Case Reports

Windsor – Congenital Radial Hypoplasia of Right Forelimb

Written by: Brianna Bowery

Michigan State University

College of Veterinary Medicine, Class of 2019

Name: Windsor

Signalment: 11 months, neutered male, Cavalier King Charles Spaniel

Diagnosis: Radial hemimelia (radial and carpal aplasia)

  

Assessment: Windsor initially presented to Pawsitive Steps Rehabilitation and Sports Medicine for evaluation of a congenital right forelimb deformity, where a portion of his right radius did not develop. At the time of initial presentation, Windsor was still growing, so a permanent device to correct the deformity was not recommended. Windsor was placed in a temporary splint and bandage until his growth plates solidified. He was then fitted for an orthotic/prosthetic device which allows him to properly posture and bear weight, realigning his anatomy to optimal positioning.  Over the past couple of months, Windsor has been acclimating well to device, demonstrating solid mobility and stability. Windsor has also gained muscle mass in his right front limb and has strengthened his core and hindlimb musculature.

 
Reason for presentation:

  • Congenital right forelimb deformity
  • Right carpal varus (laxity)

Client’s initial rehab goals:

  • Find long term solution for crooked paw -> application of right forelimb prosthetic/orthotic 11/7/18 (once matured)
  • Strengthen core, thigh and hip muscles

Initial exam:

  • Gait analysis (without device): Typical tripod gait (leg in the air) or bears weight on right elbow, wide hind limbs, short stride in hind limbs
  • Posture analysis: Carpal supination, unlevel back

Client’s rehab goals with device:

  • Acclimate to device and improve quality of movement
  • Improve flexibility
  • Build strength of right forelimb musculature
  • Strengthen core, thigh and hip muscles

Follow-up exam:

  • Gait analysis (with device): Weight bears on right forelimb, externally rotates device, level back
  • Posture analysis: level back, even weight-bearing, occasionally holds up device


Modalities utilized:

  • Therapeutic massage
  • Therapeutic exercises
  • VSMT

Homework exercises:

  • Cookie sidebends and stretches
  • Cavalettis
  • Weight shifting (wobble board)
  • Figure 8s
  • Proper sit
  • Sit to stand

Plan: Windsor’s rehab sessions were initially focused on improving his short-term comfort and mobility. After his device was fitted, rehab was utilized to help Windsor bear weight properly and comfortably on his device. Windsor has since graduated from frequent appointments and is now visiting Pawsitive Steps Rehabilitation and Sports Medicine for checkups every few months to evaluate his progress.

Windsor was also Pet of the Month at Pawsitive Steps Rehabilitation & Sports Medicine in January 2019.  You can see his POTM information here:  https://www.pawsitivestepsrehab.com/pet-of-the-month/item.html/n/200133

 

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