Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series / Complicações clínicas de longo prazo relacionadas ao uso de pino ou parafuso/polimetilmetacrilato na estabilização espinhal de cães e gatos: série de casos

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional surgical procedures. Despite the small number of cases included in this study, one can infer that complications related to the use of bone cement in spinal surgery can occur in the long term and should be highlighted during the implant choosing process for vertebral osteosynthesis in small animals.(AU)

O trauma vertebromedular é uma afecção comum na rotina clínica de pequenos animais e resulta, muitas vezes, em fraturas e luxações vertebrais (FLV) associadas à laceração, concussão, compressão ou isquemia da medula espinhal. Essas lesões apresentam sinais clínicos que variam de dor moderada a grave, acompanhada por perda parcial ou total das funções motoras, sensoriais e viscerais, podendo resultar no óbito ou na indicação de eutanásia. O objetivo deste trabalho é descrever cinco casos de complicações inerentes o uso de cimento ósseo para estabilização vertebral em quatro cães e um gato. Os pacientes possuíam idades variando entre cinco meses a quatro anos, peso entre 1,4 e 12,2kg e foram atendidos no Serviço de Ortopedia e Traumatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, com histórico de reações cutâneas ao polimetilmetacrilato (PMMA), como tratos drenantes ou exposição do cimento decorrente de infecção ou soltura precoce do implante, em períodos que variaram de nove à 18 meses após serem submetidos a osteossíntese da coluna vertebral. Foi realizada a remoção cirúrgica desses implantes em quatro pacientes e mantida a estabilização prévia em um caso. Houve resolução total do quadro de infecção nos pacientes em que se removeu o PMMA associada ao tratamento clínico, e remissão parcial no paciente em que o implante não pode ser removido. A utilização do cimento ósseo associado a parafusos ou pinos é uma técnica versátil e aplicável em todas as regiões da coluna vertebral, no entanto complicações tardias são possíveis, sendo necessário muitas vezes procedimentos cirúrgicos adicionais para a resolução do problema. Apesar da pequena quantidade de casos relatados, foi possível observar que complicações relacionadas ao uso do cimento ósseo na coluna vertebral podem ocorrer no médio ao longo prazo [...].(AU)

Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series / Complicações clínicas de longo prazo relacionadas ao uso de pino ou parafuso/polimetilmetacrilato na estabilização espinhal de cães e gatos: série de casos

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional surgical procedures. Despite the small number of cases included in this study, one can infer that complications related to the use of bone cement in spinal surgery can occur in the long term and should be highlighted during the implant choosing process for vertebral osteosynthesis in small animals.

O trauma vertebromedular é uma afecção comum na rotina clínica de pequenos animais e resulta, muitas vezes, em fraturas e luxações vertebrais (FLV) associadas à laceração, concussão, compressão ou isquemia da medula espinhal. Essas lesões apresentam sinais clínicos que variam de dor moderada a grave, acompanhada por perda parcial ou total das funções motoras, sensoriais e viscerais, podendo resultar no óbito ou na indicação de eutanásia. O objetivo deste trabalho é descrever cinco casos de complicações inerentes o uso de cimento ósseo para estabilização vertebral em quatro cães e um gato. Os pacientes possuíam idades variando entre cinco meses a quatro anos, peso entre 1,4 e 12,2kg e foram atendidos no Serviço de Ortopedia e Traumatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, com histórico de reações cutâneas ao polimetilmetacrilato (PMMA), como tratos drenantes ou exposição do cimento decorrente de infecção ou soltura precoce do implante, em períodos que variaram de nove à 18 meses após serem submetidos a osteossíntese da coluna vertebral. Foi realizada a remoção cirúrgica desses implantes em quatro pacientes e mantida a estabilização prévia em um caso. Houve resolução total do quadro de infecção nos pacientes em que se removeu o PMMA associada ao tratamento clínico, e remissão parcial no paciente em que o implante não pode ser removido. A utilização do cimento ósseo associado a parafusos ou pinos é uma técnica versátil e aplicável em todas as regiões da coluna vertebral, no entanto complicações tardias são possíveis, sendo necessário muitas vezes procedimentos cirúrgicos adicionais para a resolução do problema. Apesar da pequena quantidade de casos relatados, foi possível observar que complicações relacionadas ao uso do cimento ósseo na coluna vertebral podem ocorrer no médio ao longo prazo [...].

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)

Diagnóstico radiográfico e tomográfico de osteocondrose dissecante em tarso de cão / Radiographic and tomographic diagnosis of tarsal osteochondrosis dissecans in dog

Background: The tarsal joint is the third most commonly joint affected by osteochondrosis in dogs. This joint is affected in 4 to 9% of the cases, and in 50% of these cases the disease is bilateral. Radiological signs include defect in the subchondral bone, sclerotic margin, and fragment of mineralized cartilage. Dorsoplantar in flexion and oblique radiologic images are necessary to show tarsal osteochondrosis. Computed tomography avoid overlap of bone structures and allows better visualization of subchondral lesions, showing the exact location, size and number of fragments. The objective of this study is to report a case of bilateral osteochondrosis dissecans in tarsal joint in Rottweiler. Case: A female Rottweiler was examined and presented a history of pain and difficulty in raising the pelvic limbs. There was pain in the right tibiotarsal joint (RTJ) with evident joint cracking and, after three months, the left pelvic limb started to show the same signs. Radiographic examination of the RTJ showed a small osteochondral fragment in the distal medial border of the medial malleolus of the tibia, subchondral sclerosis with radiolucent area in the medial malleolus of the tibia, and a small lateral periarticular osteophyte in the intertarsal joint. The left tibiotarsal joint (LTJ) showed mild articular incongruity and minor increase in radiological interlinear space, diffuse sclerosis in the medial malleolus and in the subchondral surface of the trochlear crest. This exam also showed a small radiolucent area in the medial malleolus of the tibia, a small fragment of radiopaque adjacent bone, and minor subchondral bone irregularity in the medial margin of the medial trochlea. The radiographic examination of the RTJ was inconclusive. Computed tomography was requested and suggested the diagnosis of medial osteochondritis dissecans in the distal talus...(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 […]

Diagnóstico radiográfico e tomográfico de osteocondrose dissecante em tarso de cão / Radiographic and tomographic diagnosis of tarsal osteochondrosis dissecans in dog

Background: The tarsal joint is the third most commonly joint affected by osteochondrosis in dogs. This joint is affected in 4 to 9% of the cases, and in 50% of these cases the disease is bilateral. Radiological signs include defect in the subchondral bone, sclerotic margin, and fragment of mineralized cartilage. Dorsoplantar in flexion and oblique radiologic images are necessary to show tarsal osteochondrosis. Computed tomography avoid overlap of bone structures and allows better visualization of subchondral lesions, showing the exact location, size and number of fragments. The objective of this study is to report a case of bilateral osteochondrosis dissecans in tarsal joint in Rottweiler. Case: A female Rottweiler was examined and presented a history of pain and difficulty in raising the pelvic limbs. There was pain in the right tibiotarsal joint (RTJ) with evident joint cracking and, after three months, the left pelvic limb started to show the same signs. Radiographic examination of the RTJ showed a small osteochondral fragment in the distal medial border of the medial malleolus of the tibia, subchondral sclerosis with radiolucent area in the medial malleolus of the tibia, and a small lateral periarticular osteophyte in the intertarsal joint. The left tibiotarsal joint (LTJ) showed mild articular incongruity and minor increase in radiological interlinear space, diffuse sclerosis in the medial malleolus and in the subchondral surface of the trochlear crest. This exam also showed a small radiolucent area in the medial malleolus of the tibia, a small fragment of radiopaque adjacent bone, and minor subchondral bone irregularity in the medial margin of the medial trochlea. The radiographic examination of the RTJ was inconclusive. Computed tomography was requested and suggested the diagnosis of medial osteochondritis dissecans in the distal talus...

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)

Nonunion fractures in small animals - A literature review / Não união de fraturas em pequenos animais - Revisão de literatura

Bone nonunion is observed when the healing of a fracture fails and all processes of biologic repair cease. It is a frequent complication during fracture treatment in small animals. Nonunions are classified as viable or nonviable, and most cases result from technical error (e.g., inadequate or inappropriate choice of the type of stabilization), poor vascularization, excessive distance between the fragments, infection, and systemic disease, or local as well as idiopathic factors. The diagnosis is made when there is no radiographic evidence of bone healing. This condition cannot be treated conservatively; rather, nonunions require surgical intervention involving removal of implants (besides exuberant callus removal), proper alignment, and compression of the fracture site. As bone nonunion remains a common problem in clinical practice, the objective of this paper is to review the pathophysiology and methods for treating of the condition.(AU)

A não união óssea acontece quando ocorre falha na consolidação óssea de uma fratura, onde todos os sinais de reparação aparentemente cessaram. É uma freqüente complicação do tratamento de fraturas em pequenos animais. As não uniões são classificadas em viáveis e não-viáveis e podem resultar de diversos fatores como estabilização inadequada, vascularização deficiente, distância excessiva entre os fragmentos, infecção, doença sistêmica ou local e fatores idiopáticos. A maior parte das não uniões resulta de escolha inadequada da forma de estabilização ou falha técnica por parte dos cirurgiões. O diagnóstico é quando radiograficamente não existem sinais de evolução da consolidação óssea. Esta afecção não pode ser tratada de forma conservadora, o tratamento é cirúrgico e é mandatória remoção dos implantes que falharam, remoção do calo exuberante, alinhamento adequado e compressão do foco de fratura. O objetivo deste trabalho é revisar a fisiopatologia, assim como as formas de tratamento desta afecção tão comum na prática clínica.(AU)

Nonunion fractures in small animals - A literature review / Não união de fraturas em pequenos animais - Revisão de literatura

Bone nonunion is observed when the healing of a fracture fails and all processes of biologic repair cease. It is a frequent complication during fracture treatment in small animals. Nonunions are classified as viable or nonviable, and most cases result from technical error (e.g., inadequate or inappropriate choice of the type of stabilization), poor vascularization, excessive distance between the fragments, infection, and systemic disease, or local as well as idiopathic factors. The diagnosis is made when there is no radiographic evidence of bone healing. This condition cannot be treated conservatively; rather, nonunions require surgical intervention involving removal of implants (besides exuberant callus removal), proper alignment, and compression of the fracture site. As bone nonunion remains a common problem in clinical practice, the objective of this paper is to review the pathophysiology and methods for treating of the condition.

A não união óssea acontece quando ocorre falha na consolidação óssea de uma fratura, onde todos os sinais de reparação aparentemente cessaram. É uma freqüente complicação do tratamento de fraturas em pequenos animais. As não uniões são classificadas em viáveis e não-viáveis e podem resultar de diversos fatores como estabilização inadequada, vascularização deficiente, distância excessiva entre os fragmentos, infecção, doença sistêmica ou local e fatores idiopáticos. A maior parte das não uniões resulta de escolha inadequada da forma de estabilização ou falha técnica por parte dos cirurgiões. O diagnóstico é quando radiograficamente não existem sinais de evolução da consolidação óssea. Esta afecção não pode ser tratada de forma conservadora, o tratamento é cirúrgico e é mandatória remoção dos implantes que falharam, remoção do calo exuberante, alinhamento adequado e compressão do foco de fratura. O objetivo deste trabalho é revisar a fisiopatologia, assim como as formas de tratamento desta afecção tão comum na prática clínica.

Tenorrhaphy of the common calcaneal tendon in dogs and cats

Background: Common calcaneal tendon (CCT) is usually affected by injuries in dogs and less frequently in cats. The Achilles mechanism consists of the convergence of three distinct structures: the tendons of the gastrocnemius muscle, superficial digital flexor muscle and the common tendons of the biceps femoris, gracilis, and semitendinosus muscles. Classification of lesions is based upon their location, severity and chronicity. Clinical signs include lameness, plantigrade stance and various degrees of tarsal hyperflexion according to the injurys severity. The purpose of this study is to report four cases of reconstruction of the common calcaneus in three dogs and a cat. Cases: Case 1. A 10-year-old male canine, Brazilian Terrier, 7.7 kg of body weight, with a 6-month history of nonweightbearing lameness of the right hind limb attended consultation. Orthopedic examination showed plantigrade stance, hyperflexion of the right tibial-tarsal joint (TTJ) and swelling with fibrous thickening of the distal portion of the CCT. Surgical tendon repair was achieved through insertion of a locking screw on the calcaneo-tibial, tenorrhaphy and suture of a titanium plate on the caudal aspect of the CCT. Case 2. A 2-year-old female mongrel canine, with 13.3 kg of body weight was presented with the complaint of chronic left hind leg lameness. The owner described trauma at the area of the hock [...](AU)

Use of a locking plate notched head T-plate® for the fixation of an ilial body fracture in a dog / Utilização de placa bloqueada notched head T-plate® no tratamento de fratura do corpo do ílio em um cão

Several types of implants may be used to treat iliac fractures in dogs, of which osteosynthesis with plate is the most described and recommended in the literature. The type of plate and screw are major factors in osteosynthesis success. The use of locking plates has been advocated for this purpose, as they do not allow the plate-bone-screw unit to shift, providing angular stability and rigidity to the system. The present study aimed to describe the unprecedented use of a locking notched head T-plate in the treatment of a caudal body of ilium fracture. A two year old male mongrel dog was attended after falling from a third floor height, with two days of evolution. The animal was in standing position, and during orthopedic examination non-weight bearing lameness of the right hind limb, instability, and crepitus in the right body of ilium, with considerable swelling and pain. The radiographic examination allowed diagnosing a complete fracture of the caudal body of ilium with decrease of the pelvic canal diameter. The patient underwent surgery, and the fracture was stabilized with an LCP notched head T-plate. The patient evolved satisfactorily, with good weight-bearing of the affected limb within 24 hours of surgery, and complete recovery with medical discharge after 60 days of postoperative period, with consolidation of the fracture.

Vários tipos de implantes são utilizados no tratamento de fraturas de íleo em cães, sendo a osteossíntese com uso de placa a mais descrita e recomendada pela literatura. O tipo de placa, assim como o tipo de parafuso, são fatores preponderantes no sucesso da osteossíntese. Tem sido defendido o uso de placas bloqueadas, que não permitem movimentação entre a unidade placa-osso-parafuso, conferindo estabilidade angular e rigidez ao sistema. Objetivou-se descrever o uso inédito da placa bloqueada notched head T-plate no tratamento de fratura caudal de corpo de íleo. Um cão, macho, sem raça definida, de dois anos de idade foi atendido apresentando histórico de queda de terceiro andar, com dois dias de evolução. O animal apresentava-se em estação e durante a avaliação ortopédica observou-se deambulação com impotência funcional do membro pélvico direito, instabilidade e crepitação em corpo do íleo direito com aumento de volume considerável e muita dor. Diagnosticou-se fratura completa caudal do corpo do íleo com diminuição do diâmetro do canal pélvico, através de exame radiográfico. O paciente foi submetido à cirurgia e a fratura foi estabilizada com o uso de uma placa LCP em T com a cabeça chanfrada. O paciente apresentou evolução satisfatória com bom apoio do membro 24 horas após a cirurgia e completa recuperação com alta médica aos 60 dias de pós-operatório com consolidação da fratura.

Tenorrhaphy of the common calcaneal tendon in dogs and cats

Background: Common calcaneal tendon (CCT) is usually affected by injuries in dogs and less frequently in cats. The Achilles mechanism consists of the convergence of three distinct structures: the tendons of the gastrocnemius muscle, superficial digital flexor muscle and the common tendons of the biceps femoris, gracilis, and semitendinosus muscles. Classification of lesions is based upon their location, severity and chronicity. Clinical signs include lameness, plantigrade stance and various degrees of tarsal hyperflexion according to the injurys severity. The purpose of this study is to report four cases of reconstruction of the common calcaneus in three dogs and a cat. Cases: Case 1. A 10-year-old male canine, Brazilian Terrier, 7.7 kg of body weight, with a 6-month history of nonweightbearing lameness of the right hind limb attended consultation. Orthopedic examination showed plantigrade stance, hyperflexion of the right tibial-tarsal joint (TTJ) and swelling with fibrous thickening of the distal portion of the CCT. Surgical tendon repair was achieved through insertion of a locking screw on the calcaneo-tibial, tenorrhaphy and suture of a titanium plate on the caudal aspect of the CCT. Case 2. A 2-year-old female mongrel canine, with 13.3 kg of body weight was presented with the complaint of chronic left hind leg lameness. The owner described trauma at the area of the hock [...]

Use of a locking plate notched head T-plate® for the fixation of an ilial body fracture in a dog / Utilização de placa bloqueada notched head T-plate® no tratamento de fratura do corpo do ílio em um cão

Several types of implants may be used to treat iliac fractures in dogs, of which osteosynthesis with plate is the most described and recommended in the literature. The type of plate and screw are major factors in osteosynthesis success. The use of locking plates has been advocated for this purpose, as they do not allow the plate-bone-screw unit to shift, providing angular stability and rigidity to the system. The present study aimed to describe the unprecedented use of a locking notched head T-plate in the treatment of a caudal body of ilium fracture. A two year old male mongrel dog was attended after falling from a third floor height, with two days of evolution. The animal was in standing position, and during orthopedic examination non-weight bearing lameness of the right hind limb, instability, and crepitus in the right body of ilium, with considerable swelling and pain. The radiographic examination allowed diagnosing a complete fracture of the caudal body of ilium with decrease of the pelvic canal diameter. The patient underwent surgery, and the fracture was stabilized with an LCP notched head T-plate. The patient evolved satisfactorily, with good weight-bearing of the affected limb within 24 hours of surgery, and complete recovery with medical discharge after 60 days of postoperative period, with consolidation of the fracture.(AU)

Vários tipos de implantes são utilizados no tratamento de fraturas de íleo em cães, sendo a osteossíntese com uso de placa a mais descrita e recomendada pela literatura. O tipo de placa, assim como o tipo de parafuso, são fatores preponderantes no sucesso da osteossíntese. Tem sido defendido o uso de placas bloqueadas, que não permitem movimentação entre a unidade placa-osso-parafuso, conferindo estabilidade angular e rigidez ao sistema. Objetivou-se descrever o uso inédito da placa bloqueada notched head T-plate no tratamento de fratura caudal de corpo de íleo. Um cão, macho, sem raça definida, de dois anos de idade foi atendido apresentando histórico de queda de terceiro andar, com dois dias de evolução. O animal apresentava-se em estação e durante a avaliação ortopédica observou-se deambulação com impotência funcional do membro pélvico direito, instabilidade e crepitação em corpo do íleo direito com aumento de volume considerável e muita dor. Diagnosticou-se fratura completa caudal do corpo do íleo com diminuição do diâmetro do canal pélvico, através de exame radiográfico. O paciente foi submetido à cirurgia e a fratura foi estabilizada com o uso de uma placa LCP em T com a cabeça chanfrada. O paciente apresentou evolução satisfatória com bom apoio do membro 24 horas após a cirurgia e completa recuperação com alta médica aos 60 dias de pós-operatório com consolidação da fratura.(AU)

Assessment of pain submission in dogs submitted to dorsal acetabular denervation

Background: Hip dysplasia is a disease characterized by laxity of the joint and subsequent development of osteoarthritis.Pain is initially caused by joint looseness and instability. Dorsal acetabular denervation surgery have been used with ananalgesic objective. The technique initially proposed was modified, by performing a larger area of denervation. There areno studies referring to the pain parameters accepted by researchers regarding the assessment of this technique are availablein the literature. The aim of this research was express by cortisol and serum glycemia levels, the remission of pain in thepatients submitted to acetabular denervation.Materials, Methods & Results: The serum levels of cortisol and glycemia were analyzed in 11 dogs with hip dysplasiaat moments 0 (M0), I (M1), II (M2) and III (M3), which were respectively the moment of the diagnosis, 2, 7 and 15 daysafter the surgical procedure. All the patients were sumitted to the surgical intervention called dorsal acetabular denervation.The colorimetric enzymatic method was used for glucose measurement and the reading was performed using a spectrumphotometer. For the serum measurement of cortisol the ELISA method was used. The statistical analyses were processedwith the help of a computerized statistical program (Minitab Release 13). The final data obtained were analyzed regardingtheir parametric distribution using the Kolmogorov-Smirnov test. The analyzed data presented a parametric distributionand had means compared by the Tukeys analysis of variance. Differences with P values equal or smaller than 0.05 wereconsidered significant. The correlation between the glycemia and serum cortisol values was evaluated by the Pearson test.The statistical analysis of the results points out a significant difference regarding the cortisol levels (μg/dL) at moments M1and M2 regarding the moment M0, and at moment M3 regarding the other moments. There was no significant statistical...(AU)

Assessment of pain submission in dogs submitted to dorsal acetabular denervation

Background: Hip dysplasia is a disease characterized by laxity of the joint and subsequent development of osteoarthritis.Pain is initially caused by joint looseness and instability. Dorsal acetabular denervation surgery have been used with ananalgesic objective. The technique initially proposed was modified, by performing a larger area of denervation. There areno studies referring to the pain parameters accepted by researchers regarding the assessment of this technique are availablein the literature. The aim of this research was express by cortisol and serum glycemia levels, the remission of pain in thepatients submitted to acetabular denervation.Materials, Methods & Results: The serum levels of cortisol and glycemia were analyzed in 11 dogs with hip dysplasiaat moments 0 (M0), I (M1), II (M2) and III (M3), which were respectively the moment of the diagnosis, 2, 7 and 15 daysafter the surgical procedure. All the patients were sumitted to the surgical intervention called dorsal acetabular denervation.The colorimetric enzymatic method was used for glucose measurement and the reading was performed using a spectrumphotometer. For the serum measurement of cortisol the ELISA method was used. The statistical analyses were processedwith the help of a computerized statistical program (Minitab Release 13). The final data obtained were analyzed regardingtheir parametric distribution using the Kolmogorov-Smirnov test. The analyzed data presented a parametric distributionand had means compared by the Tukey’s analysis of variance. Differences with P values equal or smaller than 0.05 wereconsidered significant. The correlation between the glycemia and serum cortisol values was evaluated by the Pearson test.The statistical analysis of the results points out a significant difference regarding the cortisol levels (μg/dL) at moments M1and M2 regarding the moment M0, and at moment M3 regarding the other moments. There was no significant statistical...

Bacteriological evaluation of bone grafts stored by cryogenic freezing at 24C from a canine (Canis familiaris) bone bank / Avaliação bacteriológica de enxertos ósseos submetidos à técnica criogênica a -24C em banco de ossos de cães (Canis familiaris)

The scientific basis of bone transplantation was established during the mid-nineteenth century, when the osteogenic properties of the bone and periosteum, beneficial influence of cold preservation of bones, and first conventional attempt to store bones for elective use, were described. A bone bank has several advantages, such as the immediate availability of grafts in large quantities, and different shapes and sizes, and maintenance of osteoinductive activity in grafts. In addition, it reduces patient blood loss, surgical time, and quantity of anesthetics required. Clinical applications include the correction of comminuted fractures, treatment of non-union bones, and replacement of bone loss due to infections or malignancies. The success of these procedures depends on the preservation and integrity of the graft. This study aimed to evaluate the feasibility of maintaining a canine bone bank (Canis familiaris) by quantifying the bacterial contamination of bone grafts preserved at 24C. The samples were evaluated through a monthly assessment of bacteriological cultures over a period of 6 months. The harvest method was efficient and sterile, reducing the risk of contamination. We conclude that the techniques chosen for the implementation of a bone bank were effective and feasible (use of a common freezer reaching a temperature below 24C). The viability of the bones was...(AU)

A base científica do transplante ósseo foi estabelecida na metade do século IX quando foram descritas as propriedades osteogênicas do osso e do periósteo, a influência benéfica do frio na preservação das mesmas, e a primeira tentativa convencional para armazenar ossos para uso eletivo. As vantagens do banco de ossos são a disponibilidade imediata do enxerto em quantidade, forma e tamanhos variados, com a manutenção de sua atividade osteoindutora, e redução do tempo cirúrgico, anestésico e perda sanguínea do paciente. Dentre as aplicações clínicas cita-se a correção de fraturas cominutivas, tratamento de não união óssea e reposição de perda óssea devido a infecções ou neoplasias. O sucesso destes procedimentos depende dos parâmetros de conservação e integridade do enxerto. Este estudo teve como objetivo avaliar a viabilidade da manutenção de banco de ossos de cães (Canis familiaris) quantificando a contaminação bacteriológica dos enxertos ósseos, submetidos à técnica criogênica (-24C) e avaliados através de realização mensal de culturas bacteriológicas por um período de seis meses. O método de coleta mostrou-se eficiente e propiciou adequada manutenção de esterilidade durante o período de coleta, diminuindo o risco de contaminação dos ossos. Concluímos que as técnicas escolhidas para implantação do banco de ossos mostraram-se eficientes e factíveis, com freezer comum...(AU)

Mechanical study in vitro of the resistance of axial forces of 3.5 mm cannulated and conventional screws in head and femoral neck fractures / Estudo mecânico in vitro da resistência a forças axiais dos parafusos canulado e convencional de 3, 5 mm de diâmetro em fraturas de cabeça e colo femoral

Background: Proximal femoral fractures account for 25% of all femoral fractures in dogs and are more common in younganimals. Osteosynthesis of femoral head and neck fractures is a complex procedure that can be performed using conventionalscrews or wires. However, proper fracture reduction and fi xation are diffi cult to achieve and, despite many advancements,such fractures remain challenging to solve. Cannulated screws have good compressive capacity and can be employed tosimplify the surgical procedure while optimizing outcomes. This study was designed to compare the resistance of conventional and cannulated screws to axial loading following experimental femoral neck fracture in dogs.Materials, Methods & Results: Fourteen cadaveric canine femurs were used in this study. Femurs were collected from dogsover 20 pounds in body weight with no gross or radiographic signs of orthopedic disease. Cadaveric femurs were submitted to experimental femoral neck fracture using a Gigli saw and allocated to osteosynthesis using either conventional orcannulated screws (seven bones each). All screws were inserted below the greater trochanter of the femur from the lateralaspect of the bone and screw topography confi rmed radiographically. Test specimens were then potted in polymethylmethacrylate, coupled to a hinged device and submitted to axial loading. Data on maximum load, maximum displacement, loadwithin the proportional limit, offset within the proportional limit and load required to produce a 3 mm displacement werecollected. Mean values were calculated and compared using the Students t test (P < 0.05). Mean values varied greatlywithin groups. Maximum load and displacement correspond to the critical point from which biomechanical testing becomesdestructive. Data were missing from one test specimen (conventional screw group) due to abrupt diaphyseal fracture atthe start of the axial loading trial...(AU)

Mechanical study in vitro of the resistance of axial forces of 3.5 mm cannulated and conventional screws in head and femoral neck fractures / Estudo mecânico in vitro da resistência a forças axiais dos parafusos canulado e convencional de 3, 5 mm de diâmetro em fraturas de cabeça e colo femoral

Background: Proximal femoral fractures account for 25% of all femoral fractures in dogs and are more common in younganimals. Osteosynthesis of femoral head and neck fractures is a complex procedure that can be performed using conventionalscrews or wires. However, proper fracture reduction and fi xation are diffi cult to achieve and, despite many advancements,such fractures remain challenging to solve. Cannulated screws have good compressive capacity and can be employed tosimplify the surgical procedure while optimizing outcomes. This study was designed to compare the resistance of conventional and cannulated screws to axial loading following experimental femoral neck fracture in dogs.Materials, Methods & Results: Fourteen cadaveric canine femurs were used in this study. Femurs were collected from dogsover 20 pounds in body weight with no gross or radiographic signs of orthopedic disease. Cadaveric femurs were submitted to experimental femoral neck fracture using a Gigli saw and allocated to osteosynthesis using either conventional orcannulated screws (seven bones each). All screws were inserted below the greater trochanter of the femur from the lateralaspect of the bone and screw topography confi rmed radiographically. Test specimens were then potted in polymethylmethacrylate, coupled to a hinged device and submitted to axial loading. Data on maximum load, maximum displacement, loadwithin the proportional limit, offset within the proportional limit and load required to produce a 3 mm displacement werecollected. Mean values were calculated and compared using the Student’s t test (P < 0.05). Mean values varied greatlywithin groups. Maximum load and displacement correspond to the critical point from which biomechanical testing becomesdestructive. Data were missing from one test specimen (conventional screw group) due to abrupt diaphyseal fracture atthe start of the axial loading trial...

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)