ISSN 2398-2985      

Joint/limb luxation/subluxation

Jreptile

Introduction

Uncommon injury of exotic animals largely caused by trauma during handling. Luxation involves complete loss of contact between articulating surfaces. Subluxation involves partial separation of the joint, where one surface of the bone is still in contact with the joint.Joint luxation is poorly described in reptiles.
  • Cause: trauma during handling, falling or dropping from a height, trapping of feet or limbs in wire cages, road traffic accident.
  • Signs: lameness (acute or chronic), joint effusion and swelling (this might be difficult to appreciate in small patients such as leopard geckos), pain and/or vocalization upon palpation or upon mobility, refusing to weight bear and move, lethargy, inappetence.
  • Diagnosis: clinical signs, clinical exam, palpation findings (joint instability), diagnostic imaging (radiography, computed tomography).
  • Treatment: reduction of subluxation or luxation (closed or open). External coaptation, analgesia and rest may be suitable in some cases of subluxation or luxation. In some cases of luxation, amputation Digit / limb amputation or internal/external fixation (with or without external bandage) may be required.
  • Prognosis: guarded to good.

Pathogenesis

Etiology

Predisposing factors

General

  • Inappropriate husbandry leading to injury, eg wire floor cages, slippery floors.
  • Conformation, eg underlying osteoarthritis.
  • Underlying disease, eg metabolic bone disease Metabolic bone disease.

Specific

  • Traumatic event.

Pathophysiology

  • Traumatic (most common).

Timecourse

  • Acute: majority of cases.
  • Chronic: outdoor animals monitored less closely.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Di Geronimo P M (2019) Orthopedics in reptiles and amphibians. Vet Clin North Am Exot Anim Pract 22 (2), 285-300 PubMed.
  • Naylor A D (2013) Femoral head and neck excision arthroplasty in a Leopard Tortoise (Stigmochelys pardalis). J Zoo Wild Med 44 (4), 982-989 PubMed.
  • Abou-Madi N, Scrivani P V, Kollias G V et al (2004) Diagnosis of skeletal injuries in chelonians using computed tomography. J Zoo Wild Med 35 (2), 226-31 PubMed.
  • Hernandez-Divers S (2002) Diagnosis and repair of a stifle luxation in a spur-thighed tortoise (Testudo graeca). J Zoo Wild Med 33 (2), 125-130 PubMed.
  • Coke R L (1999) External skeletal fixation of bilateral sacroiliac luxations in a savannah monitor, Varanus exanthematicus. Assoc Rep Amphib Vet 9 (4), 4-7.
  • Barten S L & Bennett R A (1996) Treatment of chronic coxofemoral luxation by femoral head and neck excision arthroplasty in a white throated monitor (Varanus albigularis). 6 (1), 10-13.

Other sources of information

  • Raftery A (2004) Surgery: Fig. 15.166. Excision arthroplasty in a juvenile geochelone sulcata. In: Medicine and Surgery of Tortoises and Turtles. Blackwell Publishing, UK. pp 463.

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