Resumo
A infecção no sítio cirúrgico (ISC) é uma complicação grave que pode acontecer em decorrência das cirurgias ortopédicas que demandam a utilização de implantes nos equinos. Morbidade, tratamentos prolongados e, consequentemente, dispendiosos e até mesmo óbito, são decorrências desta complicação. O presente trabalho analisou de forma retrospectiva os equinos submetidos a osteossíntese ou artrodese, que apresentaram ISC no período pós-cirúrgico atendidos no Hospital Veterinário da FMVZ-USP no período de 2009 a 2021. Sessenta e sete equinos atenderam aos critérios de seleção e, destes, 13 (19,4%) apresentaram ISC no período pós-cirúrgico. Escherichia coli, Streptococcus sp. e Enterobacter cloacae complex foram os agentes mais comumente isolados e a remoção dos implantes foi realizada em 76,9% (10/13) dos pacientes. Aminoglicosídeos associados ou não aos beta-lactâmicos foram as classes de antimicrobianos utilizados na terapia prévia em 84,6% (11/13), houve alteração das drogas utilizadas depois do resultado da cultura e antibiograma em todos os casos, devido à resistência antimicrobiana identificada. A incidência de ISC foi similar ao relatado em outros trabalhos, a retirada dos implantes foi uma estratégia eficiente quando o tratamento clínico não surte melhora. A identificação dos agentes envolvidos e o antibiograma se mostraram decisivos para o manejo dos casos.(AU)
Surgical site infection (SSI) is a serious complication that can occur in orthopedic surgeries that require the use of implants in horses. Morbidity, prolonged and consequently expensive treatments, and even death are consequences of this complication. This paper retrospectively analyzed horses undergoing osteosynthesis or arthrodesis, which presented SSI in the post-surgical period, treated at the Veterinary Teaching Hospital of FMVZ-USP from 2009 to 2021. Sixty-seven horses met the selection criteria and of these, 13 (19.4%) had SSI in the postoperative period. Escherichia coli, Streptococcus sp, and Enterobacter cloacae complex were the most commonly isolated agents and implant removal was performed in 76.9% (10/13) of patients. Aminoglycosides associated or not with beta-lactams were the classes of antimicrobials used in previous therapy in 84.6% (11/13), and in all cases there was a change in the drugs used after the result of the culture and antibiogram, due to antimicrobial resistance identified. The incidence of SSI was similar as reported in other studies, and implant removal was an efficient strategy when clinical treatment fails to improve. The identification of the agents involved and the antibiogram was decisive for cases management.(AU)
Assuntos
Animais , Ortopedia/veterinária , Infecção da Ferida Cirúrgica/cirurgia , Cavalos/cirurgia , Enfermagem em Pós-AnestésicoResumo
Surgical arthrodesis is effective for treating proximal interphalangeal joint (PIJ) injuries in horses. Despite several techniques described so far, the use of a 3-hole, 4.5mm-locking compression plate, associated with two 5.5-mm transarticular cortex screws, is currently considered the "gold standard." This review describes the anatomy of the pastern, as well as causes, indications, and possibilities for arthrodesis in the equine PIJ. A description of the current surgical technique for joint fixation is also presented.(AU)
A artrodese cirúrgica é efetiva para o tratamento de condições da articulação interfalangeana proximal (AIP) em equinos. Diversas técnicas são descritas, e o uso de uma placa de compressão bloqueada de três orifícios e 4,5 mm associada com dois parafusos corticais transarticulares de 5,5 mm é atualmente o padrão ouro. Esta revisão tem por objetivo descrever a anatomia da região da quartela, bem como as causas, indicações e possibilidades para a artrodese da AIP nos equinos. É apresentada também a descrição da técnica cirúrgica atualmente utilizada para realização da fixação da articulação.(AU)
Assuntos
Animais , Osteoartrite/cirurgia , Artrodese/classificação , Artrodese/métodos , Cavalos/anatomia & histologia , Claudicação IntermitenteResumo
Background: Trauma is the main cause of spinal fractures and dislocations in humans and large animals. Clinical signspresent with acute onset and vary according to the location and severity of the spinal cord injury. The treatment of fractures in large animals depends on economic value, cost of procedures, prognosis, location and type of fracture. However,although spinal fractures in large animals are not uncommon, the literature about their clinical aspects and treatment isscanty. Therefore, the purpose of this report is to describe a surgical stabilization of atlantoaxial subluxation, fracture ofthe third cervical vertebra and C2-C3 subluxation.Case: An approximately 2-year-old Île-de-France sheep, weighing 101 kg, with a history of cervical trauma and nonambulatory tetraparesis was treated at the Veterinary Hospital of the Institution (UNIPAMPA). During physical examination, the animal presented good general physical condition and heart rate, respiratory rate and temperature was accordingto physiological parameters for the species. The animal remained in lateral decubitus, with minimal head and limb movements, and exhibited deep pain sensitivity. Clinical treatment with dexamethasone, limb physiotherapy and change inlateral decubitus position were employed, but failed to improve the animals condition. After five days of unresponsive toclinical treatment, the patient was referred to the neurology department, where it underwent neurological examination andradiographic examination of the cervical region was performed under general anesthesia. The radiographic examinationrevealed atlantoaxial subluxation, by displacement of the odontoid process into the vertebral canal, fracture of the thirdcervical vertebra and C2-C3 vertebral subluxation. The surgical planning aimed cervical vertebral instability repair usingatlantoaxial arthrodesis associated the stabilization of C1-C2 and C2-C3 vertebrae with Schanz pins and bone cement...
Assuntos
Feminino , Animais , Fixação de Fratura/veterinária , Luxações Articulares/veterinária , Ovinos/lesões , Traumatismos da Coluna Vertebral/cirurgia , Traumatismos da Coluna Vertebral/veterinária , Paresia/veterinária , Vértebras CervicaisResumo
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 [ ]
Assuntos
Animais , Gatos , Fixadores Externos/veterinária , Fraturas Cominutivas/veterinária , Fraturas do Úmero/cirurgia , Fraturas do Úmero/veterinária , Membro Anterior/cirurgia , Artrodese/veterinária , Fixação Interna de Fraturas/veterináriaResumo
Objetivou-se descrever o caso de um cão com fratura aberta de rádio e ulna esquerda associada a subluxação radiocárpica e grande perda dos tecidos moles adjacentes. A osteossíntese de rádio e ulna, bem como a artrodese, foram realizadas com fixador externo tipo I modificado. A ferida foi tratada diariamente com açúcar cristal e nitrofurazona, visando uma cicatrização por segunda intenção. A epitelização da ferida ocorreu 60 dias após a operação, junto com a consolidação óssea, o que levou à retirada do fixador externo. O paciente retornou sete meses após a cirurgia com boa locomoção e sem indícios clínicos de claudicação. As técnicas utilizadas apresentaram bons resultados, com boa cicatrização da ferida, boa estabilização da fratura e imobilização adequada da articulação radiocárpica.
This paper describes the case of a dog with an open radial and ulnar fracture associated with radiocarpal subluxation and great loss of adjacent tissues. Radial and ulnar osteosynthesis, as well as arthrodesis, were performed with modified type I external fixator. The traumatic wound was treated daily with a mixture of crystal sugar and nitrofurazone, for second intention healing. The wound epithelialization occurred within 60 postoperative days along with fracture healing which led to the removal of the external fixator. The patient returned 7 months after surgery showing good locomotion, with no clinical evidence of lameness. The techniques used in this case presented good results with good healing, good fracture stabilization and adequate immobilization of the radiocarpal joint.
Se describe el caso de un perro con una fractura abierta de radio y cúbito izquierdos, subluxación radiocárpica y gran pérdida de tejidos blandos. La osteosíntesis del radio y de la ulna, así como la artrodesis se realizaron con un fijador externo tipo I modificado. La herida fue tratada como herida abierta con azúcar y nitrofurazona aplicadas diariamente. La epitelización de la herida se completó a los 60 días de la cirugía, junto con la consolidación ósea, momento en que fue retirado el fijador. El paciente volvió a los 7 meses de la cirugía presentando buena locomoción y sin muestras de claudicación. Las técnicas usadas mostraron buenos resultados, con una correcta cicatrización de la herida, buena estabilización de la fractura y una inmovilización adecuada de la articulación radiocárpica.
Assuntos
Animais , Cães , Artrodese/veterinária , Extremidade Superior/cirurgia , Fixadores Externos/veterinária , Fraturas Expostas/cirurgia , Fraturas Expostas/veterinária , Cicatrização , Consolidação da FraturaResumo
Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fixation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fixator on the left pelvic limb of a dog. Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Articular cartilage was removed with a pneumatic burr. Manual reduction was performed. There were placed two rings proximal to the fracture and one distal with Kirschner wires were angled 45° between them through the bone. One of them was a semi-ring in the shape of a horseshoe. The 1,5 mm Kirschner wires were tensioned by a dynamometer loaded at 30 kg. For wound closure a free skin graft from the thorax was used. Articular anchylosis was reached in three months but the implant removal was posterior to that time due to the owner's choice. Discussion: Traumatic injury is the most important cause for fracture and instability of the tarsometatarsal joint and was the cause of injury for this case. Partial arthrodesis is considered the treatment of choice for tarsal instabilities with ligament disruption. Implant problems following union can complicate arthrodeses stabilized with internal fixation, and they may require a second surgery for implant removal. In this case the size of the rings conformed well to the proximal tarsus, and allowed sufficient space for wire placement in the metatarsal bones and did not interfere with ambulation. The dog recovered good limb function soon after the surgery and articular anchylosis was reached within three months as expected. In a study three of ten dogs undergoing tarsometatarsal arthrodesis due to continued lameness after bony union, using a laterally applied plate required a second surgery for implant removal. Implant failure is a common complication of tarsocrural and tarsometatarsal arthrodeses stabilized with bone screws, Steinmann pins or plate fi xation. Tarsometatarsal partial arthrodesis with use of circular skeletal fixator is a proper option for contaminated wounds without enough skin for closure. The limiting factor is the surgeon experience for this choice of fixation, material availability and the owner's commitment with the treatment.
Assuntos
Animais , Masculino , Cães , Artrodese/veterinária , Articulações Tarsianas/cirurgia , Articulações Tarsianas/lesões , Tarso Animal , Fixadores Externos/veterinária , Doenças do Cão/cirurgia , Fraturas Ósseas/veterinária , Fratura-Luxação/diagnóstico por imagem , CãesResumo
Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fi xation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fi xator on the left pelvic limb of a dog.Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Arti
Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fi xation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fi xator on the left pelvic limb of a dog.Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Arti
Resumo
REGALIN, Bruna Ditzel da Costa. Biomateriais ou enxerto de osso esponjoso como substitutos ósseos em artrodeses tarsometatarsais em ovinos. 2017. 90f. Tese (Doutorado em Ciência Animal) Universidade do Estado de Santa Catarina. Programa de Pós-Graduação em Ciência Animal, Lages, 2017. O objetivo do presente estudo foi comparar a capacidade osteorregenerativa induzida por biomateriais à base de fosfatos de cálcio e sílica para a fusão das superfícies ósseas em artrodeses tarsometatarsais induzidas experimentalmente em ovelhas. Foram utilizados 12 ovinos, fêmeas, mestiços texel, com 12 meses de idade, comprovadamente hígidos, alocados em três grupos distintos, de acordo com o material implantado: 80% de hidroxiapatita associada a 20% de tricálcio fosfato (HA/TCP- 80/20) (n=4), hidroxiapatita associada a 5% de sílica (HA/SiO2 5%) (n=4) e grupo controle (n=4), que recebeu autoenxerto de osso esponjoso. A estabilidade articular foi obtida pela colocação de uma placa de compressão dinâmica (PCD) com 10 furos, fixada com oito parafusos corticais de 3,5mm na posição lateral. Os animais foram avaliados radiograficamente no pós-operatório imediato e aos 30, 60 e 90 dias após o procedimento cirúrgico. Foi realizada a eutanásia de dois animais de cada grupo aos 60 e aos 90 dias de pós-operatório, momento em que se coletou a articulação para subsequente encaminhamento à análise histológica e à microscopia eletrônica de varredura (MEV). A avaliação macroscópica indicou fusão das superfícies ósseas em todos os animais e extensa cobertura de tecido fibroso sobre a placa e parafusos, indicando a efetividade desta técnica para artrodese tarsometatarsal em ovinos. A análise histológica e por MEV demonstrou, nos três grupos estudados, boa neoformação óssea, com presença de células de linhagem osteogênica (osteoblastos, osteócitos e osteoclastos) e tecido ósseo primário (jovem) e secundário (maduro), além de reabsorção gradativa do enxerto (biomaterial ou osso esponjoso). A presença de material remanescente foi observada nos três grupos, de maneira mais acentuada aos 60 dias, mas ainda presente aos 90 dias de pós-operatório; o grupo HA/TCP- 80/20 apresentou a maior taxa de biomaterial remanescente do estudo. No grupo controle, um animal (25%) apresentou reação periosteal exuberante na área doadora do enxerto, demonstrando a necessidade de se encontrar materiais capazes de substituir o autoenxerto e reduzir a morbidade associada à coleta de osso esponjoso. Com base nos achados deste estudo, os compostos HA/TCP- 80/20 e HA/SiO2 5% constituem uma boa alternativa ao uso do autoenxerto de osso esponjoso, uma vez que ambos os biomateriais pesquisados promoveram osteoindução e adequada neoformação de tecido ósseo.
REGALIN, Bruna Ditzel da Costa. Biomaterials or cancellous bone graft as bone substitutes in tarsometatarsals arthrodesis in sheeps. 2017. 90f. Tese (Doutorado em Ciência Animal) Universidade do Estado de Santa Catarina. Programa de Pós-Graduação em Ciência Animal, Lages, 2017. The aim of this study was to compare the osteoregenerative capacity induced by biomaterials calcium phosphate based and silica for fusion of the bone surfaces in tarsometatarsals arthrodesis experimentally induced in sheep. Twelve texel crossbred, 12 months old, healthy, female sheeps, were alocated into three distinct groups, according to the implanted material: HA/TCP- 80/20 (n = 4), HA/SiO2 5% (n = 4) and control group (n = 4), that received autograft cancellous bone. The joint stability was achieved by placing a ten holes dynamic compression plate (DCP) and eight 3.5 mm cortical screws in the lateral position. Animals were evaluated radiographically in the immediate postoperative period and at 30, 60 and 90 days after surgery. Euthanasia of two animals from each group were performed at 60 and 90 days after surgery, at which time the joint was collected for subsequent histological and scanning electron microscopy (SEM) analysis. The macroscopic evaluation showed bone surfaces fusion in all animals of the study and large coverage of fibrous tissue on the plate and screws. The histological and SEM analysis demonstrate, in the three groups studied, good bone formation with osteogenic lineage cells (osteoblast, osteocyte and osteoclast) and primary bone tissue (new formed bone) and secondary bone tissue (mature), in addition to gradual resorption of the graft (biomaterial or spongy bone). The presence of remaining material was observed in all three groups, most markedly at 60 days, but still present at 90 postoperative days; the HA/TCP- 80/20 group had the highest biomaterial rate remaining in the study. In the control group, one animal (25%) had an exuberant periosteal reaction in the graft donor area, demonstrating the need to find materials capable of replacing the autograft and reducing the morbidity associated with the harvest of spongy bone. Based on the findings of this study, compounds HA/TCP- 80/20 and HA/SiO2 5% are a good alternative to the use of sponge bone autograft, since both biomaterials researched promoted osteoinduction and adequate neoformation of bone tissue.
Resumo
The aim of this research was to present a variation of the ventral technique access to the atlantoaxial joint, for treatment of atlantoaxial instability with no section of sternothyreoid muscle. Fifteen dogs, with weight between 8 and 12kg, were randomly distributed in three groups denominated one (30 days), two (60 days) and three (90 days) for daily clinical evaluations. The atlantoaxial joint was submitted to the arthrodesis through the ventral access using pins of Steinmann associated to acrylic resin. The access and exhibition of the atlantoaxial joint with no section of the sternothyreoid muscle was obtained without complications or additional limitations. No dog of this research presented coughing, dyspnea, regurgitation, laryngeal paralysis or Horner's syndrome. It can be concluded that the section of sternothyreoid muscle is an unnecessary procedure and that there is is no interference in the exhibition of atlantoaxial joint and arthrodesis approach of dogs through ventral access.
O objetivo deste trabalho foi apresentar uma variação na técnica de acesso ventral à articulação atlantoaxial para tratamento da instabilidade atlantoaxial sem a secção do músculo esternotireóideo. Foram utilizados 15 cães, pesando entre oito e 12kg, sem raça definida, independente do sexo, distribuídos aleatoriamente em três grupos iguais de acordo com o período pós-operatório (PO) denominados de I (30dias), II (60 dias) e III (90 dias) para avaliações clínicas diárias. A articulação atlantoaxial foi submetida à artrodese por meio do acesso ventral utilizando pinos de Steinmann associados à resina acrílica autopolimerizável. O acesso e a exposição da articulação atlantoaxial sem a secção do músculo esternotireóideo foram realizados sem complicações ou limitações adicionais. Nenhum cão desta pesquisa apresentou tosse, dispnéia, regurgitação, paralisia laríngea ou Síndrome de Horner. Pode-se concluir que a secção do músculo esternotireóideo é um procedimento desnecessário e que não interfere na exposição da articulação atlantoaxial e na realização da artrodese em cães por meio do acesso ventral.
Resumo
A artrodese rádio-cárpica é procedimento radical usado no tratamento de fraturas e luxações do carpo, com danos à fibrocartilagem palmar e às estruturas ligamentares de sustentação, decorrentes de hiperextensão. Para este estudo foram selecionados 15 cães, submetidos à artrodese rádio-cárpica, entre abril/02 e julho/04. Foram estudados os casos quanto à formação de calo ósseo e às complicações pós-cirúrgicas. A técnica consistiu na ostectomia da superfície articular do rádio, expondo-a e retificando-a. Os subprodutos desta fresagem foram reintroduzidos como enxerto após sua redução em tamanho com rugina. Para a estabilização articular, em todos os casos, foram usadas placas compressivas. Foram realizados exames radiográficos imediatamente à intervenção cirúrgica e em intervalos de 30 dias, até a total fusão articular. Os resultados obtidos neste estudo, com fusão da articulação em até 300 dias de pós-cirúrgico em 80 por cento dos casos estudados, foram semelhantes aos dispostos para as técnicas que utilizam enxertos autólogos esponjosos, sendo que, em 68 por cento dos pacientes, a recuperação se deu sem qualquer complicação significativa. Pequenas complicações, como o aumento de volume, foram observadas em 22 por cento dos casos, não determinando qualquer alteração no resultado final. Tais resultados viabilizam a técnica descrita, demonstrando a exeqüibilidade da utilização dos subprodutos da fresagem do osso subcondral como enxerto em artrodeses de carpo em cães.
Pancarpal arthrodesis is an extreme procedure, used in the treatment of fractures and carpal luxations, with damage to the palmar fibro cartilage and structural ligaments, after hyperextension. For this study 15 dogs were selected, which underwent pancarpal artrodesis, betwen April/ 2002 and July/ 2004. The cases were studied in regard to bone formation and post-surgical complications. The technique consisted in the ostectomy of the articular surface of the radius, exposing and rectifying it. The byproducts of this reaming were introduced as a graft after their size reduction, with a grinder. In all cases, compressive plates were used for the articular stabilization. Immediately after surgery, radiographic exams were made and in 30 days intervals, until complete articular fusion. The results from this study, with articular fusion before 300 days after surgery in 80 percent of the cases, were extremely similar to the ones observed with techniques that use autologous cancellous bone grafts, and 68 percent of the patients recovered without significant complications. Small complications like slight swelling were observed in 22 percent of the cases, not determining any alterations in the final result. These results show that the technique is viable, demonstrating the possibility of use of the byproducts of subchondral bone reaming as a graft in the arthrodesis of dogs.
Assuntos
Animais , Cães , Artrodese/veterinária , Carpo Animal , Transplante Ósseo/veterináriaResumo
Arthrodesis of the stifle joint was performed on seven healthy dogs. The fusion of right or left femorotibial joint was made using external skeletal fixation by placing a transfixation of Steinmann pins that were connected with autopolimerized acrylic bars. Intra-articular structures were removed and ostectomy of articular sur faces of distal fémur and proximal tíbia were made. After autogenous cancellous bone graft was inserted, immobilization was placed to maintain the selected joint angle measured in the preoperative period. The functional performance was observed and radiographic evaluation was done immediately after surgery, and at 30, 60 and 90 postoperative days. Fusion of the joint was judged by microscopic and macroscopic observations. The external skeletal fixation provided early return to weight-bearing function with satisfactory functional degree. Results of this study indicated that this type of immobilization is entirely satisfactory to produce arthrodesis of the stifle joint.
Sete cães clinicamente sadios sofreram artrodese do joelho direito ou esquerdo. A imobilização foi realizada por meio de fixador externo com pinos de Steinmann e barras de acrílico autopolimerizável. Foram removidas todas as estruturas intra-articulares e seccionadas as superfícies articulares do fémur e da tíbia. Foi realizada enxertia com osso esponjoso autógeno entre os ossos e aplicada a imobilização mantendo o ângulo articular estabelecido no pré-operatório. Foi observado o retorno ao uso funcional do membro e foram feitos controles radiográficos no pós-operatório imediato, 30, 60 e 90 dias de evolução. Os aspectos da fusão articular foram avaliados macro e microscopicamente. Constatou-se que esse tipo de fixação promove retorno precoce ao uso do membro com desempenho funcional satisfatório, sendo eficiente para promover a artrodese da soldra.
Resumo
Severe disorders of the carpus in two cats were treated with arthrodesis. Hydroxyapatite was usage in filling up of the joint space in the carpus. Both cats were sent to the Orthopedic Service of the Veterinary Hospital, UNESP, Jaboticabal, São Paulo - Brazil. The first cat, a Siamese, 10 years old, showed hyperextension movements and luxation of the carpus joint and pain with inadequate support of the left thoracic limb. It was also observed joint degeneration and osteoarthritis. The second animal, a domestic shorthair, 8 months of age, showed inadequate support of the right thoracic limb with hyperflexion of the carpus joint and contractures of the carpus flexor tendons. A modified trans-articular external skeletal fixator (tipe IIb) with methylmethacrylate bars was utilized in these cases. The clinical and radiographic evaluations of the joints after the surgical procedure proved that the hydroxyapatite can be used as an promising alternative to cancellous bone grafts.
Realizaram-se artrodeses carpais em dois gatos como forma de tratamento para alterações severas na articulação carpiana. A hidroxiapatita foi empregada para preenchimento do espaço articular do carpo. Os animais foram encaminhados ao Serviço de Ortopedia do Hospital Veterinário, UNESP, Campus de Jaboticabal, São Paulo - Brasil. O animal 1, Siamês, 10 anos de idade, apresentava apoio inadequado do membro torácico esquerdo, dor, hiperextensão, instabilidade, luxação, degeneração articular e osteartrite da articulação radiocárpica. O animal 2, sem raça definida, 8 meses de idade, apresentava apoio inadequado do membro torácico direito, hiperflexão da articulação cárpica, contração dos tendões da região carpiana, rotação externa do olécrano e o membro voltado para dentro. Foram aplicados fixadores esqueléticos externos (tipo IIb) com barras de polimetilmetacrilato, em ambos os casos. As avaliações clínicas e radiográficas após os procedimentos, demonstraram que a hidroxiapatita é uma alternativa promissora como substituto para os enxertos ósseos.