Front Matter

368 Canine Sports Medicine and Rehabilitation

This results in disruption of the ligament of the
femoral head and joint capsule, with ensuing
luxation of the hip. The gluteal and iliopsoas
muscle groups act upon the greater and lesser
trochanters, causing the femoral head to move
in a craniodorsal direction (Basher et al., 1986).
Ventral luxation is less common, and is usually
a result of a slip or fall causing the stifle to be
abruptly abducted. Underlying HD is a pre­
disposing factor for both types of luxation
(Herron, 1979).

Diagnosis

The affected patient is often non‐weight‐bearing,
with external rotation of the stifle and adduc­
tion of the lower limb. The affected limb appears
shorter, with a prominent hard swelling (the
greater trochanter) palpable above the coxofem­
oral joint. Diagnosis is made upon examination
and palpation, and is confirmed with radio­
graphs (Figure 14.17). The patient is thoroughly
evaluated for concurrent injuries commonly
seen with traumatic events.

Treatment

Treatment options include closed or open

reduction. For closed reduction, the patient is

placed under general anesthesia and traction

maneuvers are employed to replace the head

of the femur into the acetabulum. Once in

place, the limb is immobilized in an Ehmer sling

for 10–14 days (Fox, 1991; McLaughlin, 1995).

Commercially available Ehmer slings (Figure

14.18) allow for decreased skin irritation and

cutaneous vascular compromise. The ability to

open and then reattach the device allows for

passive range of motion on the unaffected

joints during the convalescent period. Patients

with ventral luxation should be placed in hob­

bles to prevent abduction following reduction.

With closed reduction, hip stability is re‐estab­

lished by joint capsule healing, production of

scar tissue, and surrounding musculature.

Once the capsule is sealed, the fluid returns

to the joint, thus adding additional stability.

The ligament of the femoral head never heals.

Closed reduction is successful in approximately

50% of first attempts (Bone et al., 1984; Basher

et al., 1986; Demko et al., 2006). It is most effec­

tive if performed within the first 12–24 hours

following the traumatic event. Closed reduction

is not an appropriate treatment option if bone

fragments are present within the joint, as occurs

with avulsion of the ligament.

When closed reduction fails, if immediate

weight bearing is necessary, or if there are con­

current orthopedic injuries, surgical interven­

tion is warranted. If the hip joint conformation

is normal, open reduction with stabilization is

Figure 14.17 Radiograph showing typical appearance
of coxofemoral luxation. Figure 14.18 Commercially available Ehmer sling.