A Case Report of A Hybrid External Fixator for Fracture Repair in a 3-Month-Old Boer Goat (Capra hircus)

A 3-month-old male intact crossbred Boer Anglo Nubian caprine kid weighing 20.50Kg. presented to the School of Veterinary Medicine (SVM) with a history of acute onset lameness of the left hind limb. Initial examination at a private veterinary clinic revealed a fracture of the left tibia. The patient was referred to the SVM for treatment. Physical and radiographic examination of the animal revealed a closed, complete, short oblique fracture of the distal metaphysis of the left tibia with moderate cranio-proximal displacemnt of the distal segment, The limb was temporarily immobilized using a pre-made bivalve cast until the surgery. Surgical intervention involved using hybrid external fixator best described as a maximal bilateral uniplanar (Type II) fixator frame with a distal fabricated aluminum ring. The post-operative regimen included antibiotics, non-steroidal anti-inflammatories, frequent cleaning of the pin-skin interface and apparatus bandage changes, The animal was also confined to pen rest initially with gradual increase in exercise. Since surgery, the patient has progressively increases weight bearing on the affected limb and was fully weight bearing upon external fixator removal, 6-weeks post operatively. This method of external fixatiojm has not been commonly used foe repair of fractured limbs in goats, however in this scenario it proved ecomonical and highly effectively in provideing the stability required for fracture repair. Veterarians with limited resourcs and financially conservative clients should consider this method for repairing similar type fractures in small ruminant animal species.

An in vitro study to determine the effectiveness of a patellar ligament/fascia lata graft and new tibial suture anchor points for extracapsular stabilization of the cranial cruciate ligament-deficient stifle in the dog

OBJECTIVE-(1) To determine whether an extracapsular patellar ligament/fascia lata graft would provide stability in the cranial cruciate ligament (CrCL)-deficient stifle comparable with that of the intact. (2) To determine if different tibial anchor points would enhance stability of the CrCL-deficient stifle when compared with the standard fabellar-tibial suture (FTS) placement. STUDY DESIGN-Experimental. ANIMALS-Twenty-eight canine cadaver hind limbs. METHODS-Stifles were mounted in a jig and tested between loads of -65 and 80 N. After testing the intact CrCL, 4 stabilization techniques were tested after CrCL transection: lateral graft technique (LGT) and 3FTS with different tibial anchor points. RESULTS-There were no significant differences in displacement between the LGT and standard FTS between the LGT and the intact CrCL, or between the FTS and the intact CrCL, in either the Securos or the Screw-washer experiments. Stiffness of the intact CrCL was significantly greater than that of any stabilization techniques. Differences in stiffness were not significant between the suture stabilization techniques. CONCLUSIONS-Securely anchored, the LGT results in a reduction in drawer motion similar to that of the intact CrCL and the standard FTS. Altering the tibial anchor point of the FTs does not improve stiffness or enhance stabilization of the CrCL-deficient Stifle. CLINICAL RELEVANCE-The LGT could be used for the treatment of CrCL ruptures in the dog. A clinical study is recommended (AU)

Primary leiomyosarcoma of bone

Primary leiomyosarcoma of bone is rare. We present the clinicopathological features of a case, the first documented from the Caribbean, seen recently at our institution. (AU)

Haemoglobin SC disease in Jamaica

A skeletal survey was carried out on 84 cases of haemoglobin SC disease. The radiological features noted were increased translucency of bone, abnormal trabecular pattern, medullary expansion, wide vascular channels in phalanges, and radiological evidence of infarction, both medullary and cortical. The frequency of bone lesions thus demonstrated increased with age. The most characteristic lesions in this region were those of vascular necrosis; contributing factors such as the high haemoglobin level characteristic of the condition are discussed. An interesting feature was the lack of correlation betweeen clinical severity and degree of radiological change. (AU)

Radiological changes associated with leg ulcers in the tropics

The radiological changes associated with four distinct types of leg ulceration common in the tropics are reviewed. Only mild changes occurred in the tropical phagedenic group, but more marked radiological abnormalities occurred in the three chronic groups. The frequency and pattern of the periosteal reaction is the most useful guide to radiological differentiation of these groups. (AU)

The relationship between Blount's disease and bow legs

The radiological appearances of the infantile form of Blount's disease (tibia vara) are described. These consist of a various deformity of the upper end of the tibia, torsion of the tibial shaft, irregularity and fragmentation of the medial part of the tibial metaphysis and gross thickening of the cortex on the medial side of the tibial shaft. This condition is very common in Jamaica and presents clinically as severe as bow legs. A study of the knees of 75 Jamaican children who presented with severe bow legs was carried out. Radiological examination revealed three different appearances. I. Severe simple (physiological) bow legs. 111. Early Blount's disease, due to a defect in the medial part of the metaphyseal beak, the metaphyseal "tear". III. Typical Blount's disease. Thirty cases showed transition from I to II or III and II to III. Evidence from the present study suggests that the development of the changes of Blount's disease in children with severe but simple bow legs is due to the increased proportion of the body weight which is supported by the medial part of the tibial metaphysis. This is described as eccentric pressure. The Jamaican child walks at an earlier age than the British child which results in the Jamaican child walking on the physiological bow legs. The British child walks on legs which are straight or show physiological knock knees. This is the racial factor. It is suggested that because of the normal plasticity of bone the child who walks on physiological bow legs will develop severe bow legs. This would explain the high incidence of severe bow legs in Jamaican children and hence the fact that Blount's disease may develop. Therefore, the three factors, eccentric pressure (due to severe bow legs), racial factors (early walking) and natural plasticity of bone are thought to be responsible for the persistence of physiological bow legs, the high incidence of severe bow legs and the development of Blount'd disease in the Jamaican child.(AU)

The long-term prognosis of severe infantile malnutrition

65 Jamaican children who had been treated for severe malnutrition in hospital were traced and examined 2-8 years after their discharge from hospital. They were found to be small by North American standards, but not when they were compared with Jamaican children, similar genetically and from the same economic background. When 56 of the previously malnourished children were matched with siblings or close relatives as controls they were slightly taller and heavier, broader in the chest, and had thicker bone and muscle in the leg than the sibling who had never been severely malnourished. There is no clear evidence that a period of severe malnutrition in infancy per se causes stunting of growth in children as it does in some animals. On the contrary, children who have been successfully treated for malnutrition tend to outgrow their siblings when they return home; this may have a genetic basis.(Summary)

Non-rachitic bow leg and knock-knee deformities in young Jamaican children

Severe bow legs and knock knees are very common in Jamaican children. These two deformities are closely related and are not due to any known pathological condition including rickets. In advanced cases the bow legs change to tibia vara and the knock knees to tibia valga, while changes appear in the tibial metaphysis which resemble osteochondritis radiologically. Three factors, racial, eccentric pressure on the knee and increased plasticity of bone, have been shown to play a part in the development of these deformities. In severe bow legs treatment appears to be indicated when the angle formed by the femur and tibia exceeds 25 deg. Spontaneous correction of lesser angulation can occur (Summary)

The patterns of cartilage canals

The pattern of vascular canals in the cartilagenous upper end of the developing tibia was investigated in the sheep, goat, rabbit, cat, rat and man. The blood vessels were injected with a visually opaque fluid, and the cartilage was fixed, dehydrated and cleared. Specimens immersed in their clearing fluid were examined visually in transmitted light with a stereoscopic microscope. In each species the upper tibial cartilage showed a constant vascular canal pattern at all stages prior to development of the secondary centre of ossification. The pattern was constant in broad outline only, and allowed great variation in individual details. The canal pattern in any one species differed from the patterns of all other species studied. The different patterns were not obviously related to differences in the size and/or shape of the homologous cartilage in the different species examined. The course and distribution of the vascular canals indicated that the presence of these canals in cartilage cannot be explained soley as the result of passive inclusion of perichondrial cartilage around them (Summary)

Observations on the etiology of tibia vara

Twenty-eight cases of the infantile and three cases of the adolescent type of tibia vara occurring in West Indian Negroes are reported. The condition is characterised by failure of growth of the postero-medial part of the upper tibial epiphysis. The deformity produced is acute varus at the upper tibia with medial torsion and eventually flexion of the diaphysis on the epiphysis. These deformities are considered to be due to a vicious circle set up by considerable alteration of the lines of force on the medial portion of the upper tibial epiphysial line (Summary)

Tibia vara

This is defined as a varus and internal torsion deformity at the upper end of of the tibia due to abnormal growth at the upper medial epiphysis. Clinical material covers 20 cases with no significant sex nor side relationship. No definite aetiological factor found. Little spontaneous correction, progressing to marked deformity so surgery recommended before the age of 5 years. Fair results only in later age groups. Type of operation and management discussed (AU)