February 25, 2025 • 20 mins
Discover how exposed digits increase weight bearing and alter sub-bandage pressures in dogs with forelimb splints with Sarah Stark, a fourth-year veterinary student from the University of Minnesota. Guided by her mentor, Dr. Wanda Gordon-Evans, Sarah shares her groundbreaking research on forelimb splints and their influence on weight bearing and pressure distribution in dogs. Her study unveils how the design of splints, particularly whether the digits are exposed or enclosed, can significantly impact fracture healing. These revelations not only provide vital insights for veterinary professionals but also open doors for veterinary students to gain recognition through journal awards.
But the journey doesn't stop there. We also spotlight the indispensable role pet owners play in their animal's recovery process. From understanding the intricacies of splint placement to the critical task of monitoring exposed digits, owners are key players in ensuring proper post-injury care. Be sure to check out Sarah's article in JAVMA and join us in appreciating her significant contributions to veterinary medicine.
JAVMA open access article: https://doi.org/10.2460/javma.24.10.0684
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Sarah Wright (00:01):
You're listening to Veterinary Vertex, a podcast
of the AVMA Journals.
In this episode we chat abouthow exposed digits increase
weight bearing and altersubbandage pressures in dogs
with forelimb splints, with ourguest Sarah Stark.
Lisa Fortier (00:16):
Welcome to Veterinary Vertex.
I'm Editor-in-Chief, LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Sarah Starkjoining us.
Sarah, thank you so much forbeing here with us today and
sharing some evidence on somerehab and other things that I'm
keenly interested in.
Sarah Stark (00:32):
Yeah, thanks so much for having me.
I'm excited to talk with youguys.
Sarah Wright (00:36):
All right, let's dive right in.
So, Sarah.
Your JAVMA article discusseshow exposed digits increase
weight bearing and alter subbandage pressures in dogs with
forelimb splints.
Please share with our listenersthe background on this article.
Sarah Stark (00:50):
Yeah, so I'm actually a fourth year
veterinary student at theUniversity of Minnesota and this
study was conceptualized anddesigned by my mentor, Dr Wanda
Gordon-Evans, who's one of thesurgery faculty here, and the
(01:13):
idea came from just kind ofclinical experience and seeing
how there seem to be two groupsof people when it comes to
putting splints on and thedistal extent of the splint.
Some people choose to end thesplint just proximally to the
end of the.
Some people choose to end thesplint just proximally to the
end of the, really to the endsof digits three and four, and
that's to allow for monitoringof the digits for swelling.
Obviously we don't want that.
(01:34):
And then there's a differentgroup of people that extend the
splint a little farther andfully encompass the digits with
the splint.
So it's the distal extent ofthe splint is past the distal
end of the digits and that's toencourage the animal to weight
bear on the splint itself.
You can still monitor thedigits for swelling when it's
(01:54):
like that.
You can kind of observe thetoenails for lateral spread to
see that's indicative ofswelling of the toes or palpate
them or kind of look into theend of the bandage.
So it's like a little lessobvious but it's still totally
possible to monitor them.
Well.
And then, you know, she justkind of wanted to know is there
(02:15):
a difference in these splinttypes for the patient?
And so what we did was take 10university employee-owned dogs
and apply each of these splinttypes to the same forelimb, and
we used sub-bandage pressuresensors and a force platform to
(02:38):
record how much weight they'rebearing on the limb itself, as
well as to see if there's anydifferences in subbandage
pressure distribution betweenthe two splint types.
And you know, similarly,actually in the literature
there's kind of a group ofpeople that say leave the toes
(03:01):
past the end of the splint, andsome people say leave the toes
inside the splint and somepeople don't say at all.
So it's really, you know, kindof an interesting thing to look
at, because it doesn't seem likepeople have really investigated
that before if there's animpact to splint length.
And so what we found was that inthe toes out bandage so where
(03:27):
the toes are slightly past theend of the splint there was an
increase, a significant increasein pressure along those exposed
digits versus with the toes-inbandage.
There was kind of a more evenspread and even pressure
distribution.
There was kind of a more evenspread and even pressure
(03:47):
distribution.
And also we found with the toesout bandage that the dogs
actually bear significantly moreweight on the splinted limb
overall than they do with a toesin splint.
So definitely there's some, youknow, interesting clinical
relevance there.
If you're considering fracturehealing and Wolf's Law, you know
we don't want too much forcegoing through a fractured limb
(04:09):
that can delay healing, and soyou know it's just kind of
something to be considering inpractice.
That I think that we kind ofhaven't really talked about
before is we should be thinkingabout that when we're applying
bandages.
Sarah Wright (04:25):
It's a really great topic, really clinically
applicable, and there's actuallytwo things that come to mind,
too, when I hear you talkingabout this.
First is, since you are aveterinary student, did you know
that you're eligible for ourjournal awards?
Sarah Stark (04:36):
No, I had no idea.
Sarah Wright (04:38):
So we have journal awards for student, intern and
resident authors of manuscriptssubmitted to JAVMA and AJVR.
So I'll send you theinstructions after this.
But you would qualify
Sarah Stark (04:48):
oh exciting.
Sarah Wright (04:48):
And you can self-nominate too.
It's fairly like informalprocess, so nothing too
stressful about it, which isnice, that's cool, that sounds
like fun.
And secondly is I think thisalso would be a great topic for
our technical tutorial videos.
Did you know that we also havevideo manuscripts?
Sarah Stark (05:06):
No, I didn't know that either.
Yeah, Also.
Sarah Wright (05:09):
I'll definitely need it, Sarah Go, Sarah, I was
like listening to you talk.
I'm like these would be perfect.
But if you want to submit avideo showing just how to even
like, do a splint on a dog andcat like, I think that would be
excellent Because a lot of timesin like vet school you might
not have a case where you get todo that or you're just doing it
on, like you know, like adabber limb, and not going to
actually do it in the livepatient.
(05:29):
So I think that'd be a reallyexcellent teaching video and
I'll send you more informationon the podcast about how to
submit and what we're lookingfor in those.
Lisa Fortier (05:36):
Sure, yeah, while Sarah's plugging, the difference
between our video manuscripts,as she said, and like a YouTube
video is these will go throughpeer review and they get a DOI
document identifier number.
Very, I mean, they aremanuscripts, so you get academic
credit for them as well.
(05:56):
Cool, I like that, really coolfor just starting veterinarians
veterinarians that might betaking on new responsibilities
in their roles and maybe they,as Sarah said, maybe they, sarah
right, maybe maybe you did thestudent didn't get to do that or
even maybe even see it,depending on the caseload, maybe
the student didn't get to dothat, or even maybe even see it,
depending on the caseload.
Sarah Stark (06:20):
Sure, yeah, and definitely like part of our
thought process when doing thispaper was like this is super
relevant for everybody, like wedidn't want to submit it to a
surgery specific journal becausewe're like this is, this is for
everyone, like all across theboard journal.
Because we're like this is foreveryone, like all across the
board.
Everybody has to put bandagesand splints on and you know it's
relevant for everyone, not justspecialists, certainly.
Lisa Fortier (06:37):
Yeah, very much so .
A really elegant study too.
You know I love these are myfavorite types of studies and
manuscripts where somebody says,huh, I wonder about that.
And then I mean, it's just, itdoesn't take a bunch of
molecular diagnostics or any ofthat sort of stuff and you're
making it, you move the needle.
As a vet student, that's prettycool.
Sarah Stark (06:57):
Yeah, it was.
I mean, she, wanda, has thislike huge list of like study
ideas.
She's just one of those peoplethat's always brainstorming and
helping house officers doprojects, and so she sat down
and was scrolling through herlist and I was like I like that
one.
That's straightforward, it'ssimple.
(07:17):
I like the idea.
It seems so relevant.
Lisa Fortier (07:21):
So yeah, I was amazed about it.
Funny, you say that I was atwell, still am partly at Cornell
, but for 30 some years as anequine surgeon.
And the amazing study questions.
And I just kept a rolling listof them.
Yes, and students would say isthat true?
Do we know that that's true?
And you're like, huh, I don'tknow.
Yeah, Then you have to go backand dig in the literature.
(07:44):
Has somebody done that before?
Because maybe you just didn'tread it.
But yeah, those are the beststudies before.
Because maybe you just didn'tread it.
Sarah Stark (07:50):
But yeah, those are the best studies.
Very rewarding.
Yeah, definitely, it's been fun.
It was a good one as a student.
Now are you interested inpursuing surgery or what are
your next steps?
No-transcript residency Likethat's the plan.
(08:39):
So we're getting there.
Lisa Fortier (08:42):
Very good.
Well, veterinary techniciansare obviously critical to our
profession as well, so that'syeah, and it's.
Sarah Stark (08:51):
I think it'll really like serve me well.
It's certainly served me wellin vet school itself, like
having the clinical relevanceand being especially having
worked in a teaching setting fora long time, like I've I've
just listened in on rounds foryears and had the opportunity to
absorb some of that informationalong the way.
(09:12):
Or like in this case, withbandages how many bandage
changes have I been present for?
You know?
Like hundreds and hundreds.
So it's, it definitely hashelped a lot and I think it'll
help in my career as well, justhaving been in the shoes of
support staff.
Lisa Fortier (09:32):
Absolutely, and knowing how you could leverage
your support staff and how toappreciate them and promote them
so they don't feel liketechnicians.
Yeah, yeah, you'll be, fabulousEvery time, sarah, when we do a
study, and maybe the wholefinding was surprising to you,
but you know we find resultsthat may be sort of predicted,
(09:53):
but there's always somethingthat's surprising.
What surprised you from thefindings of this?
Sarah Stark (09:57):
article and there was actually a difference.
There's a very statisticallysignificant difference in weight
bearing between the toes insplint and the toes out splint
with the dogs.
When we're looking at the subbandage pressure sensor data,
(10:38):
they're kind of walking on thoseexposed toes and so it kind of
just reinforces that conceptthat they're walking on the
exposed toes and they're alsowalking, you know, more, on that
foot.
They're bearing more weight onit.
So yeah, that was surprising.
It was interesting that we wereexcited when we found that.
Lisa Fortier (10:52):
So that probably means that there there's a role
in any given situation foreither of the splint types.
Sarah Stark (11:00):
Yes, yeah, that was kind of the takeaway for us,
that, um, you know, maybe if youhave a one-year-old Labrador,
that's like totally bananas,like you're going to want for
sure to have a toes in splintwhere their foot isn't touching
the ground.
We kind of hypothesize thatmaybe tactile input is the
(11:23):
reason why they're more willingto bear weight if the toes are
out.
So if you're kind of takingthat away by keeping the splint
as the thing that's touching theground and it encourages the
dog to bear less weight on theleg, that's probably good in
most situations for mostfracture configurations.
You know, slowing them down andhaving less force going through
(11:44):
the limb is going to benefitfracture healing.
But conversely, if you'retalking about a two-kig mini
poodle with an RU fracture thatyou're not fixing, primarily
you're just going to manage withsplinting, those dogs are
already predisposed to anon-union.
Maybe having their toes exposeda little bit and allowing that
(12:07):
tactile input would encourageweight bearing.
So it's just, you know we can'tsay one way or another what's
right or wrong, and I think it'svery dependent on the patient
and the situation and thefracture type and location and
all of that.
But it's just a good thing tokeep in mind really when you're
(12:28):
putting a splint on.
It's just a good thing to keepin mind.
Really, when you're putting asplint on, we think about how
far to extend splints proximallyor what materials to use or
whatever else, but we shouldalso probably think about how
far it's going distally to.
Sarah Wright (12:44):
So, sarah, you talked about how your mentor has
that long list of researchquestions.
What are next steps forresearch?
Sarah Stark (12:51):
Well, man, I don't know what else is on her list,
but I think in the case of thisproject there's a lot more to
expand upon.
You know, we kept it simple andjust looked at forelimbs.
Somebody could do the samething in hindlimbs.
Maybe there's less of adifference because they bear
(13:11):
less weight on their hindlimbsthan they do their forelimbs.
You know it.
Also, we had some limitationswith small sample size and
really short duration of wear.
We just put the splints on,acclimated them for a few
minutes and collected data andthen put the next one on.
(13:32):
So having splints on for a fewdays or a few weeks could allow
the dog to acclimate and maybethat would negate the
differences between the twosplints if they've had them on
longer.
Yeah, I mean there's.
I think that it would beinteresting to continue looking
at it.
It's such a clinically relevantthing that kind of affects
(13:55):
everyone.
So I would love to see morepeople repeat it or do it in
dogs with fractures.
That could change things aswell.
Sarah Wright (14:03):
So Well, sounds like there's more work to be
done.
Well, sounds like there's morework to be done.
Always, right, always.
Sarah Stark (14:16):
So do you see a role for AI in this area of
research?
I mean, I bet somebody has doneit already, but I feel like AI
would have a really good placein gait analysis, like for any
animal or people.
It's, you know, kind of acomplicated thing, and I bet
that that would be reallybeneficial in that area.
Sarah Wright (14:35):
Yeah, I can definitely see that.
I remember when I was a vetstudent, one of the coolest
resident rounds I saw was one ofthe residents did a gait
analysis in Humboldt Penguins ata local zoological institution.
Yeah, yeah, so it's the firstthing that mind jumped to.
So super cool species you canuse it for.
Yeah, and for those of you justjoining us, we're discussing
how exposed digits increaseweight bearing and alter
(14:55):
sub-vantage pressures in dogswith four-limb splints, with our
guest Sarah.
Lisa Fortier (15:01):
Sarah, you talked earlier about your career as a
certified veterinary technicianand now you're a final year
veterinary student.
How did or maybe you didn't howdid any of that training help
you write this article?
Sarah Stark (15:14):
Yeah, it definitely did.
I think having a lot of likerelevant clinical experience,
just like dealing with bandages,definitely helped, and I was
like I'm comfortable placingthem as well and making splints,
so I placed all of the splints.
And then I also have had a fairamount of opportunities to get
(15:41):
involved in research through vetschool and even before, when I
worked here as a tech, I woulddabble in the resident projects
and stuff.
So all of that has kind ofallowed me to get enough
practice to be comfortable doingsomething.
Obviously I had a lot ofsupport and a lot of questions
for Dr Gordon Evans but I wasable to do a lot of it.
(16:03):
You know kind of myself.
And that was really fun to havethe training wheels taken off a
little bit and get thatpractice.
I really enjoy doing clinicalresearch, so it was fun.
Sarah Wright (16:17):
You look forward to seeing how your career
progresses.
Sarah Stark (16:20):
Me too.
Sarah Wright (16:21):
We'll see.
So, sarah, this next part ofquestioning is going to be
really important for ourlisteners.
The first one is going to befrom the veterinarian's
perspective, so it is one pieceof information the veterinarian
should know about how exposeddigits increase weight bearing
and alters sub-bandage pressuresin dogs with foil splints of
(16:52):
what we talked about before,just that this particular topic
hasn't really been explored yet.
Sarah Stark (16:54):
That we know of, and we think it just should be a
conscious consideration whenyou're placing a splint,
depending on the needs of yourpatient you know their
disposition or their fracturetype and location.
It should just be somethingthat we think about, you know,
when we're placing a splint,because it could have, you know,
based on our results of ourstudy it seems to have a
(17:15):
relevant impact on how theanimal walks and how much weight
they're bearing.
So it should just be somethingto think about.
Sarah Wright (17:26):
And then the other side of the relationship.
What's one thing that clientsshould know about forelimb
splints?
Sarah Stark (17:32):
I mean, I think that it's just important to that
owners realize how much impactthey have on how their pet does
with fractures or wounds.
Anytime there's a bandageinvolved, you know the owner at
home is with the pet andmanaging them for the, you know,
(17:52):
the vast majority of the time.
And I think it's important toempower them to realize that
they have a lot of impact on howtheir pet does.
If they're being, you know,really aware of the how the
animal's doing and, um, thestate of the bandage, you know
they can make or break thehealing process and so it's
(18:14):
important for them to realizethat they have a lot of power
there.
Um, if they're being really, um, you know they're being careful
to monitor closely, they canreally help their dog do better.
So and that's kind of you knowthe whole monitoring the digits
thing that you know, justbecause the digits are slightly
more covered by the bandagedoesn't mean we can't be aware
(18:36):
of them.
Lisa Fortier (18:37):
So yeah, Same for horses, right, yeah, and you
have the two, well, threedifferent types of clients the
compliant, the ones that arecompletely non-compliant and the
ones that are over-compliant,right, and then don't let the
dog jump on the couch.
Oh, I felt sorry for her.
No, the horse.
I remember as a residentactually, I fixed an elbow
(18:59):
fracture in a horse, sent ithome and about three days later,
after it went home, I got avideo of the horse.
She's doing great.
She's turned out galloping andbucking and running around.
I was like great, great, Looksgood.
That's the same thing as boxstall rest.
Sarah Stark (19:19):
Yeah, I think we've all been there.
I remember one little dog.
He had like a tarsal fractureor something and he came in a
couple different times and wetook the bandage off and like
sand fell out of it and they'relike, oh yeah, he runs around
down by the river and it's like,ok, great, ok yeah, sounds good
(19:40):
.
Lisa Fortier (19:42):
Well, thank you, sarah.
As we wind down, we like to aska kind of a fun question and
what for you?
I'd like to know what is yourfavorite animal fact?
Sarah Stark (19:52):
I think it's super cool that whales used to be land
animals like and they have allthese like vestigial structures
that they have evidence ofhaving walked on land before,
like just thinking about thatprocess and like how big they
are and how much transformationthey had to go through to do
(20:14):
that.
I just think it's super cool.
I want to know what they lookedlike before.
Sarah Wright (20:19):
You've had so many aquatic animal facts for that
question.
I love it.
I learn something new everytime.
So thank you so much, Sarah.
We appreciate you being hereand sharing insights from your
article with us today.
Yeah, thank you so much, Sarah.
We appreciate you being hereand sharing insights from your
article with us today.
Sarah Stark (20:30):
Yeah, thank you so much for having me.
It was really fun to talk about.
I'm excited to kind ofdisseminate the information I
think it's important foreveryone.
Oh, definitely.
Sarah Wright (20:41):
Agreed and to our listeners.
You can read Sarah's article inJabma.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
You're listening to Veterinary Vertex, a podcast
of the AVMA Journals.
In this episode we chat abouthow exposed digits increase
weight bearing and altersubbandage pressures in dogs
with forelimb splints, with ourguest Sarah Stark.
Lisa Fortier (00:16):
Welcome to Veterinary Vertex.
I'm Editor-in-Chief, LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Sarah Starkjoining us.
Sarah, thank you so much forbeing here with us today and
sharing some evidence on somerehab and other things that I'm
keenly interested in.
Sarah Stark (00:32):
Yeah, thanks so much for having me.
I'm excited to talk with youguys.
Sarah Wright (00:36):
All right, let's dive right in.
So, Sarah.
Your JAVMA article discusseshow exposed digits increase
weight bearing and alter subbandage pressures in dogs with
forelimb splints.
Please share with our listenersthe background on this article.
Sarah Stark (00:50):
Yeah, so I'm actually a fourth year
veterinary student at theUniversity of Minnesota and this
study was conceptualized anddesigned by my mentor, Dr Wanda
Gordon-Evans, who's one of thesurgery faculty here, and the
(01:13):
idea came from just kind ofclinical experience and seeing
how there seem to be two groupsof people when it comes to
putting splints on and thedistal extent of the splint.
Some people choose to end thesplint just proximally to the
end of the.
Some people choose to end thesplint just proximally to the
end of the, really to the endsof digits three and four, and
that's to allow for monitoringof the digits for swelling.
Obviously we don't want that.
(01:34):
And then there's a differentgroup of people that extend the
splint a little farther andfully encompass the digits with
the splint.
So it's the distal extent ofthe splint is past the distal
end of the digits and that's toencourage the animal to weight
bear on the splint itself.
You can still monitor thedigits for swelling when it's
(01:54):
like that.
You can kind of observe thetoenails for lateral spread to
see that's indicative ofswelling of the toes or palpate
them or kind of look into theend of the bandage.
So it's like a little lessobvious but it's still totally
possible to monitor them.
Well.
And then, you know, she justkind of wanted to know is there
(02:15):
a difference in these splinttypes for the patient?
And so what we did was take 10university employee-owned dogs
and apply each of these splinttypes to the same forelimb, and
we used sub-bandage pressuresensors and a force platform to
(02:38):
record how much weight they'rebearing on the limb itself, as
well as to see if there's anydifferences in subbandage
pressure distribution betweenthe two splint types.
And you know, similarly,actually in the literature
there's kind of a group ofpeople that say leave the toes
(03:01):
past the end of the splint, andsome people say leave the toes
inside the splint and somepeople don't say at all.
So it's really, you know, kindof an interesting thing to look
at, because it doesn't seem likepeople have really investigated
that before if there's animpact to splint length.
And so what we found was that inthe toes out bandage so where
(03:27):
the toes are slightly past theend of the splint there was an
increase, a significant increasein pressure along those exposed
digits versus with the toes-inbandage.
There was kind of a more evenspread and even pressure
distribution.
There was kind of a more evenspread and even pressure
(03:47):
distribution.
And also we found with the toesout bandage that the dogs
actually bear significantly moreweight on the splinted limb
overall than they do with a toesin splint.
So definitely there's some, youknow, interesting clinical
relevance there.
If you're considering fracturehealing and Wolf's Law, you know
we don't want too much forcegoing through a fractured limb
(04:09):
that can delay healing, and soyou know it's just kind of
something to be considering inpractice.
That I think that we kind ofhaven't really talked about
before is we should be thinkingabout that when we're applying
bandages.
Sarah Wright (04:25):
It's a really great topic, really clinically
applicable, and there's actuallytwo things that come to mind,
too, when I hear you talkingabout this.
First is, since you are aveterinary student, did you know
that you're eligible for ourjournal awards?
Sarah Stark (04:36):
No, I had no idea.
Sarah Wright (04:38):
So we have journal awards for student, intern and
resident authors of manuscriptssubmitted to JAVMA and AJVR.
So I'll send you theinstructions after this.
But you would qualify
Sarah Stark (04:48):
oh exciting.
Sarah Wright (04:48):
And you can self-nominate too.
It's fairly like informalprocess, so nothing too
stressful about it, which isnice, that's cool, that sounds
like fun.
And secondly is I think thisalso would be a great topic for
our technical tutorial videos.
Did you know that we also havevideo manuscripts?
Sarah Stark (05:06):
No, I didn't know that either.
Yeah, Also.
Sarah Wright (05:09):
I'll definitely need it, Sarah Go, Sarah, I was
like listening to you talk.
I'm like these would be perfect.
But if you want to submit avideo showing just how to even
like, do a splint on a dog andcat like, I think that would be
excellent Because a lot of timesin like vet school you might
not have a case where you get todo that or you're just doing it
on, like you know, like adabber limb, and not going to
actually do it in the livepatient.
(05:29):
So I think that'd be a reallyexcellent teaching video and
I'll send you more informationon the podcast about how to
submit and what we're lookingfor in those.
Lisa Fortier (05:36):
Sure, yeah, while Sarah's plugging, the difference
between our video manuscripts,as she said, and like a YouTube
video is these will go throughpeer review and they get a DOI
document identifier number.
Very, I mean, they aremanuscripts, so you get academic
credit for them as well.
(05:56):
Cool, I like that, really coolfor just starting veterinarians
veterinarians that might betaking on new responsibilities
in their roles and maybe they,as Sarah said, maybe they, sarah
right, maybe maybe you did thestudent didn't get to do that or
even maybe even see it,depending on the caseload, maybe
the student didn't get to dothat, or even maybe even see it,
depending on the caseload.
Sarah Stark (06:20):
Sure, yeah, and definitely like part of our
thought process when doing thispaper was like this is super
relevant for everybody, like wedidn't want to submit it to a
surgery specific journal becausewe're like this is, this is for
everyone, like all across theboard journal.
Because we're like this is foreveryone, like all across the
board.
Everybody has to put bandagesand splints on and you know it's
relevant for everyone, not justspecialists, certainly.
Lisa Fortier (06:37):
Yeah, very much so .
A really elegant study too.
You know I love these are myfavorite types of studies and
manuscripts where somebody says,huh, I wonder about that.
And then I mean, it's just, itdoesn't take a bunch of
molecular diagnostics or any ofthat sort of stuff and you're
making it, you move the needle.
As a vet student, that's prettycool.
Sarah Stark (06:57):
Yeah, it was.
I mean, she, wanda, has thislike huge list of like study
ideas.
She's just one of those peoplethat's always brainstorming and
helping house officers doprojects, and so she sat down
and was scrolling through herlist and I was like I like that
one.
That's straightforward, it'ssimple.
(07:17):
I like the idea.
It seems so relevant.
Lisa Fortier (07:21):
So yeah, I was amazed about it.
Funny, you say that I was atwell, still am partly at Cornell
, but for 30 some years as anequine surgeon.
And the amazing study questions.
And I just kept a rolling listof them.
Yes, and students would say isthat true?
Do we know that that's true?
And you're like, huh, I don'tknow.
Yeah, Then you have to go backand dig in the literature.
(07:44):
Has somebody done that before?
Because maybe you just didn'tread it.
But yeah, those are the beststudies before.
Because maybe you just didn'tread it.
Sarah Stark (07:50):
But yeah, those are the best studies.
Very rewarding.
Yeah, definitely, it's been fun.
It was a good one as a student.
Now are you interested inpursuing surgery or what are
your next steps?
No-transcript residency Likethat's the plan.
(08:39):
So we're getting there.
Lisa Fortier (08:42):
Very good.
Well, veterinary techniciansare obviously critical to our
profession as well, so that'syeah, and it's.
Sarah Stark (08:51):
I think it'll really like serve me well.
It's certainly served me wellin vet school itself, like
having the clinical relevanceand being especially having
worked in a teaching setting fora long time, like I've I've
just listened in on rounds foryears and had the opportunity to
absorb some of that informationalong the way.
(09:12):
Or like in this case, withbandages how many bandage
changes have I been present for?
You know?
Like hundreds and hundreds.
So it's, it definitely hashelped a lot and I think it'll
help in my career as well, justhaving been in the shoes of
support staff.
Lisa Fortier (09:32):
Absolutely, and knowing how you could leverage
your support staff and how toappreciate them and promote them
so they don't feel liketechnicians.
Yeah, yeah, you'll be, fabulousEvery time, sarah, when we do a
study, and maybe the wholefinding was surprising to you,
but you know we find resultsthat may be sort of predicted,
(09:53):
but there's always somethingthat's surprising.
What surprised you from thefindings of this?
Sarah Stark (09:57):
article and there was actually a difference.
There's a very statisticallysignificant difference in weight
bearing between the toes insplint and the toes out splint
with the dogs.
When we're looking at the subbandage pressure sensor data,
(10:38):
they're kind of walking on thoseexposed toes and so it kind of
just reinforces that conceptthat they're walking on the
exposed toes and they're alsowalking, you know, more, on that
foot.
They're bearing more weight onit.
So yeah, that was surprising.
It was interesting that we wereexcited when we found that.
Lisa Fortier (10:52):
So that probably means that there there's a role
in any given situation foreither of the splint types.
Sarah Stark (11:00):
Yes, yeah, that was kind of the takeaway for us,
that, um, you know, maybe if youhave a one-year-old Labrador,
that's like totally bananas,like you're going to want for
sure to have a toes in splintwhere their foot isn't touching
the ground.
We kind of hypothesize thatmaybe tactile input is the
(11:23):
reason why they're more willingto bear weight if the toes are
out.
So if you're kind of takingthat away by keeping the splint
as the thing that's touching theground and it encourages the
dog to bear less weight on theleg, that's probably good in
most situations for mostfracture configurations.
You know, slowing them down andhaving less force going through
(11:44):
the limb is going to benefitfracture healing.
But conversely, if you'retalking about a two-kig mini
poodle with an RU fracture thatyou're not fixing, primarily
you're just going to manage withsplinting, those dogs are
already predisposed to anon-union.
Maybe having their toes exposeda little bit and allowing that
(12:07):
tactile input would encourageweight bearing.
So it's just, you know we can'tsay one way or another what's
right or wrong, and I think it'svery dependent on the patient
and the situation and thefracture type and location and
all of that.
But it's just a good thing tokeep in mind really when you're
(12:28):
putting a splint on.
It's just a good thing to keepin mind.
Really, when you're putting asplint on, we think about how
far to extend splints proximallyor what materials to use or
whatever else, but we shouldalso probably think about how
far it's going distally to.
Sarah Wright (12:44):
So, sarah, you talked about how your mentor has
that long list of researchquestions.
What are next steps forresearch?
Sarah Stark (12:51):
Well, man, I don't know what else is on her list,
but I think in the case of thisproject there's a lot more to
expand upon.
You know, we kept it simple andjust looked at forelimbs.
Somebody could do the samething in hindlimbs.
Maybe there's less of adifference because they bear
(13:11):
less weight on their hindlimbsthan they do their forelimbs.
You know it.
Also, we had some limitationswith small sample size and
really short duration of wear.
We just put the splints on,acclimated them for a few
minutes and collected data andthen put the next one on.
(13:32):
So having splints on for a fewdays or a few weeks could allow
the dog to acclimate and maybethat would negate the
differences between the twosplints if they've had them on
longer.
Yeah, I mean there's.
I think that it would beinteresting to continue looking
at it.
It's such a clinically relevantthing that kind of affects
(13:55):
everyone.
So I would love to see morepeople repeat it or do it in
dogs with fractures.
That could change things aswell.
Sarah Wright (14:03):
So Well, sounds like there's more work to be
done.
Well, sounds like there's morework to be done.
Always, right, always.
Sarah Stark (14:16):
So do you see a role for AI in this area of
research?
I mean, I bet somebody has doneit already, but I feel like AI
would have a really good placein gait analysis, like for any
animal or people.
It's, you know, kind of acomplicated thing, and I bet
that that would be reallybeneficial in that area.
Sarah Wright (14:35):
Yeah, I can definitely see that.
I remember when I was a vetstudent, one of the coolest
resident rounds I saw was one ofthe residents did a gait
analysis in Humboldt Penguins ata local zoological institution.
Yeah, yeah, so it's the firstthing that mind jumped to.
So super cool species you canuse it for.
Yeah, and for those of you justjoining us, we're discussing
how exposed digits increaseweight bearing and alter
(14:55):
sub-vantage pressures in dogswith four-limb splints, with our
guest Sarah.
Lisa Fortier (15:01):
Sarah, you talked earlier about your career as a
certified veterinary technicianand now you're a final year
veterinary student.
How did or maybe you didn't howdid any of that training help
you write this article?
Sarah Stark (15:14):
Yeah, it definitely did.
I think having a lot of likerelevant clinical experience,
just like dealing with bandages,definitely helped, and I was
like I'm comfortable placingthem as well and making splints,
so I placed all of the splints.
And then I also have had a fairamount of opportunities to get
(15:41):
involved in research through vetschool and even before, when I
worked here as a tech, I woulddabble in the resident projects
and stuff.
So all of that has kind ofallowed me to get enough
practice to be comfortable doingsomething.
Obviously I had a lot ofsupport and a lot of questions
for Dr Gordon Evans but I wasable to do a lot of it.
(16:03):
You know kind of myself.
And that was really fun to havethe training wheels taken off a
little bit and get thatpractice.
I really enjoy doing clinicalresearch, so it was fun.
Sarah Wright (16:17):
You look forward to seeing how your career
progresses.
Sarah Stark (16:20):
Me too.
Sarah Wright (16:21):
We'll see.
So, sarah, this next part ofquestioning is going to be
really important for ourlisteners.
The first one is going to befrom the veterinarian's
perspective, so it is one pieceof information the veterinarian
should know about how exposeddigits increase weight bearing
and alters sub-bandage pressuresin dogs with foil splints of
(16:52):
what we talked about before,just that this particular topic
hasn't really been explored yet.
Sarah Stark (16:54):
That we know of, and we think it just should be a
conscious consideration whenyou're placing a splint,
depending on the needs of yourpatient you know their
disposition or their fracturetype and location.
It should just be somethingthat we think about, you know,
when we're placing a splint,because it could have, you know,
based on our results of ourstudy it seems to have a
(17:15):
relevant impact on how theanimal walks and how much weight
they're bearing.
So it should just be somethingto think about.
Sarah Wright (17:26):
And then the other side of the relationship.
What's one thing that clientsshould know about forelimb
splints?
Sarah Stark (17:32):
I mean, I think that it's just important to that
owners realize how much impactthey have on how their pet does
with fractures or wounds.
Anytime there's a bandageinvolved, you know the owner at
home is with the pet andmanaging them for the, you know,
(17:52):
the vast majority of the time.
And I think it's important toempower them to realize that
they have a lot of impact on howtheir pet does.
If they're being, you know,really aware of the how the
animal's doing and, um, thestate of the bandage, you know
they can make or break thehealing process and so it's
(18:14):
important for them to realizethat they have a lot of power
there.
Um, if they're being really, um, you know they're being careful
to monitor closely, they canreally help their dog do better.
So and that's kind of you knowthe whole monitoring the digits
thing that you know, justbecause the digits are slightly
more covered by the bandagedoesn't mean we can't be aware
(18:36):
of them.
Lisa Fortier (18:37):
So yeah, Same for horses, right, yeah, and you
have the two, well, threedifferent types of clients the
compliant, the ones that arecompletely non-compliant and the
ones that are over-compliant,right, and then don't let the
dog jump on the couch.
Oh, I felt sorry for her.
No, the horse.
I remember as a residentactually, I fixed an elbow
(18:59):
fracture in a horse, sent ithome and about three days later,
after it went home, I got avideo of the horse.
She's doing great.
She's turned out galloping andbucking and running around.
I was like great, great, Looksgood.
That's the same thing as boxstall rest.
Sarah Stark (19:19):
Yeah, I think we've all been there.
I remember one little dog.
He had like a tarsal fractureor something and he came in a
couple different times and wetook the bandage off and like
sand fell out of it and they'relike, oh yeah, he runs around
down by the river and it's like,ok, great, ok yeah, sounds good
(19:40):
.
Lisa Fortier (19:42):
Well, thank you, sarah.
As we wind down, we like to aska kind of a fun question and
what for you?
I'd like to know what is yourfavorite animal fact?
Sarah Stark (19:52):
I think it's super cool that whales used to be land
animals like and they have allthese like vestigial structures
that they have evidence ofhaving walked on land before,
like just thinking about thatprocess and like how big they
are and how much transformationthey had to go through to do
(20:14):
that.
I just think it's super cool.
I want to know what they lookedlike before.
Sarah Wright (20:19):
You've had so many aquatic animal facts for that
question.
I love it.
I learn something new everytime.
So thank you so much, Sarah.
We appreciate you being hereand sharing insights from your
article with us today.
Yeah, thank you so much, Sarah.
We appreciate you being hereand sharing insights from your
article with us today.
Sarah Stark (20:30):
Yeah, thank you so much for having me.
It was really fun to talk about.
I'm excited to kind ofdisseminate the information I
think it's important foreveryone.
Oh, definitely.
Sarah Wright (20:41):
Agreed and to our listeners.
You can read Sarah's article inJabma.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
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