture healing times (6 – 8 weeks for primary healing) so that they don’t allow jumping or rip-roaring around running!  The padding can be put into a sock or bootie.  One client has one of those ‘dry bags’ that can go over the foot and leg, that Velcro around the legs nicely to keep them on.  Another padded foot option could be winter boots with padding (but many of them aren’t actually padded).  The good folks at Therapaw.com make a product called Cushy-Paws that were designed for greyhounds with corn problems… they’d work for this application as well.

What did I use?  I had this fabulous chunk of ‘fake fur’ (actually given to me as a sample by the folks at Therapaw).  I’ve had it for maybe 4 years now, but I’ve never had cause to use it.  Well, here is the perfect application.  I just cut a circle – the size of the foot – and handed to the owners to insert into the sock, bootie, baggie of choice.  I must admit, I love having odds & sods of weird materials around for exactly this sort of project!

And where are we at right now?  Well, we’re just waiting for the healing.   But the owners have each reported that the padding has made all the difference in the world! 

So there you go!  Find a sesamoid fracture?  Pad it!

On that note,  

Cheers until next time!

Laurie