{"id":3125,"date":"2021-09-06T09:01:02","date_gmt":"2021-09-06T07:01:02","guid":{"rendered":"https:\/\/crarbcn.com\/?p=3125"},"modified":"2021-09-13T11:40:16","modified_gmt":"2021-09-13T09:40:16","slug":"luxacion-de-tarso-traumatica","status":"publish","type":"post","link":"https:\/\/crarbcn.com\/es\/luxacion-de-tarso-traumatica\/","title":{"rendered":"Luxaci\u00f3n de tarso traum\u00e1tica."},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">Caso realizado por Eva Vidal, veterinaria rehabilitadora de CRAR<\/h3>\n\n<p class=\"wp-block-paragraph\">El caso que compartimos este mes en el blog de CRAR \u2013 Centro de Rehabilitaci\u00f3n Animal de Referencia, especialistas en fisioterapia veterinaria en Barcelona es el de<strong> Belty<\/strong>, perra hembra cruzada de 5 a\u00f1os que sufri\u00f3 una <strong>luxaci\u00f3n de tarso traum\u00e1tica<\/strong>.<\/p>\n\n<blockquote class=\"wp-block-quote is-style-default is-layout-flow wp-block-quote-is-layout-flow\"><p><\/p><cite> <p>La articulaci\u00f3n del tarso se estabiliza gracias a una compleja red de peque\u00f1os ligamentos que unen sus diferentes huesos. La luxaci\u00f3n y subluxaci\u00f3n tarsocrurales normalmente son consecuencia de un traumatismo grave, como un accidente de tr\u00e1fico, y suelen ir acompa\u00f1adas de fractura maleolar, ruptura del ligamento colateral y lesi\u00f3n por cizallamiento o \u00abShearing injury\u00bb. Los ligamentos mediales suelen ser los m\u00e1s afectados, a causa de que soportan m\u00e1s estr\u00e9s a causa del ligero valgus postural de la articulaci\u00f3n del tarso.<\/p>(Fossum, 2009; Tobias &amp; Johnston, 2012)<\/cite><\/blockquote>\n\n<p class=\"wp-block-paragraph\">Como consecuencia de un <strong>atropello<\/strong> Belty sufri\u00f3 <strong>lesiones<\/strong> en la zona del <strong>tarso<\/strong> de la extremidad posterior izquierda:<\/p>\n\n<ul class=\"wp-block-list\"><li>Desgarro de la piel con visualizaci\u00f3n de tendones y hueso.<\/li><li>Abrasi\u00f3n del maleolo lateral.<\/li><li>Inestabilidad por p\u00e9rdida del ligamento colateral.<\/li><\/ul>\n<p class=\"wp-block-paragraph\">En el <strong><a href=\"http:\/\/www.hvmolins.com\/\">Hospital Veterinario Molins<\/a><\/strong> procedieron a realizar <strong>cirug\u00eda reconstructora<\/strong>.<\/p>\n\n<ul class=\"wp-block-list\"><li>4 tornillos del 2&#8217;7, 3 arandelas, sutura nylon del 1 y cerclaje del 0&#8217;7.<\/li><li>Fijadores externos transarticulares con 3 agujas.<\/li><\/ul>\n<figure class=\"wp-block-gallery columns-2 is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\"><ul class=\"blocks-gallery-grid\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-1.png\" alt=\"\" data-id=\"3100\" data-full-url=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-1.png\" data-link=\"https:\/\/crarbcn.com\/?attachment_id=3100\" class=\"wp-image-3102\" srcset=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-1.png 300w, https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-1-150x150.png 150w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-2.png\" alt=\"\" data-id=\"3103\" data-full-url=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-2.png\" data-link=\"https:\/\/crarbcn.com\/?attachment_id=3103\" class=\"wp-image-3105\" srcset=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-2.png 300w, https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiografia-2-150x150.png 150w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/figure><\/li><\/ul><figcaption class=\"blocks-gallery-caption\">Im\u00e1genes cedidas por Hospital Veterinari Molins.<\/figcaption><\/figure>\n<p class=\"wp-block-paragraph\">Los <strong>fijadores externos<\/strong> se retiraron al cabo de<strong>2 meses<\/strong>, a pesar de que radiogr\u00e1ficamente parec\u00eda todo correcto la evoluci\u00f3n de Belty no fue buena. Presentaba mucha inflamaci\u00f3n por una <strong>posible infecci\u00f3n<\/strong>, hizo <strong>adherencias<\/strong> en el calc\u00e1neo con el tend\u00f3n flexor digital, <strong>contractura<\/strong> del cuadriceps, isquios y gastroctemio debido a no apoyar nunca la extremidad&#8230; <\/p>\n\n<p class=\"wp-block-paragraph\">Despu\u00e9s de <strong>3-4 meses<\/strong> en los que Belty continuaba con <strong>cojera sin apoyo<\/strong> y la herida siendo un foco de infecci\u00f3n y dolor, sus cuidadores se llegaron a plantear la <strong>amputaci\u00f3n de la extremidad<\/strong> afectada. <\/p>\n\n<p class=\"wp-block-paragraph\">El servicio de fisioterapia del Hospital Veterinario Molins decidi\u00f3 referirnos el caso para complementar el trabajo que hab\u00edan iniciado ellos.<\/p>\n\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Primera valoraci\u00f3n funcional<\/span><\/h2>\n\n<ul class=\"wp-block-list\" id=\"block-c1bc3c8f-5d7c-4070-befd-244b25f8acc6\"><li><strong>Examen neurol\u00f3gico:<\/strong> normal<\/li><li><strong>BCS:<\/strong> 5\/9<\/li><li><strong>Din\u00e1mica:<\/strong> cojera 6\/6, rigidez lumbar al trote. Se levanta y se sienta de forma aut\u00f3noma usando solo EPD.<\/li><li><strong>Est\u00e1tica:<\/strong> <strong>falta<\/strong>completa de apoyo de la extremidad posterior izquierdo, hipertrofia de la extremidad posterior derecha y tercio anterior. Perimetria EPD 37cm y EPI 32cm. Engrosamiento c\u00e1psula articular del tarso izquierdo con limitaci\u00f3n mec\u00e1nica de la flexi\u00f3n. Limitaci\u00f3n extensi\u00f3n cadera y rodilla extremidad izquierda con leve acortamiento de los m\u00fasculos flexores. Presentaba mucha tensi\u00f3n en m\u00fasculos adductores de la EPI. Trigger points en tr\u00edceps bilaterales.<\/li><\/ul>\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Objetivos<\/span><\/h2>\n\n<ul class=\"wp-block-list\" id=\"block-44085a34-21e1-4b16-aff7-fe9ca4d04c27\"><li><strong>Controlar dolor e inflamaci\u00f3n<\/strong>.<\/li><li><strong>Reeducaci\u00f3n<\/strong>postural y de la marcha.<\/li><li><strong>Controlar cambios compensatorios: <\/strong>espalda, EPD, EAD.<\/li><li>Favorecer <strong>trofismo muscular<\/strong>.<\/li><\/ul>\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Plan de rehabilitaci\u00f3n<\/span><\/h2>\n\n<p class=\"wp-block-paragraph\"><strong>En el caso de Belty realizamos un total de 6 sesiones, a raz\u00f3n de 1 vez por semana, despu\u00e9s pasamos a realizar sesiones cada 15 d\u00edas.<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Las<strong>terapias de rehabilitaci\u00f3n<\/strong> veterinaria que usamos fueron<strong>:<\/strong><\/p>\n\n<ul class=\"wp-block-list\" id=\"block-d5beb36b-2163-4e1c-94f1-2c9ea7af30d8\"><li><strong>Radiofrecuencia <a href=\"https:\/\/crarbcn.com\/es\/indiba-la-radiofrecuencia-en-rehabilitacion-veterinaria\/\">INDIBA<\/a><\/strong>: trabajamos la musculatura de la extremidad para relajarla y darle m\u00e1s flexibilidad. De este modo, favorecimos un correcto y completo movimiento de la extremidad para que pudiera volver a apoyarla con la m\u00e1xima normalidad posible.<\/li><li><strong>Terapia manual:<\/strong> aprovechando la aplicaci\u00f3n de la radiofrecuencia realizamos movilizaciones pasivas de las articulaciones de la extremidad afectada para mejorar el rango de movilidad. As\u00ed, tambi\u00e9n, activ\u00e1bamos el linfonodo popl\u00edteo para ayudar a disminuir la inflamaci\u00f3n del tarso.<\/li><li><a href=\"https:\/\/crarbcn.com\/es\/la-cinesiterapia-activa-y-el-control-neuromotor-en-crar\/\"><strong>Cinesiterapia activa<\/strong><\/a> con circuitos <strong>cavaletti<\/strong>.<\/li><li><a href=\"https:\/\/crarbcn.com\/es\/la-hidroterapia-en-el-crar\/\"><strong>Hidroterapia<\/strong><\/a>en cinta subacu\u00e1tica.<\/li><\/ul>\n<p class=\"wp-block-paragraph\">C\u00f3mo es habitual en los casos que tratamos, instauramos<strong>rutinas de rehabilitaci\u00f3n<\/strong> en casa, que tienen un papel muy importante en el tratamiento y la buena evoluci\u00f3n de los pacientes.<\/p>\n\n<figure class=\"wp-block-gallery columns-2 is-cropped wp-block-gallery-2 is-layout-flex wp-block-gallery-is-layout-flex\"><ul class=\"blocks-gallery-grid\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacio_tars_cavaletti.png\" alt=\"\" data-id=\"3112\" data-full-url=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacio_tars_cavaletti.png\" data-link=\"https:\/\/crarbcn.com\/?attachment_id=3112\" class=\"wp-image-3114\" srcset=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacio_tars_cavaletti.png 300w, https:\/\/crarbcn.com\/wp-content\/uploads\/luxacio_tars_cavaletti-150x150.png 150w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"300\" src=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiofrecuencia_indiba-1.png\" alt=\"\" data-id=\"3109\" data-full-url=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiofrecuencia_indiba-1.png\" data-link=\"https:\/\/crarbcn.com\/?attachment_id=3109\" class=\"wp-image-3111\" srcset=\"https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiofrecuencia_indiba-1.png 300w, https:\/\/crarbcn.com\/wp-content\/uploads\/luxacion_tarso_radiofrecuencia_indiba-1-150x150.png 150w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/figure><\/li><\/ul><\/figure>\n<h2 class=\"wp-block-heading\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">Evoluci\u00f3n<\/span><\/h2>\n\n<p class=\"wp-block-paragraph\">En el video puedes ver la evoluci\u00f3n de Belty durante el tratamiento de fisioterapia postquir\u00fargica de su luxaci\u00f3n de tarso. <\/p>\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Luxaci\u00f3n de tarso traum\u00e1tica | CRAR BCN\" width=\"1080\" height=\"608\" src=\"https:\/\/www.youtube.com\/embed\/NElI3HF5w5E?feature=oembed\"  allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<ul class=\"wp-block-list\"><li> Ha mejorado el <strong>tono muscular<\/strong>.<\/li><li>Control del <strong>dolor<\/strong> y de la <strong>inflamaci\u00f3n<\/strong> del tarso.<\/li><li><strong>Apoya<\/strong> la EPI en el 70% de las situaciones, solo la levanta un poco cuando corre.<\/li><\/ul>\n<hr class=\"wp-block-separator\"\/>\n\n<figure class=\"wp-block-pullquote\"><blockquote><p><\/p><cite>La inmovilizaci\u00f3n de la articulaci\u00f3n despu\u00e9s de la cirug\u00eda favorece la regeneraci\u00f3n y la formaci\u00f3n de tejido fibroso. Se recomienda limitar la actividad a paseos con correa y rehabilitaci\u00f3n f\u00edsica espec\u00edfica durante 6 semanas, despu\u00e9s de retirar la f\u00e9rula y\/o vendaje se tiene que volver gradualmente a la normalidad durante 6 semanas m\u00e1s.<br\/>Todav\u00eda se desconoce cu\u00e1nto se tarda en cicatrizar un ligamento, puede necesitar hasta un a\u00f1o, y no acabar de recuperar del todo su capacidad de tensi\u00f3n.<br\/>Lo que s\u00ed se sabe es que una movilizaci\u00f3n pasiva y un apoyo parcial durante las primeras fases de la regeneraci\u00f3n ligamentosa resulta en una regeneraci\u00f3n m\u00e1s r\u00e1pida y un mejor alineamiento anat\u00f3mico de las fibras de col\u00e1geno.<br\/>(Fossum 2009, Levine &amp; Millis 2014, Basas 2018, Olmstead, 1995).<\/cite><\/blockquote><\/figure>\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link\" href=\"https:\/\/crarbcn.com\/referencies\/\"><span style=\"color:#4ab69f\" class=\"has-inline-color\">\u00bfQuieres referirnos un caso?<\/span><\/a><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Caso realizado por Eva Vidal, veterinaria rehabilitadora de CRAR El caso que compartimos este mes en el blog de CRAR \u2013 Centro de Rehabilitaci\u00f3n Animal de Referencia, especialistas en fisioterapia veterinaria en Barcelona es el de Belty, perra hembra cruzada de 5 a\u00f1os que sufri\u00f3 una luxaci\u00f3n de tarso traum\u00e1tica. La articulaci\u00f3n del tarso se [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":3118,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","_joinchat":[],"footnotes":""},"categories":[44],"tags":[139,145,149,150,151,140,147],"class_list":["post-3125","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-es","tag-dolor-es","tag-fisioterapia-es","tag-hidroterapia-es","tag-laser-es","tag-luxacion-tarso-es","tag-rehabilitacion-es","tag-veterinaria-es"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Luxaci\u00f3n de tarso traum\u00e1tica. - CRAR BCN<\/title>\n<meta name=\"description\" content=\"El caso que compartimos este mes en el blog de CRAR es el de Belty, perra hembra cruzada de 5 a\u00f1os que sufri\u00f3 una luxaci\u00f3n de tarso traum\u00e1tica.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/crarbcn.com\/es\/luxacion-de-tarso-traumatica\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Luxaci\u00f3n de tarso traum\u00e1tica. - 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