Slocum TPLO Surgery Report

Slocum Enterprises, Inc.
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tplo_surgeons.htm

Sample Form

Slocum TPLO Surgery Report
Client Name:			Date:
Patient Name:			Case #:

Side:
Measurements: perpendicular to the-			________________	________________
	Sagittal Plane (TPLO):		________________	________________
	Frontal Plane (varus/valgus):		________________	________________
	Transverse Plane (int./ext. torsion):		________________	________________
Approach:
	None:		________________	________________
	Craniomedial:		________________	________________
	Caudal to MCL:		________________	________________
Cranial Cruciate Ligament:
	Complete Rupture:		________________	________________
	Partial Rupture:		________________	________________
Meniscal Treatment:
	Meniscectomy:		________________	________________
	Meniscal Release:		________________	________________
Slocum Plate Size:			________________	________________
Additional Fixation:			________________	________________
Changes in Technique:			________________	________________
	Double Cut:		________________	________________
	Other:		________________	________________
Adjucnt Procedures:
Pathologic Notes:			________________	________________
	Cranial Cruciate Ligament:		________________	________________
		Partial Rupture	________________	________________
		Advanced Partial	________________	________________
		Complete Rupture	________________	________________
		Resorbed	________________	________________
	Meniscus:
		Appears Normal	________________	________________
		Bucket Handle	________________	________________
		Folded	________________	________________
		Torn	________________	________________
		Woody	________________	________________
		Discoid	________________	________________
	Inflammed Joint:		________________	________________
	Osteophytes:		________________	________________
	Patellar Rubbing:		________________	________________
	Flexion of Stifle (degrees):		________________	________________
Rx:
Meds and Post-op care gone over with owners:

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To place an order with Slocum Enterprises, Inc. please phone: (800) 346-5489, if calling from outside the US: (541) 689-8441, or fax: (541) 689-1448. Or email us at orders@slocumenterprises.com

Slocum Enterprises, Inc. products are available to or on the order of a licensed veterinarian.