Chapter 11 Veterinary Orthotics and Prosthetics 279addition to the effect of supraphysiological load
ing of the tarsal joint structures themselves.
Fuchs et al. (2014) studied a simulated model
of pelvic limb amputation in Beagles. They
found that amputation led to an alteration in
the forces exerted by the remaining pelvic limb
and the ipsilateral forelimb. Changes in exter
nal forces lead to alterations in internal forces
and moments acting on the joints, which may
then lead to orthopedic problems. This sup
ports the conclusions of Hogy et al. (2013) where
the contralateral thoracic limb and the remain
ing pelvic limb were found to withstand greater
forces and therefore greater wear on the joints
and soft tissues. Both studies advocated for
close monitoring of the intact support limbs,
especially the diagonal pair. It was concluded
that compensatory gaiting strategies may lead
to increased wear on joints and soft tissues.
In 2015, Goldner et al. evaluated joint angular
excursions, concentrating on the swing phase of
gait. They found substantial kinematic changes
in all three remaining limbs and in the axial skel
eton. Their findings contradict Hogy et al. (2013)
and Jarvis et al. (2013) in that they found compen
satory mechanisms to require changes in all joint
excursions and not just in the tarsus and carpus.
Further, they found that changes were not lim
ited to the weight‐bearing (stance) phases, but
that impacts were found in all aspects of the loco
motor cycle. This study took the Hogy et al. (2013)
study findings on pelvic inclination and lateral
izing long axis torque a step further, noting that
such compensation modifies trunk musculature
not only in terms of moments, but also in neuro
muscular recruitment patterns. They concluded
that tripedal locomotion requires an overall con
certed kinematic adjustment of the appendicular
and axial musculoskeletal systems. This study
recommended comprehensive and whole‐body
preventative, therapeutic, and rehabilitative care
of canine amputees.
The studies reported here, both for thoracic and
pelvic limb amputees, are helpful, however there
are as yet no longitudinal studies documenting
the potential for damage to soft tissues and joints
in the amputee. Anecdotally, one author (PMM)
routinely treats appendicular and axial myofascial
pain syndromes, carpal hyperextension, carpal
valgus and varus instability, superficial and deep
digital flexor tendon failure, and osteoarthritis
in pelvic and thoracic limb amputees. Further
studies are needed to quantify the incidence of
such sequelae as well as to determine risk factors
for breakdown and tissue damage, which may
relate to conformation, breed, level of amputation,
previous injury, and so on (Figure 11.11).Orthotic devices
Splinting and bracing are described as passive
immobilization to rest a limb segment in a fixed
position (Heijnen et al., 1997). The term coapta
tion refers to approximation and involves trans
mitting compressive (vertical) and bending
(horizontal) forces through the engineered
coaptation with specific mechanical purpose
(Oakley, 1999). The resulting corrective forces
are transmitted through skin to the bony struc
tures beneath. Customized external coaptation
can be used to provide limb segment stability
before surgical repair and help prevent wounds
or surgical failures caused by splinting, wet
bandages, splint material fatigue/breakdown,
and lack of patient tolerance of a splint. As a(A)(B)Figure 11.11 (A) The pathomechanical consequences of
pelvic limb loss can be mitigated with the use of a
properly fitted prosthesis. (B) Below‐tarsus prosthesis for
traumatic tarsometatarsal amputation. (Images derived
from videos.)