Fractures and Luxations of the Hock

摘要

Fractures and luxations of the hock occur infrequently, and involve numerous sites and fracture configurations, making treatment and assessment of prognosis challenging. The hock is heavily invested by collateral and periarticular ligaments and the insertions of extensive muscles and ligaments, including the cranial tibial and peroneus tertius muscles. Osteomyelitis, sequestration of fracture fragments, and chronic drainage are common complications of this fracture. Additionally, disruption of the sustentaculum tali, infection of the tarsal sheath and deep flexor tendon, and displacement of the superficial flexor tendon from the tuber calcaneus are possible sequelae to calcaneal fracture. Multiple radiographic projections of these bones are important if surgical repair is being considered. Ideally, three-dimensional imaging using standing magnetic resonance imaging or standing robotic computed tomography (CT) should be used to establish the fracture configuration. Additionally, use of CT under anesthesia immediately prior to surgery allows for better assessment of the fracture planes and more appropriate screw placement.