Thinking outside the box and innovative surgery helps cure Lola of lameness

A DOG whose leg became lame while playing in the park has been cured thanks to innovative surgery.

Lola, a lively three-year-old neutered female Hungarian Vizsla, was referred to East of England Veterinary Specialists, Cambridgeshire, after suddenly becoming lame on her right hind limb.

Specialist Orthopaedic surgeon Mark Bush took charge of the case and immediately identified a swollen and painful tarsus.

CT imaging uncovered rare and complex fractures - one affecting the sustentaculum tali of the calcaneus and another involving the lateral ridge of the talus, extending into the joint.

Treatment of Lola's leg proved tricky and required innovative solutions

Due to their unusual, non-displaced nature and challenging location, initial treatment was conservative.

Lola’s limb was immobilised in a cast for six weeks with regular bandage changes. On re-examination, the calcaneal fracture was showing signs of healing however, the talar fracture remained unchanged and Lola was still lame.

Surgical repair posed a dilemma. A standard lag screw technique was impractical - the fracture's location offered insufficient bone stock to safely countersink a conventional screw head, risking protrusion that could impinge on the tibial malleolus and compromise joint function.

The salvage option, pantarsal arthrodesis, would have severely limited limb use and carries a significant complication rate, making it undesirable for such a young, active dog.

Instead, Mark and the team opted for an innovative solution: a headless compression screw (HCS), commonly used in human orthopaedic surgery for peri-articular fractures.

Techniques from human surgery were used to fix Lola's leg

The HCS generates compression along the fracture line thanks to its differential thread pitch, while its headless design allows full burial within the bone, eliminating the risk of joint interference.

The fracture’s small size, delicate location, and proximity to the joint meant precision was critical. To ensure accurate screw placement, Mark performed the surgery under real-time intra-operative imaging, a technique he has refined over more than a decade.

Using continuous X-ray guidance allowed confirmation of ideal screw trajectory and depth, avoiding both joint violation and inadequate fracture engagement.

Post-operatively, Lola’s limb was supported in a bandage for an additional six weeks to protect the repair.

At recheck, CT scans confirmed good healing progress, and the bandage was removed. Just two weeks later, Lola had returned to full activity, completely sound and free from lameness.

Mark said: “Cases like Lola’s highlight why experience matters. Being able to think outside the box and apply techniques borrowed from human surgery - combined with real-time imaging - lets us solve complex problems and avoid last-resort procedures like arthrodesis.

“It’s this mix of technology, skill and innovation that makes a real difference for our patients here at East of England Veterinary Specialists.”