Fraturas apendiculares em cães e gatos: métodos de tratamento e desfechos / Appendicular fractures in dogs and cats: treatment methods and outcome

O objetivo deste estudo retrospectivo foi identificar a ocorrência de fraturas apendiculares em cães e gatos, os métodos de tratamento e os resultados obtidos com os mesmos, no Hospital Veterinário (HV) da Universidade Regional do Noroeste do Estado do Rio Grande do Sul (Unijuí), no município de Ijuí - RS, no período de abril de 2013 a abril de 2022. De um total de 370 procedimentos cirúrgicos para tratamento de fraturas do esqueleto apendicular, 117 foram em fêmur (31,6%), 77 em tíbia e fíbula (20,8%), 62 em rádio e ulna (16,8%), 49 em úmero (13,2%), 45 em pelve (12,2%), 7 em metatarso e metacarpo (1,9%), 7 em tarso e carpo (1,9%), 4 em escápula (1,1%) e 2 em falanges (0,5%). O número de procedimentos foi superior ao número de animais, pois alguns apresentavam mais de uma fratura em diferentes ossos. Entre os 329 animais reportados neste estudo, concluiu-se que a principal causa de fraturas em cães e gatos foi atropelamento, sendo os filhotes os mais acometidos e as fraturas femorais as mais frequentes. Os fixadores esqueléticos externos destacaram-se como o método mais utilizado e o desfecho das osteossínteses foi satisfatório, sendo que a maior casuística correspondeu a fraturas cicatrizadas.

This retrospective study aimed to identify the occurrence of appendicular fractures in dogs and cats, treatment methods, and results obtained with them, at the Veterinary Hospital (VH) of the Regional University of the Northwest of the State of Rio Grande do Sul (Unijuí), in the city of Ijuí/RS, from April 2013 to April 2022. A total of 370 surgical procedures for the treatment of fractures of the appendicular skeleton was performed: 117 were in the fêmur (31,6%), 77 in the tíbia and fíbula (20,8%), 62 in the radius and ulna (16,8%), 49 in the humerus (13,2%), 45 in pélvis (12,2%), 7 in metatarsus and metacarpus (1,9%), 7 in tarsus and carpus (1,9%), 4 in the scapula (1,1%), and 2 in phalanges (0,5%). The number of procedures was higher than the number of animals, as some had more than one fracture in different bones. Among the 329 animals reported in this study, it was concluded that the main cause of fractures in dogs and cats was being run over, puppies were the most affected, and femoral fractures were the most frequent. External skeletal fixators stood out as the most used method and the outcome of osteosynthesis was satisfactory, with the largest number of cases corresponding to healed fractures.

Fratura exposta do fêmur em preguiça-real (Choloepus didactylus) - tratamento e reabilitação / Open fracture of the femur in a two-toed sloth (Choloepus didactylus) - treatment and rehabilitation

Background: The Choloepus didactylus is characterized by having 2 fingers on the forelimbs and 3 on the hind limbs, being found more frequently in northern South America, in countries such as Venezuela, Guyana, Ecuador, Peru, and Brazil. In Brazil, deforestation of the Amazon rainforest has threatened the survival of C. didactylus. In addition, these animals can be affected by several diseases, being those of the musculoskeletal system with limited reports. Thus, the present report aimed to describe the treatment and evolution of an open fracture of the femur in a free-living Choloepus didactylus, which after rehabilitation was released back to the wild. Case: A free-living female two-toed sloth (Choloepus didactylus), weighing 7.0 kg, was found in Manaus city and referred to the Wild Animal Treatment Center (CETAS - IBAMA-AM) located in Amazonas, Brazil, after initial treatment and osteosynthesis in a private clinic (CVMinasPet). According to history, the animal had suffered electrocution 30 days ago and, as a result, had an extensive wound that resulted in the exposure of the knee joint, distal fracture of the femur, and areas of necrosis in the right pelvic limb. After cleansing of the area and removal of necrotic tissues, the fracture was stabilized with the cross-pinning technique (2 Steinmann pins). Then, the stifle joint was stabilized with external skeletal fixation (Type 1b, unilateral biplanar). The external fixator and cross-pins were removed 2 months after the surgical procedure, being observed bone healing. Next, the animal underwent physical rehabilitation for 30 days. After the rehabilitation period, a microchip and a radio collar were applied, and the sloth was released back to the wild. Discussion: Electrocution has been one of the causes of wildlife rescue, with consequences varying depending on the degree of the burn. Generally, the burn is most severe at the entry and exit sites. Since suspensory quadrupedal locomotion requires that sloths have specialized hands and feet to connect with the supports, probably the animal of the current report touched the right pelvic limb on a high-tension pole. The cross-pinning technique combined with the external fixator was used because the animal had an exposed Salter-Harris type I fracture with soft tissue loss. The younger the animal presents physeal fractures, the greater is the chance of developing growth abnormalities due to growth plate closure caused by fracture type or immobilization method. Since the sloth was a free-living animal, the age was unknown. However, pelvic limb length discrepancy was not observed after removing the implants. Culture and antimicrobial susceptibility test were not done and may be considered a limitation of this report. However, the application of ceftriaxone was adequate to control the infection, since the animal did not show signs of infection or draining sinus tracts. Ceftriaxone is a third-generation antibiotic that can be used in chronic osteomyelitis. In addition, the animal in the present report showed good adaptation to captive conditions that contributed to the clinical management. The longevity of the sloth in captivity can reach more than 30 years, but the goal is always to return the animal to nature after the treatment. Surgical treatment of the fracture and physical therapy after implant removal allowed this action in the current report, confirmed by monitoring with the radio collar.

Tratamento do rádio curvo em cão jovem com associação das técnicas de grampeamento fisário radial, ostectomia ulnar e fixador externo dinâmico transarticular / Treatment of radius curvus in a young dog with association of radial physeal stapling, ulnar ostectomy and transarticular dynamic external fixator techniques

Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...

Tratamento do rádio curvo em cão jovem com associação das técnicas de grampeamento fisário radial, ostectomia ulnar e fixador externo dinâmico transarticular / Treatment of radius curvus in a young dog with association of radial physeal stapling, ulnar ostectomy and transarticular dynamic external fixator techniques

Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...(AU)

Reconstrução cirúrgica da tíbia em fratura mal consolidada em um cão / Surgical reconstruction of tibia in poorly consolidated fracture in a dog

Objetiva-se com este trabalho relatar um caso de reconstrução cirúrgica tibial em uma fratura mal consolidada em um canino, salientando a versatilidade do fixador esquelético externo (FEE) e a importância do enxerto esponjoso como coadjuvante da cicatrização. Para a reconstrução cirúrgica da tíbia, esta foi refraturada, e em seguida, alinhada com o auxílio de pino intramedular de Steinmann temporário. Empregou-se fixação esquelética externa associada à enxertia óssea esponjosa autógena coletada da asa do ílio. No protocolo pós-cirúrgico, foi recomendado os mesmos cuidados e medicações de uma osteossíntese habitual. Decorridos 35 dias da cirurgia, observou-se perda da linha de fratura e formação de calo ósseo, permitindo a remoção do FEE. O animal voltou a apoiar o membro normalmente, apenas com um leve encurtamento do mesmo, mas sem prejuízo à deambulação.

The aim of this study is to report a case of tibial surgical reconstruction in a poorly consolidated canine fracture, emphasizing the versatility of the external skeletal fixator (ESF) and the importance of the cancellous graft as an adjunct to healing. For surgical reconstruction of the tibia, it was refracted and then aligned with support by temporary Steinmann intramedullary pin. External skeletal fixation was applied in association with bone grafting of spongy autogenous tissue collected by iliac wing. In the post-surgical protocol, the same care and medications as usual for osteosynthesis were recommended. Fracture line loss and bone callus formation were observed thirty-five days after the surgery, allowing the removal of the ESF. The animal returned to support the limb normally, only with a slight shortening of the limb, but without prejudice to the walking.

Reconstrução cirúrgica da tíbia em fratura mal consolidada em um cão / Surgical reconstruction of tibia in poorly consolidated fracture in a dog

Objetiva-se com este trabalho relatar um caso de reconstrução cirúrgica tibial em uma fratura mal consolidada em um canino, salientando a versatilidade do fixador esquelético externo (FEE) e a importância do enxerto esponjoso como coadjuvante da cicatrização. Para a reconstrução cirúrgica da tíbia, esta foi refraturada, e em seguida, alinhada com o auxílio de pino intramedular de Steinmann temporário. Empregou-se fixação esquelética externa associada à enxertia óssea esponjosa autógena coletada da asa do ílio. No protocolo pós-cirúrgico, foi recomendado os mesmos cuidados e medicações de uma osteossíntese habitual. Decorridos 35 dias da cirurgia, observou-se perda da linha de fratura e formação de calo ósseo, permitindo a remoção do FEE. O animal voltou a apoiar o membro normalmente, apenas com um leve encurtamento do mesmo, mas sem prejuízo à deambulação.(AU)

The aim of this study is to report a case of tibial surgical reconstruction in a poorly consolidated canine fracture, emphasizing the versatility of the external skeletal fixator (ESF) and the importance of the cancellous graft as an adjunct to healing. For surgical reconstruction of the tibia, it was refracted and then aligned with support by temporary Steinmann intramedullary pin. External skeletal fixation was applied in association with bone grafting of spongy autogenous tissue collected by iliac wing. In the post-surgical protocol, the same care and medications as usual for osteosynthesis were recommended. Fracture line loss and bone callus formation were observed thirty-five days after the surgery, allowing the removal of the ESF. The animal returned to support the limb normally, only with a slight shortening of the limb, but without prejudice to the walking.(AU)

Physics behind the implants used for high strain fractures: literature review / A física por trás dos implantes utilizados para fraturas de alto strain: revisão de literatura

Whenever bone fractures occur, external forces produce continuous interfragmentary motion and a stabilization method is necessary. It is known that the mechanical conditions at the fracture site influence bone callus formation during healing process. To achieve primary (direct) bone healing, absolute stability at the fracture site is necessary. Perren's concept of strain determines that relative deformation at the fracture gap depends on the original gap's conformation. Simple fractures (without comminution) are considered high strain fractures since a small force applied to the fracture site results in great movement with deleterious effects on the healing process. The purpose of this study is to review the available literature regarding factors that influence the mechanics of high strain fractures in veterinary medicine, its treatment methods and implants available. Each fracture configuration requires special attention and critical care in choosing the osteosynthesis method and the type of stability required for consolidation to occur within the expected time. One must know the strain theory to become an orthopedic surgeon.(AU)

Quando fraturas ósseas ocorrem, forças externas produzem movimentação interfragmentária continuamente e um método de estabilização se faz necessário. É sabido que as condições mecânicas no local de fratura influenciam a formação de calo durante o processo de cicatrização óssea e para que cicatrização óssea primária seja obtida é necessária estabilidade absoluta no foco de fratura. O conceito de strain de Perren determina que a deformação relativa no foco de fratura estabilizado depende do tamanho da lacuna de fratura original. Fraturas redutíveis (sem cominuição) são consideradas de alto strain, pois uma pequena força aplicada a linha de fratura resulta em grande movimentação com efeito deletério ao processo de consolidação. O presente trabalho revisa a literatura disponível a respeito de fatores que influenciam a mecânica de fraturas de alto strain em medicina veterinária, seus métodos de tratamento e a física por trás dos implantes disponíveis. Cada configuração de fratura requer atenção especial e cuidado crítico na escolha do método de osteossíntese e no tipo de estabilidade necessária para que a consolidação ocorra no tempo esperado. Conhecimento da teoria do strain é mandatório para a formação de cirurgiões ortopédicos.(AU)

Physics behind the implants used for high strain fractures: literature review / A física por trás dos implantes utilizados para fraturas de alto strain: revisão de literatura

Whenever bone fractures occur, external forces produce continuous interfragmentary motion and a stabilization method is necessary. It is known that the mechanical conditions at the fracture site influence bone callus formation during healing process. To achieve primary (direct) bone healing, absolute stability at the fracture site is necessary. Perren's concept of strain determines that relative deformation at the fracture gap depends on the original gap's conformation. Simple fractures (without comminution) are considered high strain fractures since a small force applied to the fracture site results in great movement with deleterious effects on the healing process. The purpose of this study is to review the available literature regarding factors that influence the mechanics of high strain fractures in veterinary medicine, its treatment methods and implants available. Each fracture configuration requires special attention and critical care in choosing the osteosynthesis method and the type of stability required for consolidation to occur within the expected time. One must know the strain theory to become an orthopedic surgeon.(AU)

Quando fraturas ósseas ocorrem, forças externas produzem movimentação interfragmentária continuamente e um método de estabilização se faz necessário. É sabido que as condições mecânicas no local de fratura influenciam a formação de calo durante o processo de cicatrização óssea e para que cicatrização óssea primária seja obtida é necessária estabilidade absoluta no foco de fratura. O conceito de strain de Perren determina que a deformação relativa no foco de fratura estabilizado depende do tamanho da lacuna de fratura original. Fraturas redutíveis (sem cominuição) são consideradas de alto strain, pois uma pequena força aplicada a linha de fratura resulta em grande movimentação com efeito deletério ao processo de consolidação. O presente trabalho revisa a literatura disponível a respeito de fatores que influenciam a mecânica de fraturas de alto strain em medicina veterinária, seus métodos de tratamento e a física por trás dos implantes disponíveis. Cada configuração de fratura requer atenção especial e cuidado crítico na escolha do método de osteossíntese e no tipo de estabilidade necessária para que a consolidação ocorra no tempo esperado. Conhecimento da teoria do strain é mandatório para a formação de cirurgiões ortopédicos.(AU)

Ensaio biomecânico para determinação do diâmetro de barra conectora de polimetilmetacrilato em fixador esquelético externo tipo Ia no úmero de suínos / Biomechanical test to determination the diameter of the polymethylmethacrylate bar in external skeletal fixator type Ia in swine humerusi

Fraturas ósseas podem ser corrigidas com a utilização de fixadores esqueléticos externos (FEE), método de estabilização bastante comum. Para tanto, têm-se utilizado barras conectoras de polimetilmetacrilato (PMMA) sem critério de diâmetro, as quais podem quebrar, se ficarem muito delgadas, ou ocasionar incômodo, quando muito pesadas e volumosas. O objetivo deste trabalho foi testar, por meio de ensaio biomecânico de compressão axial e flexão, qual é o diâmetro ideal da barra conectora de PMMA, correlacionado com o diâmetro ósseo para utilização em FEE tipo Ia. Utilizaram-se 24 úmeros para se realizarem medidas de comprimento, diâmetro, circunferência e ensaios biomecânicos. Após, foram confeccionadas barras de 1,5 vezes a média do diâmetro ósseo (grupo I), do mesmo diâmetro ósseo (grupo II) e de 0,5 vezes o diâmetro (grupo III). Com os resultados obtidos ao se compararem os valores dos ossos com os dos grupos II e III, verificou-se que as barras conectoras do grupo II mostraram-se mais resistentes do que o tecido ósseo no ensaio de compressão. No ensaio de flexão, os ossos resistiram mais quando comparados aos grupos II e III, sendo 4,3 vezes mais resistentes do que o grupo III nesse mesmo ensaio mecânico. Os resultados permitem um direcionamento para confecção de barras considerando-se o diâmetro ósseo como referência.(AU)

Bone fractures can be corrected from external skeletal fixators (ESF) in a fairly common internal stabilization method, in which connector bars polymethylmethacrylate (PMMA) is used. PMMA is used without criterion of diameter, and it can break if it is too thin or too heavy. It can be uncomfortable when bulky. The aim of this study was to test, through biomechanical axial compression and bending which is the ideal connector bar diameter PMMA, correlated to bone diameter for use in type Ia ESF. Twenty-four humerus were used to make measurements of length, diameter, circumference, and biomechanical testing. After the bars confected with 1.5 times the average diameter of the bone (group I), the same diameter (group II) and 0.5 times the diameter of the bone (group III). With the obtained results, using GII and GIII results, it was observed that the connector bars in group II were more resistant than the bones in the compression test. In the bending test, the bones resisted flexion strength when compared to group III and the group II was 4.3 times more resistant than group III in the same mechanical test. The results allow a direction for making bars considering bone diameter as a reference.(AU)

Ensaio biomecânico para determinação do diâmetro de barra conectora de polimetilmetacrilato em fixador esquelético externo tipo Ia no úmero de suínos / Biomechanical test to determination the diameter of the polymethylmethacrylate bar in external skeletal fixator type Ia in swine humerusi

Fraturas ósseas podem ser corrigidas com a utilização de fixadores esqueléticos externos (FEE), método de estabilização bastante comum. Para tanto, têm-se utilizado barras conectoras de polimetilmetacrilato (PMMA) sem critério de diâmetro, as quais podem quebrar, se ficarem muito delgadas, ou ocasionar incômodo, quando muito pesadas e volumosas. O objetivo deste trabalho foi testar, por meio de ensaio biomecânico de compressão axial e flexão, qual é o diâmetro ideal da barra conectora de PMMA, correlacionado com o diâmetro ósseo para utilização em FEE tipo Ia. Utilizaram-se 24 úmeros para se realizarem medidas de comprimento, diâmetro, circunferência e ensaios biomecânicos. Após, foram confeccionadas barras de 1,5 vezes a média do diâmetro ósseo (grupo I), do mesmo diâmetro ósseo (grupo II) e de 0,5 vezes o diâmetro (grupo III). Com os resultados obtidos ao se compararem os valores dos ossos com os dos grupos II e III, verificou-se que as barras conectoras do grupo II mostraram-se mais resistentes do que o tecido ósseo no ensaio de compressão. No ensaio de flexão, os ossos resistiram mais quando comparados aos grupos II e III, sendo 4,3 vezes mais resistentes do que o grupo III nesse mesmo ensaio mecânico. Os resultados permitem um direcionamento para confecção de barras considerando-se o diâmetro ósseo como referência.(AU)

Bone fractures can be corrected from external skeletal fixators (ESF) in a fairly common internal stabilization method, in which connector bars polymethylmethacrylate (PMMA) is used. PMMA is used without criterion of diameter, and it can break if it is too thin or too heavy. It can be uncomfortable when bulky. The aim of this study was to test, through biomechanical axial compression and bending which is the ideal connector bar diameter PMMA, correlated to bone diameter for use in type Ia ESF. Twenty-four humerus were used to make measurements of length, diameter, circumference, and biomechanical testing. After the bars confected with 1.5 times the average diameter of the bone (group I), the same diameter (group II) and 0.5 times the diameter of the bone (group III). With the obtained results, using GII and GIII results, it was observed that the connector bars in group II were more resistant than the bones in the compression test. In the bending test, the bones resisted flexion strength when compared to group III and the group II was 4.3 times more resistant than group III in the same mechanical test. The results allow a direction for making bars considering bone diameter as a reference.(AU)

Fratura cominutiva e articular distal de úmero tratada com fixador esquelético externo transarticular em três gatos / Comminuted articular fractures of the distal humerus of the three cats treated by transarticular skeletal fixators

Background: Humeral fractures account for 13% of all fractures in cats and commonly affect the middle diaphysis and supracondylar region with comminution. They are usually the result of high energy traumas such as falls, car accidents and firearm injuries. There are few treatment options for these types of fractures and since they are joint injuries, early surgical repair is mandatory to achieve perfect anatomical reduction, to maintain joint congruence and to allow early weight bearing. Our purpose is to report four subacute and chronic fractures of the distal diaphysis associated with comminuted supra and intercondylar fractures, stabilized with transarticular external skeletal fixator in three domestic felines. Cases: (1)- A 3-year-old male docile Siamese cat with 3.7 kg of body weight was presented for consultation with a 14-day history of high rise syndrome after falling from a 12-meter high. It presented distal comminuted humeral fracture that involved the inter and supracondylar regions. It also had right carpal-ulnar subluxation and comminuted right olecranon fracture involving the articular surface in the left thoracic limb. Fracture and joint stabilization was achieved by use of a transarticular hybrid external skeletal fixator on the right front limb. Fracture healing was observed at 150 days postoperatively. (2)- A 10-year-old female aggressive mixed breed cat with 4.1 kg of body weight was presented for consultation with a 16-day history of high rise syndrome after falling from a 9-meter high. The cat had a comminuted right humeral articular fracture with supra and intercondylar involvement and scapular fracture on the contralateral limb. The humerus fracture was treated with a transarticular linear external skeletal fixator and fracture healing was obtained at 240 postoperative days […]

Fratura cominutiva e articular distal de úmero tratada com fixador esquelético externo transarticular em três gatos / Comminuted articular fractures of the distal humerus of the three cats treated by transarticular skeletal fixators

Background: Humeral fractures account for 13% of all fractures in cats and commonly affect the middle diaphysis and supracondylar region with comminution. They are usually the result of high energy traumas such as falls, car accidents and firearm injuries. There are few treatment options for these types of fractures and since they are joint injuries, early surgical repair is mandatory to achieve perfect anatomical reduction, to maintain joint congruence and to allow early weight bearing. Our purpose is to report four subacute and chronic fractures of the distal diaphysis associated with comminuted supra and intercondylar fractures, stabilized with transarticular external skeletal fixator in three domestic felines. Cases: (1)- A 3-year-old male docile Siamese cat with 3.7 kg of body weight was presented for consultation with a 14-day history of high rise syndrome after falling from a 12-meter high. It presented distal comminuted humeral fracture that involved the inter and supracondylar regions. It also had right carpal-ulnar subluxation and comminuted right olecranon fracture involving the articular surface in the left thoracic limb. Fracture and joint stabilization was achieved by use of a transarticular hybrid external skeletal fixator on the right front limb. Fracture healing was observed at 150 days postoperatively. (2)- A 10-year-old female aggressive mixed breed cat with 4.1 kg of body weight was presented for consultation with a 16-day history of high rise syndrome after falling from a 9-meter high. The cat had a comminuted right humeral articular fracture with supra and intercondylar involvement and scapular fracture on the contralateral limb. The humerus fracture was treated with a transarticular linear external skeletal fixator and fracture healing was obtained at 240 postoperative days […](AU)

External skeletal fixator intramedullary pin "tie-in" for the repair of comminuted tibial fracture in a Brazilian fox (Pseudalopex vetulus)

Background: The Brazilian fox (Pseudalopex vetulus, Lund 1842) is a naturally endemic specie of the Brazilian savanna vegetation. Due to the rapid destruction of its habitat, the specie is considered vulnerable and subject to different kinds of trauma that usually results in fractures and dislocations. Among the methods of fractures fixation, highlights the external skeletal fixator intramedullary pin tie-in which consists of the intramedullary pin associated to the external fixator. The aim of the present report was to describe the case of a Brazilian fox with a comminuted tibial fracture, submitted to osteosynthesis using an external skeletal fixator intramedullary pin tie-in. Case: It was attended an exemplar of Pseudalopex vetulus, male, young adult, with 3.9 kg body weight and history of functional impotence of the left hindlimb. At the physical and orthopedic evaluations were observed loss of bone continuity and crepitus in tibial region, and the presence of a contaminated lacerating skin wound about 3 cm in diameter in the lateral side of the injured limb. Craniocaudal and mediolateral radiographic projections of the left hindlimb revealed the presence of a complete comminuted fracture at the proximal and distal shaft of the left tibia; and a complete transverse fracture at mid shaft of the left fibula. Due to this, the animal was submitted to fracture fixation [...]

External skeletal fixator intramedullary pin "tie-in" for the repair of comminuted tibial fracture in a Brazilian fox (Pseudalopex vetulus)

Background: The Brazilian fox (Pseudalopex vetulus, Lund 1842) is a naturally endemic specie of the Brazilian savanna vegetation. Due to the rapid destruction of its habitat, the specie is considered vulnerable and subject to different kinds of trauma that usually results in fractures and dislocations. Among the methods of fractures fixation, highlights the external skeletal fixator intramedullary pin tie-in which consists of the intramedullary pin associated to the external fixator. The aim of the present report was to describe the case of a Brazilian fox with a comminuted tibial fracture, submitted to osteosynthesis using an external skeletal fixator intramedullary pin tie-in. Case: It was attended an exemplar of Pseudalopex vetulus, male, young adult, with 3.9 kg body weight and history of functional impotence of the left hindlimb. At the physical and orthopedic evaluations were observed loss of bone continuity and crepitus in tibial region, and the presence of a contaminated lacerating skin wound about 3 cm in diameter in the lateral side of the injured limb. Craniocaudal and mediolateral radiographic projections of the left hindlimb revealed the presence of a complete comminuted fracture at the proximal and distal shaft of the left tibia; and a complete transverse fracture at mid shaft of the left fibula. Due to this, the animal was submitted to fracture fixation [...](AU)

Femoral fracture repair in a ferret (Mustela putorius furo) / Tratamento de fratura femoral em ferret (Mustela putorius furo)

Background: Ferrets (Mustela putorius furo) are increasingly popular as pets. They require similar medical and surgical care as small animals, and orthopedic lesions are more and more common. Fracture diagnosis is based on history, orthopedic exam, and diagnostic imaging. The preferred treatment for femur fractures is surgery, which has a favorable outcome in the majority of cases. However, surgical fracture repair in ferrets can be challenging due to the small size of the bones. The objective of this paper is to report the surgical repair of a femoral fracture in a ferret using an external skeletal fixation system type IA connected to an intramedullary pin (tie-in configuration). Case: An adult ferret was referred to the veterinary hospital after being stepped on. The ferret was diagnosed with an oblique diaphyseal fracture of the left femur and surgery was recommended. Open fracture reduction was performed with a 1 mm intramedullary pin (Kirschner wire) placed in a retrograde direction into the proximal bone segment. After fracture reduction, the intramedullary pin was inserted into the distal bone segment. The external skeletal fixator type IA was created by the insertion of a 1.5 mm Schanz pin into the distal diaphysis and another, also 1.5 mm, inserted into the proximal metaphysis, both percutaneously. The three pins were connected externally to an aluminum bar with the [...]

Femoral fracture repair in a ferret (Mustela putorius furo) / Tratamento de fratura femoral em ferret (Mustela putorius furo)

Background: Ferrets (Mustela putorius furo) are increasingly popular as pets. They require similar medical and surgical care as small animals, and orthopedic lesions are more and more common. Fracture diagnosis is based on history, orthopedic exam, and diagnostic imaging. The preferred treatment for femur fractures is surgery, which has a favorable outcome in the majority of cases. However, surgical fracture repair in ferrets can be challenging due to the small size of the bones. The objective of this paper is to report the surgical repair of a femoral fracture in a ferret using an external skeletal fixation system type IA connected to an intramedullary pin (tie-in configuration). Case: An adult ferret was referred to the veterinary hospital after being stepped on. The ferret was diagnosed with an oblique diaphyseal fracture of the left femur and surgery was recommended. Open fracture reduction was performed with a 1 mm intramedullary pin (Kirschner wire) placed in a retrograde direction into the proximal bone segment. After fracture reduction, the intramedullary pin was inserted into the distal bone segment. The external skeletal fixator type IA was created by the insertion of a 1.5 mm Schanz pin into the distal diaphysis and another, also 1.5 mm, inserted into the proximal metaphysis, both percutaneously. The three pins were connected externally to an aluminum bar with the [...](AU)

Epoxy putty external skeletal fixation in a tibiotarsal fracture of a wild choroy parakeet (Enicognathus leptorhynchus) / Fixação externa com massa epóxi em uma fratura tibiotársica de um periquito choroy selvage (Enicognathus leptorhynchus)

Tibiotarsal fractures are common in birds because in most birds this is the longest, most exposed bone in the leg. Transverse fractures are most common and rotational and shear forces must be stabilized in order to achieve good bone regeneration. A 230g male Slender-billed Parakeet or Choroy parakeet (Enicognathus leptorhynchus), with more than five years of age, was received with non-weight bearing lameness with 24 hours duration. X-rays were taken, and these revealed a closed, complete, non-comminuted transverse fracture of the distal diaphysis of the left tibiotarsal bone. Fixation was planned with 10-minute fast-setting epoxy putty. In order to assess the temperature of polymerization of the epoxy dough and the possibility of heat-bone necrosis, the temperature was recorded every 30 seconds for 12 minutes with three different amounts of the epoxy material in an ex vivo test. The temperature of the pieces reached a peak of 50-60ºC, where the highest peak corresponds to the highest amount of material. When approximately 6g of putty were used, the peak temperature reached only 51ºC. This peak changed to 58ºC when 4 times more epoxy was mixed and measured. If the temperature of the pins inserted in the bone exceeds 70ºC, bone necrosis could occur. In light of these results, the fracture was treated with 6 g of epoxy putty that was allowed to polymerize over a 1A 2/2 external skeletal fixation, with 1-mm pins bent at 90º and joined together with cerclage wire. At 6 weeks after surgery the bird had formed a good primary bone callus, and the external fixators were therefore removed. With this approach a satisfactory recovery of the patient was achieved with normal use of the affected limb(AU)

Fraturas tibiotársicas são comuns em aves, pois, na maioria das aves, o tibiotarso é o osso mais longo e exposto nesses animais. Fraturas transversais são mais comuns, sendo que as forças de rotação e cisalhamento devem ser estabilizadas de modo a alcançar uma boa regeneração óssea. Um periquito macho do tipo psitacídeo de 230g, com mais de 5 anos, foi recebido apresentando claudicação a 24 horas não devido a transferência de carga. Os exames radiográficos revelaram uma fratura fechada completa, não triturada, transversal de diáfise distal do osso esquerdo tibiotársico. A fixação foi feita com massa epóxi de endurecimento rápido (10 minutos). A fim de avaliar a temperatura de polimerização da massa epóxi e a possibilidade de necrose desses ossos, a temperatura foi registrada a cada 30 segundos durante 12 minutos, com três quantidades diferentes de epóxi em teste in vivo. A temperatura das amostras fragmentadas atingiu um pico de 50-60ºC, em que o pico mais elevado corresponde à maior quantidade de massa epóxi. Quando foram utilizados cerca de 6g de massa de vidraceiro, o pico de temperatura foi de apenas 51ºC. Esse pico foi alterado para 58ºC quando se aumentou a quantidade de massa epóxi quatro vezes. Se a temperatura dos pinos inseridos no osso for superior a 70ºC, pode ocorrer necrose do osso. À luz desses resultados, a fratura foi tratada com 6g de massa epóxi deixada polimerizar sobre uma fixação externa, em configurações 1A 2/2 usando pinos de 1mm, dobrados em 90º e unidos com fios de cerclage. Após 6 semanas da cirurgia, o pássaro tinha formado um calo ósseo primário, sendo os fixadores externos removidos. Com essa abordagem, conclui-se que houve a restauração das funções normais do membro e total recuperação da ave(AU)

Evaluation of mechanical and metal alloy composition of two sizes of circular external fixator rings for three different manufacturers for dogs / Avaliação mecânica e de composição de liga metálica de dois tamanhos de anéis para fixador externo circular de três diferentes fabricantes para cães

Background: Circular external skeletal fixator Ilizarov is a fixation method widely used to stabilize fractures. The method is performed using several components but the ring stands out as the fundamental component of this device, and compression loads in the same plane of the ring are mainly due to the wires connected from one side to another of the implant. The axial load is reached on the rings with a proper tension distractor device connected to the wires and fixed with bolts, washers and nuts during surgical procedure. Additional loads to axial tension are employed during patient`s physical activities after surgery. The study aimed to compare the resistance to axial compression load and analyze the alloy composition of the Ilizarov rings with different diameter sizes and alloys. Materials, Methods & Results: We tested two diameters of rings acquired from three manufacturers for mechanical axial compression. Manufacture sample (N = 30 rings of each trademark) was divided into two groups (60 and 80 diameter mm). The tests to evaluate strength and deformation parameters were performed in a universal testing machine Kratos ® 3.000 MP KE model, equipped with a load cell of 3000 N with test speed of 10 mm per minute. We also evaluated the elemental alloy composition by the method of the TTPIXE (Thick Target Proton Induced X-Ray Emission) in external PIXE...(AU)

Evaluation of mechanical and metal alloy composition of two sizes of circular external fixator rings for three different manufacturers for dogs / Avaliação mecânica e de composição de liga metálica de dois tamanhos de anéis para fixador externo circular de três diferentes fabricantes para cães

Background: Circular external skeletal fixator Ilizarov is a fixation method widely used to stabilize fractures. The method is performed using several components but the ring stands out as the fundamental component of this device, and compression loads in the same plane of the ring are mainly due to the wires connected from one side to another of the implant. The axial load is reached on the rings with a proper tension distractor device connected to the wires and fixed with bolts, washers and nuts during surgical procedure. Additional loads to axial tension are employed during patient`s physical activities after surgery. The study aimed to compare the resistance to axial compression load and analyze the alloy composition of the Ilizarov rings with different diameter sizes and alloys. Materials, Methods & Results: We tested two diameters of rings acquired from three manufacturers for mechanical axial compression. Manufacture sample (N = 30 rings of each trademark) was divided into two groups (60 and 80 diameter mm). The tests to evaluate strength and deformation parameters were performed in a universal testing machine Kratos ® 3.000 MP KE model, equipped with a load cell of 3000 N with test speed of 10 mm per minute. We also evaluated the elemental alloy composition by the method of the TTPIXE (Thick Target Proton Induced X-Ray Emission) in external PIXE...

Tratamento conservativo e cirúrgico em 22 ruminantes com fraturas em membros / Conservative and surgical treatment in 22 ruminants with limb fractures

O objetivo do presente trabalho foi relatar os principais locais de fraturas em membros de 22 ruminantes e determinar a eficiência dos tratamentos utilizados. Foram incluídos no estudo oito caprinos, oito ovinos e seis bovinos Em casos de fraturas distais, o tratamento conservativo com imobilização foi o método de eleição. Em casos de fraturas proximais e fraturas expostas de metatarso ou metacarpo, os ruminantes foram tratados cirurgicamente. Observou-se maior frequência de fraturas envolvendo o metacarpo ou metatarso (54,5%), seguido por fraturas de tíbia (22,7%), fêmur (9%) e casos isolados de fraturas de falange medial, úmero, rádio e ulna (4,5% cada). O índice de recuperação total alcançou 95,4%. A imobilização com gesso associada à tala de Thomas, ou apenas com talas de madeira em animais jovens, foi eficiente na redução de fraturas de metacarpo, metatarso, tíbia, úmero e rádio nos ruminantes tratados. Enquanto no caso de fratura de falange medial, a imobilização com uso apenas de gesso foi suficiente para proporcionar reparação óssea adequada. A fixação esquelética externa ou interna deve ser considerada uma opção no tratamento de fraturas metacárpicas, metatársicas, tibiais e femorais em ruminantes, principalmente quando o animal for de baixo peso corporal.(AU)

The aim of the present study was to report the main locations of limb fractures in 22 ruminants and to determine the efficiency of the treatment choices. Eight goats, eight sheep and six cattle were included. In cases of distal fractures, the conservative treatment with immobilization was the method of choice. In cases of proximal, exposed metatarsal or metacarpal fractures, the ruminants were treated surgically. The higher frequency of fractures involved the metacarpal or metatarsal (54.5%) followed by fractures of the tibia (22.7%), femur (9%) and isolated cases of medial phalanx, humerus, radius and ulna fractures (4.5% each). Total recovery rate reached 95.4%. Immobilization with plaster associated with Thomas splint, or just with wooden splints in young animals, was efficient in reducing fractures of metacarpal, metatarsal, tibia, humerus, and radio in the treated ruminants. In the case of medial phalanx fracture, immobilization using only plaster was sufficient to provide adequate bone repair. The internal or external skeletal fixation should be considered an option in the treatment of metacarpal, metatarsal, tibial and femoral fractures in ruminants, especially in low body weight animals.(AU)