Treatment of bicondylar femoral fractures complicated by concurrent ligament or tendon injuries in four dogs.

OBJECTIVE: Retrospective case series describing the surgical treatment and outcome in dogs with bicondylar femoral fractures complicated by ligament or tendon injuries. METHODS: Medical records were reviewed for three immature and one mature dog with traumatic bicondylar fractures of the distal femur and concurrent ligament or tendon injury treated surgically. Data retrieved included physical examination, imaging, and treatment. Long-term follow-up and return to function was assessed by owner feedback, physical examination, radiology, and force plate analysis. The immediate, four-week, and two-year postoperative outcomes were described. RESULTS: All four dogs were presented with injuries to either the cranial or caudal cruciate ligament. Only two dogs underwent surgical repair of the caudal cruciate ligament. Anatomical reduction and rigid internal fixation of the distal femoral fractures was performed using a combination of lag screws, Kirschner wires, and bone plates. At the long-term follow-up, all cases had good to excellent return to function, as assessed by force plate analysis and owner assessment of quality of life and satisfaction. Radiographs revealed evidence of complete fracture healing, with moderate to severe osteoarthritis of the stifle. CLINICAL SIGNIFICANCE: Bicondylar femoral fractures can be associated with ligament or tendon injuries. Anatomical reduction and internal fixation of bicondylar femoral fractures is recommended and may offer a good to excellent return function, with or without repair of associated caudal cruciate ligament injuries.

Hinged circular fixator construct for correction of congenital metatarsal deformity in a foal.

A five-week-old American Quarter Horse colt was presented for evaluation of a left hindlimb deformity and lameness. Radiographs of the left hindlimb revealed a varus deformity with recurvatum originating in the mid-diaphysis of the third metatarsal bone. Surgical correction was undertaken by performing an osteotomy through the centre of rotation of angulation located within the mid-diaphysis of the third metatarsal bone, and a four-ring hinged circular external fixator construct was applied. Distraction of the osteotomy site was performed over an 11 day period. Notable complications included failure of a fixation pin, infection of the surgical site, and temporary laxity of the supporting tendons and ligaments of the contralateral metatarsophalangeal joint. The fixator was maintained until there was sufficient bone formation to allow frame removal, 152 days after the initial surgery. Use of a hinged circular construct allowed for partial correction of the deformity with resultant lengthening and resolution of the lameness in this colt.

Clinical evaluation of a pre-tied ligating loop for liver biopsy and liver lobectomy.

OBJECTIVES: The aim of this prospective case series was to evaluate the suitability of a pre-tied ligating loop for liver biopsy or partial or complete liver lobectomy via midline coeliotomy for diagnosis or treatment of hepatic disease. METHODS: Nine client-owned animals (six dogs and three cats) in which liver biopsy or partial or complete liver lobectomy was performed using a 2-0 Polysorb™ pre-tied ligating loop (SurgiTie™; Covidien) via midline coeliotomy were included. The fit of the loop, space for incision and presence and character of bleeding from the incised surface were assessed. Pre- and postoperative haematocrit and peri-operative complications were noted. Dimensions, histopathology and mineral analysis of acquired specimens were reviewed. RESULTS: The pre-tied ligating loop was successfully employed for liver biopsy and resection of torsed liver lobes and neoplastic tissue. Dirty margins were obtained in one case in which complete resection of neoplastic tissue was the primary goal. Few perioperative complications were noted, the most common being generalised oozing from the cut surface in four cases, effectively controlled with local haemostasis. CLINICAL SIGNIFICANCE: The pre-tied ligating loop is a versatile and safe method for liver biopsy or lobectomy. As with other surgical techniques, alternative methods of haemostasis should always be available.