Treatment of fractures and other orthopedic problems in cats and dogs using versatile external fixator / Tratamento de fraturas de extremidades de cães e gatos usando fixador externo versátil

Many complicated bone fractures can be healed by different techniques including linear external fixation. New generation linear external fixators enhanced the scope of application for bone fractures by mechanical progress. Difficulties include implementing enough pins through fixation clamps to the comminuted fragments or clamp addition and fixing it properly to the rod with the correct pin insertion angle. Effective configurations may not always result. This study sought to reveal the clinical efficiency of modified clamps of a versatile external fixator (VEF) to fix different types of fractures and orthopedic problems according to the radiographic and clinical results. We used this fixator on 17 cats and 17 dogs of different ages and sizes, having different types of antebrachium, humerus, tibia, ulna fractures, and bone-muscle deformities. Clamps had different features to connect fixator pins. Many fixator configurations were created according to the fracture type and body weight of the animals. The most used ones were unilateral and bilateral configurations. The callus formation and visual gait analysis were observed after the operations, until the removal of the fixator. After fixator removal, the visual gait status of the limbs was excellent in 67% of the cases, good in 15%, fair in 12%, and poor in 6%. We found that rods and fixator pins were connected easily by semi-locked clamps. Also, the double pin holding clamps saved space on the fixation rod by the application of two pins through one clamp. We think that clamps of versatile external fixators can easily be constructed to limb fractures and save time during surgery.(AU)

Diversas fraturas ósseas complicadas podem ser tratadas por diferentes técnicas, incluindo fixadores externos lineares. Os fixadores externos lineares de nova geração aumentaram o escopo de aplicação para fraturas ósseas devido ao progresso mecânico. A dificuldade é implementar um número suficiente de pinos através de clamps de fixação aos fragmentos osseos ou adição de clamps com fixação adequadamente à haste com o ângulo correto de inserção do pino. As configurações eficazes nem sempre podem ser realizadas. Este estudo pretendia revelar a eficácia clínica das clamps modificadas de um fixador externo versátil para corrigir diferentes tipos de fraturas e problemas ortopédicos de acordo com os resultados radiográficos e clínicos. O fixador foi utilizado em 17 gatos e 17 cães de diferentes idades e tamanhos, com diferentes tipos de antebraço, úmero, tíbia, fratura de ulna e deformidades ósseo-musculares. Os clamps tinham recursos diferentes para conectar os pinos do fixador. Muitas configurações de fixadores foram criadas de acordo com o tipo de fratura e peso corporal dos animais. As mais utilizadas foram as configurações unilateral e bilateral. A formação do calo e a análise visual da marcha foram observadas após as cirurgias, até a retirada do fixador. Após a retirada do fixador, a utilização dos membros foi excelente em 67% dos casos, bom em 15% dos casos, regular em 12% dos casos, ruim em 6% dos casos. Concluímos que as hastes e os pinos do fixador foram facilmente conectados por clamps semi-travados. Além disso, os clamps de fixação de pino duplo economizaram espaço na haste de fixação com a aplicação de dois pinos em clamp. Acreditamos que os clamps de fixadores externos versáteis podem ser facilmente construídas para fraturas de membros, economizando tempo na cirurgia.(AU)

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

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

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

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

Tratamento de fratura exposta tipo Salter Harris I em felino através de artrodese temporária utilizando fixação externa / Treatment of exposed Salter Harris I fracture in feline by temporary arthrodesis using external fixation

A feline with a history of trauma for three days was diagnosed with Salter Harris I. The animal was then submitted to a surgical procedure where temporary joint arthrodesis was performed using pins and polymethylmethacrylate. The animal was followed by clinical orthopedic exams and radiographic evaluations.

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

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

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

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

Tratamento de fratura exposta tipo Salter Harris I em felino através de artrodese temporária utilizando fixação externa / Treatment of exposed Salter Harris I fracture in feline by temporary arthrodesis using external fixation

A feline with a history of trauma for three days was diagnosed with Salter Harris I. The animal was then submitted to a surgical procedure where temporary joint arthrodesis was performed using pins and polymethylmethacrylate. The animal was followed by clinical orthopedic exams and radiographic evaluations.(AU)

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

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

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

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

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

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

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

Uso de fixador externo e tratamento de ferida por segunda intenção em fratura aberta com extensa perda de tecido cutâneo e muscular em membro torácico de um cão: relato de caso / External fixator and second intention wound treatment in open fracture with extensive loss of cutaneous and muscular tissue in a dog's thoracic limb: case report / Uso de fijador externo y tratamiento de herida por segunda intención en fractura abierta con pérdida extensa de piel y tejido muscular en miembro anterior de un perro: relato de caso

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.

Uso de fixador externo e tratamento de ferida por segunda intenção em fratura aberta com extensa perda de tecido cutâneo e muscular em membro torácico de um cão: relato de caso / External fixator and second intention wound treatment in open fracture with extensive loss of cutaneous and muscular tissue in a dog's thoracic limb: case report / Uso de fijador externo y tratamiento de herida por segunda intención en fractura abierta con pérdida extensa de piel y tejido muscular en miembro anterior de un perro: relato de caso

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.(AU)

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.(AU)

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.(AU)

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

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

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

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

Afundamento costal estabilizado com suporte externo de metilmetacrilato em um felino / Ditching costal stabilized with external support of methylmethacrylate in a feline

O tórax instável ou afundamento costal acontece quando há fraturas múltiplas de pelo menos duas costelas consecutivas (CROWE et al., 2005). Nesse caso, durante a inspiração, o segmento fraturado, ao invés de expandir com o restante da caixa torácica, tende a penetrar no tórax. Subsequentemente, no momento da expiração, o conjunto instável tende a expansão (CROWE et al., 2005, FOSSUM, 2008). O tratamento inicial consiste em tornar o tórax estável, com uma pinça backhaus (AGUIAR, 2011). Posteriormente faz-se necessária a imobilização externa, que permitirá a adequada expansão torácica, sendo mantida por alguns dias até a estabilização do paciente. Para o tratamento cirúrgico recomenda-se a reconstrução anatômica das costelas fraturadas (CUNHA et al., 2009). O objetivo desse trabalho é demonstrar o tratamento da instabilidade costal com metilmetacrilato em felino, descrita por Coutinho et al. (2012).

Afundamento costal estabilizado com suporte externo de metilmetacrilato em um felino / Ditching costal stabilized with external support of methylmethacrylate in a feline

O tórax instável ou afundamento costal acontece quando há fraturas múltiplas de pelo menos duas costelas consecutivas (CROWE et al., 2005). Nesse caso, durante a inspiração, o segmento fraturado, ao invés de expandir com o restante da caixa torácica, tende a penetrar no tórax. Subsequentemente, no momento da expiração, o conjunto instável tende a expansão (CROWE et al., 2005, FOSSUM, 2008). O tratamento inicial consiste em tornar o tórax estável, com uma pinça backhaus (AGUIAR, 2011). Posteriormente faz-se necessária a imobilização externa, que permitirá a adequada expansão torácica, sendo mantida por alguns dias até a estabilização do paciente. Para o tratamento cirúrgico recomenda-se a reconstrução anatômica das costelas fraturadas (CUNHA et al., 2009). O objetivo desse trabalho é demonstrar o tratamento da instabilidade costal com metilmetacrilato em felino, descrita por Coutinho et al. (2012).(AU)

Artrodese parcial tarsometatársica com uso de fixador esquéletico externo circular em cão / Tarsometatarsal Partial Arthrodesis with Use of Circular Skeletal Fixator on a Dog

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.

Utilização de fixação externa em fratura de úmero em caprino / Utilization of external fixation in humerus fracture in a goat

A six-month-old, 14.8kg male Saanen goat was referred to a veterinary hospital presenting functional impotence of its right thoracic member. By radiographic and physical examination it was found out a complete fracture of the humerus. The treatment was based on successful external fixation.(AU)