Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening.

OBJECTIVE: To describe the short-term outcome of acute arthroscopically assisted ulnar shortening (AUS), to treat short radius syndrome in dogs. STUDY DESIGN: Case series. ANIMALS: Eleven client owned dogs. METHODS: Records of dogs that had undergone AUS for treatment of short radius syndrome were reviewed for inclusion. Reporting data included among others pre- and postoperative radioulnar, humeroradial and humeroulnar distances, lameness scores, surgical times, complications and clinical outcome. RESULTS: Following AUS, radiohumeral articulation was improved in all dogs. Median presurgery radioulnar, humeroradial and humeroulnar values were 4.5, 3.2, and 2.2 mm and were improved with surgery by a median of 3.2, 1.8, and 1.2 mm, respectively. Median surgery time was 140 min. Median time to bone healing was 8 weeks (range: 4-14). Median time to last follow-up was 9 weeks (4-468). Median lameness score (scale 0-4) improved from 2 to 1. No major complications were reported. Short-term clinical outcome was graded by the surgeons as full function in four cases and acceptable function in seven. CONCLUSION AND CLINICAL RELEVANCE: Radiographic and arthroscopic radiohumeral articulation were improved and short-term clinical improvement was documented following AUS in all 11 dogs.

Delayed union, non-union and mal-union in 442 dogs.

OBJECTIVES: (1) To estimate the prevalence of delayed union, non-union and mal-union in canine fractures; (2) to describe fracture, demographic, and treatment characteristics for these outcomes; (3) to identify risk factors for delayed or non-union. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Four hundred and forty two dogs (461 fractures). METHODS: A review was conducted of clinical records and radiographs from 2 teaching hospitals. "Union," "delayed union," "non-union" and "mal-union" were defined, and fracture, demographic, treatment, and outcome variables described. Differences in proportions or medians between "union," "delayed union" and "non-union" were tested using χ2 and Mann-Whitney U-tests for categorical and continuous variables respectively. Potential explanatory variables for "delayed or non-union" were tested using logistic regression to identify risk factors. RESULTS: Median radiographic follow up was 53 days (14-282). Delayed union occurred in 13.9% of fractures (64/461), non-union in 4.6% (21/461), and mal-union in 0.7% (3/461). Risk factors for delayed or non-union were age (OR 1.21, 95% CI 1.12-1.31); comminuted fracture (OR 4.24, 95% CI 2.4-7.5); treatment with bone graft (all types) (OR 3.32, 95% CI 1.3-8.5); surgical site infection (OR 3.24, 95% CI 1.17-8.97), and major implant failure (OR 12.94, 95% CI 5.06-33.1). CONCLUSION: Older dogs, dogs with comminuted fractures, surgical site infection, or major implant failure were at increased odds of delayed or non-union. Radius and ulna fractures in toy breed dogs were not at increased odds of delayed or non-union. CLINICAL SIGNIFICANCE: The identified risk factors should inform fracture planning and prognosticating. The prognosis for radial fractures in toy breeds appears better than historically believed.

Use of coccygeal vertebra autograft and platelet-rich plasma for treating a distal radial nonunion fracture in a small-breed dog.

A 4.3-kg, 11-month-old, spayed female poodle was presented for treatment of a right radio-ulnar nonunion fracture. Clinical history included failed surgical correction of a radius fracture with internal fixation 1 mo before presentation. Radiographic examination revealed a 1.5-cm lytic lesion on the right distal radius. Surgery was planned with a coccyx autograft and platelet-rich plasma. A 2.8-cm-long bone defect was created, and the lytic lesion was removed. Caudectomy was performed; the 6th and 7th coccygeal bones were harvested, placed into the defect, and fixed to the radius with a locking plate. Remnants of coccygeal bone were ground, mixed with platelet-rich plasma, and used to fill the bone defects. There was no evidence of nonunion or delayed union at the 18-month follow-up examination. Key clinical message: Based on the study findings, we inferred that a coccyx autograft and platelet-rich plasma can be used for successful reconstruction of a distal radial defect.

Utilisation d'une autogreffe de vertèbre coccygienne et de plasma riche en plaquettes pour le traitement d'une fracture radiale distale avec non-union chez un chien de petite race. Une femelle caniche stérilisée de 4,3 kg, âgée de 11 mois, a été présentée pour le traitement d'une fracture radio-ulnaire droite avec non-union. Les antécédents cliniques comprenaient l'échec de la correction chirurgicale d'une fracture du radius avec fixation interne 1 mois avant la présentation. L'examen radiographique a révélé une lésion lytique de 1,5 cm sur le radius distal droit. La chirurgie était prévue avec une autogreffe de coccyx et du plasma riche en plaquettes. Un défaut osseux de 2,8 cm de long a été créé et la lésion lytique a été retirée. Une caudectomie a été réalisée; les 6e et 7e os coccygiens ont été prélevés, placés dans le défaut et fixés au radius avec une plaque de verrouillage. Les restes d'os coccygien ont été broyés, mélangés avec du plasma riche en plaquettes et utilisés pour combler les défauts osseux. Il n'y avait aucune évidence de non-union ou de retard de consolidation lors de l'examen de suivi à 18 mois.Message clinique clé :Sur la base des résultats de l'étude, nous avons déduit qu'une autogreffe de coccyx et du plasma riche en plaquettes peuvent être utilisés pour une reconstruction réussie d'un défaut radial distal.(Traduit par Dr Serge Messier).

Use of three-dimensionally printed ß-tricalcium phosphate synthetic bone graft combined with recombinant human bone morphogenic protein-2 to treat a severe radial atrophic nonunion in a Yorkshire terrier.

OBJECTIVE: To describe a novel surgical approach to treat a critical-sized bone defect due to severe, radial atrophic nonunion in a miniature dog. STUDY DESIGN: Case report ANIMAL: A 1-year-old Yorkshire terrier with a critical-sized left radial defect after failed internal fixation of a transverse radial fracture. METHODS: Computed tomographic (CT) images of the radius were imported for three-dimensional (3D) printing of a custom-designed synthetic 3D-printed ß-tricalcium phosphate (ß-TCP) scaffold. The radius was exposed, and the ß-TCP scaffold was press-fitted in the bone gap underneath the plate. Recombinant human bone morphogenic protein-2 (RhBMP-2) collagen sponges were squeezed to soak the scaffold with growth factor and then placed on both sides of the synthetic graft. Two additional cortical screws were also placed prior to routine closure of the surgical site. RESULTS: Radiographic examination was consistent with complete healing of the radius defect 4 months after surgery. The bone plate was removed 10 months after surgery. According to CT examination 18 months after surgery, there was no evidence of the synthetic graft; instead, complete corticalization of the affected area was noted. Complete functional recovery was observed until the last clinical follow-up 36 months postoperatively. CONCLUSION: Screw fixation and use of a 3D-printed ceramic scaffold augmented with rhBMP-2 resulted in excellent bone regeneration of the nonunion and full recovery of a miniature breed dog. CLINICAL SIGNIFICANCE: The therapeutic approach used in this dog could be considered as an option for treatment of large-bone defects in veterinary orthopedics, especially for defects affecting the distal radius of miniature dogs.

Human placenta-derived matrix with cancellous autograft and demineralized bone matrix for large segmental long-bone defects in two dogs with septic nonunion.

OBJECTIVE: To report the successful treatment of septic nonunion in two dogs with large segmental defects secondary to long-bone fractures by using a novel human placenta-derived matrix (hPM) as adjunct to fixation. ANIMALS: One 3-kg 9-year-old neutered male Yorkshire terrier with a distal antebrachial fracture and one 6-kg 4-year-old spayed female miniature pinscher with a distal humeral fracture. STUDY DESIGN: Short case series. METHODS: Both dogs presented for septic nonunion after internal fixation of Gustilo type II open diaphyseal fractures from dog bite injuries. During revision, debridement of nonviable bone resulted in segmental defects of 32% and 20% of the bone length for the antebrachial and humeral fractures, respectively. The antebrachial fracture was stabilized with a circular external fixator, and the humeral fracture was stabilized with biaxial bone plating. The fracture sites were not collapsed, and full length was maintained with the fixation. Autogenous cancellous bone graft and canine demineralized bone allograft were packed into the defects, and hPM was injected into the graft sites after closure. RESULTS: Radiographic union was documented at 8 weeks and 6 weeks for the antebrachial and humeral fractures, respectively. Both dogs became fully weight bearing on the affected limbs and returned to full activity. CONCLUSION: Augmenting fixation with grafts and hPM led to a relatively rapid union in both dogs reported here.

SUCCESSFUL REPAIR OF ANTEBRACHIAL FRACTURES WITH EXTERNAL SKELETAL FIXATION IN THREE MACROPODS.

Three captive macropods comprising three different species sustained unilateral antebrachial fractures. All fractures were assumed to be trauma related, although the specific circumstances surrounding each case was unknown. Each fracture was surgically repaired with type Ia (unilateral, monoplanar) external skeletal fixators, which were all removed approximately 3 mo postoperatively. Although each animal experienced at least one complication, all animals showed adequate bridging and remodeling at the fracture sites and had good-to-excellent return to normal function after fixator removal. This case series is the first to describe the successful repair of antebrachial fractures using external skeletal fixation in captive macropods and details some of the complications that can occur with postoperative management of captive animals.

Clinical outcomes of 119 miniature- and toy-breed dogs with 140 distal radial and ulnar fractures repaired with free-form multiplanar type II external skeletal fixation.

OBJECTIVE: To report the clinical outcomes of miniature- and toy-breed dogs with primary and previously treated distal radial and ulnar fractures (RUF) treated with a free-form multiplanar type II external skeletal fixation (ESF). STUDY DESIGN: Retrospective study. ANIMALS: One hundred nineteen dogs with 140 distal RUF. METHODS: Medical records (2003-2017) were reviewed for dogs weighing up to 7 kg that had been treated for distal RUF with a free-form multiplanar type II ESF. Data collected included signalment, fracture location and configuration, fracture reduction, intraoperative realignment, time to bone union and implant removal, duration of destabilization and postoperative splint, complications, and outcomes. Follow-up consisted of clinical and radiographic evaluation or telephone interview. RESULTS: All fractures healed, with a median time of 60 days, and entire ESF was removed, with a median time of 89 days. Major complications occurred in four fractures: premature pin loosening, elbow subluxation, osteomyelitis, and delayed union. Minor complications occurred in 52 fractures (61 events). All dogs had a successful return to normal limb function at final follow-up (median, seven months; range, 2-97). CONCLUSION: All primary and previously treated distal RUF in miniature- and toy-breed dogs healed and allowed return to normal function after fixation with a free-form multiplanar type II ESF. CLINICAL SIGNIFICANCE: The free-form multiplanar type II ESF provides an alternative for minimally invasive fixation of distal RUF in miniature- and toy-breed dogs that facilitates fracture reduction, intraoperative realignment, adequate initial fixation stability, destabilization, and implant removal.

Release Rates and Complications for Birds of Prey With Antebrachial Fractures at a Veterinary Teaching Hospital.

A retrospective case series that included 253 free-ranging birds of prey admitted to a rehabilitation center was conducted to describe the treatment and outcome of antebrachial fractures. Medical records from birds of prey belonging to 21 species admitted with antebrachial fracture between 1989 and 2015 at the University of California, Davis, were reviewed. Species distribution on admission, treatment, outcome, and complications were described by fracture category and species. Among 134 birds treated after initial triage on the day of admission, 4 bone/ wing categories were identified: 83 birds had an ulnar fracture only; 18 birds had a radial fracture only; 28 birds had a concomitant fracture of the radius and ulna on the same wing; and 5 birds had bilateral antebrachial fractures. Logistic regressions were performed to determine which factors were associated with a positive outcome within each of these 4 categories. Among birds having only an ulnar fracture, those with a closed fracture were significantly more likely to be released than birds with open fractures (P = .03; odds ratio = 5.43, 95% confidence interval: 1.29-28.12). In addition, birds with a fracture of the middle third of the ulna were significantly more likely to be released than birds diagnosed with a single fracture of the proximal third of the ulna (P = .02; odds ratio = 4.54, 95% confidence interval: 1.35-16.64). No significant prognostic factor was detected in other fracture categories.

Randomized, controlled, prospective clinical trial of autologous greater omentum free graft versus autogenous cancellous bone graft in radial and ulnar fractures in miniature breed dogs.

OBJECTIVE: To determine the rate of radiographic healing, complications, vascularization, and bone density after repair of radial and ulnar fractures in dogs <6 kg that were treated with an autogenous cancellous bone graft (BG) or free autologous omentum graft (OG). STUDY DESIGN: Prospective, randomized, controlled clinical trial with owners/radiologists blinded to treatment. ANIMALS: 25 dogs with naturally occurring traumatic radial/ulnar fractures. METHODS: Fractures underwent plate fixation with OG or BG. Power Doppler ultrasonographic, computed tomographic (CT), and radiographic examinations of the affected antebrachium were performed preoperatively and every 3 weeks postoperatively until healed. Pressure-sensitive walkway gait analysis and owner and veterinarian assessments were obtained preoperatively (0 weeks) and 3, 6, 9, 12, and 24 weeks postoperatively. RESULTS: Owner/veterinarian assessments improved postoperatively but did not differ significantly between groups. The improvement in peak vertical force/vertical impulse was greater in dogs with OG than in those with BG, beginning 3 weeks postoperatively. Radiographic healing occurred earlier in bones treated with OG (median, 9 weeks) than in those treated with BG (12 weeks). Cortical bone density derived from CT of the distal ulna was higher in bones with BG compared with bones with OG. Signal intensity and the number of vessels in the fracture callus declined over time in both groups, according to results of ultrasonography. However, bones retained more vessels and greater signal intensity when treated with OG compared with treatment with BG, according to multiple views at 6 and 9 weeks postoperatively. CONCLUSION: Omental grafting was not associated with major complications, and it accelerated bone healing and return to weight bearing in dogs. CLINICAL SIGNIFICANCE: Omental grafting should be considered as an adjunct to stabilization of antebrachial fractures in toy and small breed dogs.

Radius and ulna fracture repair with the IMEX miniature circular external skeletal fixation system in 37 small and toy breed dogs: A retrospective study.

OBJECTIVE: To determine outcome and prognostic factors after radius and ulna fracture repair with a modified IMEX miniature circular external skeletal fixation (MCESF) in small and toy breed dogs. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Thirty-seven young small and toy breed dogs with 41 radial and ulnar fractures. METHODS: Records of radial and ulnar fractures repaired with a modified IMEX MCESF were reviewed. Constructs included 3-4 complete rings, 2 threaded rods, 4 mm-diameter nuts and 6-8 transfixation wires. MCESF configuration, type of fracture reduction, dynamization of the apparatus, inclusion of a dowel pin, and implantation of allograft were recorded. Outcome measures included complications, limb alignment, time to clinical union, and functional outcomes, scored as excellent, good, fair, or poor. RESULTS: Radiographic union was achieved in 40/41 fractures. Fractures reached bony union within 33-84 days after repair. Time to union was not influenced by the type of fracture reduction (P = .11), use of a dowel pin (P = .099), or implantation of an allograft (P = .45). Fracture dynamization delayed radiographic union (P = .0005). At implant removal, mean frontal (FPA) and mean sagittal plane alignments (SPA) were 7.9° ± 6.5° and 7.5° ± 5.8°, respectively. Limb alignment did not differ between radiographs obtained immediately after surgery and those obtained at time of radiographic union in the frontal (P = .062) or sagittal (P = .14) planes. Ninety-five percent of cases had good-to-excellent outcomes, based on return to function at final re-evaluations. CONCLUSION: This modified IMEX MCESF construct provided an effective alternative to treat young small and toy breed dogs with radius and ulna fractures.

Cuttable plate fixation for small breed dogs with radius and ulna fractures: Retrospective study of 31 dogs.

This retrospective study evaluated complication rates for radius and ulna fractures in small breed dogs in which 1.5 mm to 2.7 mm cuttable bone plates were used for internal fixation. The medical records of all cases from 2004 to 2011 that were presented to our clinic were reviewed. Inclusion criteria were: dogs with body weight < 9 kg, fracture of the radius and ulna with open reduction, and internal fixation utilizing a cuttable bone plate. Thirty-four fractures in 31 dogs met the inclusion criteria. Of 25 dogs that were available for follow-up, all achieved union, minor complications occurred in 9, and major complications occurred in 8. External coaptation was responsible for complications in 8 cases and the need for coaptation needs to be investigated. Excluding minor complications, 32% of patients required at least 1 additional surgery or additional hospitalization. All but 2 of the dogs returned to full function. The 1.5 mm straight plate was successfully used in all dogs with a body weight of 0.9 to 2.6 kg.

Fixation à l'aide d'une plaque taillable chez les chiens de petites races pour les fractures de radius et de cubitus : étude rétrospective de 31 chiens. Cette étude rétrospective a évalué les taux de complication pour les fractures de radius et de cubitus chez les chiens de petites races pour lesquels des plaques vissées taillables de 1,5 mm à 2,7 mm ont été utilisées pour la fixation interne. Les dossiers médicaux de tous les cas de 2004 à 2011 présentés à notre clinique ont été examinés. Les critères d'inclusion étaient les suivants : chiens avec un poids corporel de < 9 kg, la fracture de radius et de cubitus avec une réduction ouverte et une fixation interne utilisant une plaque vissée taillable. Trente-quatre fractures de 31 chiens ont satisfait aux critères d'inclusion. Parmi les 25 chiens qui étaient disponibles pour le suivi, on a observé une union réussie, des complications mineures se sont produites dans neuf cas et des complications majeures ont eu lieu dans huit cas. La coaptation externe a été responsable des complications dans huit cas et le besoin de coaptation doit être étudié. En excluant les complications mineures, 32 % des patients ont requis au moins une chirurgie additionnelle ou une hospitalisation additionnelle. Tous les chiens sauf deux sont retournés à une fonction complète. La plaque de 1,5 mm a été utilisée avec succès chez tous les chiens ayant un poids corporel de 0,9 à 2,6 kg.(Traduit par Isabelle Vallières).

Diagnosis and Treatment Considerations for Nonphyseal Long Bone Fractures in the Foal.

Many long bone fractures that are not considered repairable in the adult horse are repairable in the foal. This is largely because of reduced patient size and more rapid healing in the foal. When there is no articular communication, the long-term prognosis for athletic function can be very good. Emergency care and transport of the foal with a long bone fracture is different than the adult.

Physeal Fractures in Foals.

Physeal fractures are common musculoskeletal injuries in foals and should be included as a differential diagnosis for the lame or nonweightbearing foal. Careful evaluation of the patient, including precise radiographic assessment, is paramount in determining the options for treatment. Prognosis mostly depends on the patient's age, weight, and fracture location and configuration.

Dual Bone Fixation: A Biomechanical Comparison of 3 Implant Constructs in a Mid-Diaphyseal Fracture Model of the Feline Radius and Ulna.

OBJECTIVE: To compare the biomechanical properties of dual bone fixation (DBF) constructs to radial locking compression plating (LCP) in an ex vivo feline antebrachial fracture gap model. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Cadaveric feline antebrachii (n=12 pairs). METHODS: Antebrachii were radiographed to confirm normal skeletal appearance and maturity. After creation of a 5 mm radial and ulnar ostectomy, each antebrachium received 1 of 3 constructs using an incomplete randomized block design (n=8 per group). All groups received a 10 hole 2.0 mm radial LCP. DBF groups received either a 1.2 mm ulnar intramedullary pin (LCP with pin) or an 8 hole 2.0 mm ulnar LCP in addition to the radial LCP. Biomechanical testing was performed in axial compression and caudocranial and mediolateral 4-point bending before destruction in axial compression. RESULTS: DBF constructs (LCP with pin and dual LCP) were significantly stiffer than radial LCP alone in axial compression and caudocranial bending. There were no differences between LCP with pin and dual LCP constructs in axial compression and caudocranial bending or between any constructs in mediolateral bending. Failure load was significantly greater for dual LCP than LCP with pin or LCP alone constructs. Failure loads were not different between LCP with pin and LCP alone. CONCLUSION: DBF significantly increased construct stiffness and strength. Given the high complication rate reported in cat antebrachial fractures when only the radius is stabilized, surgeons should consider DBF.

Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.

OBJECTIVE: To determine (1) survival to discharge of horses with radial fractures (excluding osteochondral fragmentation of the distal aspect of the radius and stress fractures); and (2) risk factors affecting survival to hospital discharge in conservative and surgically managed fractures. STUDY DESIGN: Case series. ANIMALS: Horses (n = 54). METHODS: Medical records (1990-June 2012) and radiographs of horses admitted with radial fracture were reviewed. Horses with osteochondral fragmentation of the distal aspect of the radius or stress fractures were excluded. Evaluated risk factors were age, fracture configuration, surgical repair method, surgical duration, hospitalization time, implant failure rate, and surgical site infection (SSI) rate. RESULTS: Of 54 horses, overall survival to discharge was 50%. Thirteen (24%) were euthanatized on admission because of (1) fracture severity; (2) presence of an open fracture; or (3) financial constraints. Fourteen (26%) horses with minimally displaced incomplete fractures were conservatively managed and 12 (86%) survived to discharge. Twenty-seven (50%) horses had surgical treatment by open reduction and internal fixation (ORIF) and 15 (56%) survived to hospital discharge. Open fractures were significantly more likely to develop SSI (P = .008), which also resulted in a 17-fold increase in implant failure (P < .005). Six of 8 surgically managed horses with an open fracture did not survive to discharge. Outcome was also adversely affected by age (P < .005) and surgical duration > 168 minutes (P < .027). Presence of SSI trended toward a decreased survival rate (P = .09). CONCLUSION: Prognosis for survival to discharge with minimally displaced incomplete fractures is good. Young horses have a good prognosis survival to discharge for ORIF, whereas ORIF in adult horses has a poor prognosis and SSI strongly correlates with catastrophic implant failure.

Elucidation of the radius and ulna fracture mechanisms in toy poodle dogs using finite element analysis.

Fractures occurring in the distal radius and ulna of toy breed dogs pose distinctive challenges for veterinary practitioners, requiring specialized treatment approaches primarily based on anatomical features. Finite Element Analysis (FEA) was applied to conduct numerical experiments to determine stress distribution across the bone. This methodology offers an alternative substitute for directly investigating these phenomena in living dog experiments, which could present ethical obstacles. A three-dimensional bone model of the metacarpal, carpal, radius, ulna, and humerus was reconstructed from Computed Tomography (CT) images of the toy poodle and dachshund forelimb. The model was designed to simulate the jumping and landing conditions from a vertical distance of 40 cm to the ground within a limited timeframe. The investigation revealed considerable variations in stress distribution patterns between the radius and ulna of toy poodles and dachshunds, indicating notably elevated stress levels in toy poodles compared to dachshunds. In static and dynamic stress analysis, toy poodles exhibit peak stress levels at the distal radius and ulna. The Von Mises stresses for toy poodles reach 90.07 MPa (static) and 1,090.75 MPa (dynamic) at the radius and 1,677.97 MPa (static) and 1,047.98 MPa (dynamic) at the ulna. Conversely, dachshunds demonstrate lower stress levels for 5.39 MPa (static) and 231.79 MPa (dynamic) at the radius and 390.56 MPa (static) and 513.28 MPa (dynamic) at the ulna. The findings offer valuable insights for modified treatment approaches in managing fractures in toy breed dogs, optimizing care and outcomes.

Erythropoietin as promoter of engraftment for treatment of radius/ulnar non-union fracture in a dog: Case report.

Background: Fractures with large bone defects and non-unions are a great challenge for veterinary orthopaedists. In small dog breeds, this complication is commonly encountered in fractures of the radius and ulna due to poorer vascularisation of the distal antebrachium region. Case Description: A case of radius/ulnar non-union in a 1.5-year-old Pinscher occurring after trauma and two successive unsuccessful osteosyntheses is described. During the operative revision, after the removal of existing bone implants, the bone defect was filled with cortical autologous bone graft. Autocancellous bone mixed with erythropoietin was applied proximally and distally to the cortical autograft for stimulation of bone healing. The post-operative period was without complications. As early as the 9th post-operative week, the animal was able to bear weight on the limb, without signs of lameness, pain, and swelling. Radiologically, a very good bridging of the graft was observed. Fifteen weeks after the operative revision, the fracture was completely healed with excellent clinical outcome. Conclusion: The application of autogenous cortical bone graft and cancellous autograft mixed with erythropoietin demonstrated an excellent therapeutic effect and resulted in complete regeneration of the large bone defect over a 15-week period.

Successful centralisation technique for treatment of post-traumatic absence of the radial shaft in a dog.

This report describes a centralisation procedure for the treatment of a radial non-union, characterised by extensive bone loss and an intact ulna, in an 18-month-old toy poodle. A lateral approach to the radius/ulna shafts was realised and, after debridement of the non-union site, an ulnar osteotomy was performed proximal to the styloid process of the ulna. Transposition of the distal fragment of the radius to the distal end of the osteotomised proximal segment of the ulna was performed and the stabilisation was obtained using a locking plate with proximal screws in the ulnar shaft and distal screws in the radius epiphysis. The patient achieved bone union in 10 weeks and the last evaluation, performed 112 weeks postoperatively, showed a full return to pre-injury function. Based on the results of this report, the centralisation was effective in the treatment of post-traumatic absence of the radial shaft in a dog.

Effect of plating technique on periosteal vasculature of the radius in dogs: a cadaveric study.

OBJECTIVE: To (1) evaluate the normal extraosseous blood supply of the cranial aspect of the canine radius and (2) to compare the effects of minimally invasive (MIPO) and open plating technique on its preservation. STUDY DESIGN: Experimental cadaveric study. SAMPLE POPULATION: Adult canine thoracic limbs (n = 36) obtained from cadavers weighing 25-35 kg. METHODS: Twelve unpaired limbs were used to study the normal extraosseous blood supply. Each limb was injected with blue latex and India ink, and then underwent microdissection. Twelve paired limbs were used to study the effects of the 2 surgical plating techniques. On each of the paired radii, either MIPO or open plating was performed. After surgery, limbs were prepared and injected using the same methodology as the normal limbs. The dorsal surface of the radius was divided into 4 zones. Extravasation and periosteal filling were scored and the results were compared between groups using the Wilcoxon matched-pairs signed rank test; significance was set at P < .05. RESULTS: The topography of the vasculature on the cranial aspect of the radius consisted of a complex network of periosteal vessels originating from the median, radial, caudal interosseous, and cranial interosseous arteries. Open plating caused significantly greater extravasation than MIPO (P = .0003). For each zone the MIPO group had significantly greater periosteal filling compared to those in the open plating group. CONCLUSIONS: In this cadaveric model, based on the superior periosteal filling and vascular integrity, MIPO disrupted less periosteal vasculature of the canine radius than open plating.

Retrospective comparison of minimally invasive plate osteosynthesis and open reduction and internal fixation of radius-ulna fractures in dogs.

OBJECTIVE: To compare the efficacy of reduction, time to union, and clinical outcome of radius and ulna fractures stabilized using either minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF). STUDY DESIGN: Retrospective, case-controlled study. ANIMALS: Dogs with radius and ulna fractures stabilized with plates applied using MIPO (n = 15) or ORIF (n = 15). METHODS: Dogs in each stabilization group were matched for type and location of fracture, age, and body weight. Outcome measures including surgical time, fracture alignment, gap width, plate length, plate bridging and span ratio, working length and screw density, and time to union were compared between the groups using an unpaired t-test. Statistical significance was set at P < .05. RESULTS: All fractures obtained radiographic union although infection developed in 1 dog in each stabilization group. Dogs treated with MIPO had a significant longer plate working length and lesser screw-density (P < .05). No statistical difference was found in operating time, postoperative alignment, gap width, or time to union (MIPO: 51.9 ± 18.4 days; ORIF: 49.5 ± 26.5 days). CONCLUSIONS: Radius and ulna fractures managed with MIPO had similar alignment, reduction, and time to union as fractures managed with ORIF. Future prospective clinical studies are warranted and should assess healing more frequently and in a standardized manner to compare MIPO to ORIF in a larger population of dogs.