Pensioners Jean and John bring in their rescue dog, 18 month old Ted, to see Professor Noel Fitzpatrick. Ted was rescued in Spain where he was living as a stray and he has been with Jean and John for only 10 weeks, but he has already captured their hearts. They could not be more devoted to him nor he to them; a marriage made in Heaven.

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However Ted has seriously deformed front legs (antebrachial deformity), because the bones in both forearms (radius and ulna) have grown at different rates with the ulna shorter than the radius. The overgrown radius on each side has pushed Ted’s front feet out sideways. Noel performs a CT scan and takes some x-ray images which reveal the true extent of the problem. The forearms are so deformed, and the front feet so out of alignment, that the ligaments of the wrists have been stretched significantly. Ted is suffering constant pain from the malalignment of both of this wrists (carpi) and both of his elbows, which also have suffered from a poor fit of the bones.

The 3D CT scan of Ted’s legs showing how deformed the wrist and paw are relative to the elbow.

The 3D CT scan of Ted’s legs showing how deformed the wrist and paw are relative to the elbow.

Jean and John really want to do their best for Ted to make sure he’s not in pain and can run around with a good quality of life. Noel explains that both front legs will need the same operation and it will be necessary to cut both of the bones of the forearms (radius and ulna). Noel uses a saw shaped like an ice-cream scoop (dome saw) so that when the cut is made it creates ball and socket surfaces. This allows the foot to be manipulated in three dimensions relative to the elbow so that the limbs can be re-aligned.

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This is a major operation but Noel feels it’s best for Ted to straighten both front legs at the same time. Once straightened out, the bone segments are secured in place on both sides using two metal plates and multiple screws. The operation takes 3 hours for both  limbs and post-operative imaging shows that the elbow and the wrist on both sides are realigned appropriately and locked in their new position.

Ted is taken through to the wards for recovery under the watchful care of the nurses and ward staff who all promptly fall in love with him. However, he proves a tricky patient in that he is raring to go and he needs to be kept calm to allow his legs to fully heal.

When the day came for Jean and John to take Ted home, they were overjoyed with his newly straightened legs. Ted doesn’t like water but soon grows used to it since hydrotherapy is the most efficient way to build up strength and muscle power in his realigned legs

2 months on and Ted runs around with a delighted Jean and John who can now look forward to years of pain-free happiness with their friend. We couldn’t put it better then Jean: “He has everything now, and so do we”

 

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