Accuracy of correction of a hexapod frame, patient-specific osteotomy and reduction guides, and hinged circular external fixation in a 3D-printed canine antebrachial deformity model.

Objectives: This study aimed to objectively define whether human hexapod fixation (Maxframe), with or without the use of 3D-printed positioning guides, can correct a canine antebrachial deformity with greater accuracy than the clinically established techniques of 3D patient-specific osteotomy and reduction guides (3D-PSORG) or hinged circular external skeletal fixation (CESF). Methods: CT of a canine antebrachium was manipulated to induce distal radial deformity of the valgus, external torsion, and procurvatum, each of magnitude 20o. Five experiments were performed to correct the deformity via a distal radial and ulna opening osteotomy using: (1) A 3D-PSORG with the application of a locking plate, (2) hinged CESF, (3) Maxframe standard protocol, (4) Maxframe applied with patient-specific positioning guides (PSPGs), and (5) Maxframe with frame adjustment calculated from post-application CT. Following correction, all constructs were optically scanned, and objective measurement of the correction achieved was performed. Results: No construct returned the distal bone segment to its preoperative position in all planes. Translational malalignment in the sagittal plane had the highest magnitude of error for all constructs, with the Maxframe standard protocol showing the greatest error. Maxframe (PSPGs) showed the minimum error of all constructs in the frontal and sagittal planes. Clinical significance: In this 3D-printed model of antebrachial deformity correction, the hexapod frame with the use of PSPGs achieved better accuracy than 3D-PSORG and hinged CESF and may be a technique of future interest and development in the management of canine antebrachial limb deformity.

Review of minimally invasive surgical procedures for assessment and treatment of medial coronoid process disease.

OBJECTIVE: To summarize the current peer-reviewed publications on minimally invasive surgery (MIS) for medial coronoid process disease (MCPD) in dogs. STUDY DESIGN: Invited review. METHODS: Pubmed, CAB Abstracts and Scopus databases were utilized for literature review (1990-2023). RESULTS: More than 60 papers have been published that involve MIS evaluation or treatment of MCPD. Six prospective trials incorporated quantitative gait analysis evaluating outcome following MCPD debridement, of which three included a control group. Whilst case numbers were limited, all studies employing a control group failed to demonstrate superiority of surgery over nonsurgical management. Of three studies employing gait analysis and no control group, all documented some improvement in function compared to pretreatment lameness. Multiple studies document progression of osteoarthritis in dogs following MCPD debridement although this may not be synonymous with worsened function. Subtotal coronoid osteotomy (SCO) is described as an alternative to MCP fragment removal, although the long-term biomechanical consequences are currently unclear and quantitative data on the efficacy of this treatment in isolation for MCPD is awaited. CONCLUSION: Arthroscopy of the canine elbow joint is a safe means by which to evaluate MCP pathology. Quantitative longitudinal analysis of outcome following minimally invasive surgery for MCPD is required. Correlation with clearly defined subclassification inclusion criteria such as age, incongruity and the precise arthroscopic findings in each case are required to more accurately differentiate any superiority of surgery over nonsurgical management for this disease.

Design and topographic evaluation of a canine humeral anatomic plating system (CHAPS) for humeral condylar fracture repair in spaniels.

OBJECTIVE: To design a precontoured plating system for humeral condylar fracture repair in spaniels with humeral intracondylar fissure (HIF) and quantify accuracy of fit of the system on 3D printed bone models. STUDY DESIGN: Experimental on 3D printed models. METHODS: The plating system was based on morphometric data obtained from CT. Plates were applied to models and impression material was measured under the plates at points of interest to define plate bone gap (PBG). Data on locking screw interference on plate application were also obtained. RESULTS: Eleven elbows models were plated. Statistical analysis to assess for any difference in PBG measurements between left and right humuri revealed two loci (3 and 17) under the lateral plate and two loci (3 and 17) under the medial plate. On cumulate portion analysis, 67% of lateral plate loci and 80% of medial plate loci had a PBG of ≤2 mm respectively. An incidence of 2.1% (3/143) screw interference occurred. CONCLUSION: Design of a contoured plating system for application to humeral models from spaniels with HIF and its application with objective measurement of PBG is described. The majority of the loci measured under both lateral and medial plates had a BPG of ≤2 mm and the incidence of locking screw interference on plate application was low. CLINICAL SIGNIFICANCE: This novel system may have application for the stabilization of humeral condylar fractures in spaniels avoiding the need for plate contouring and minimizing the incidence of locking screw interference.

Clients' perception of referral and veterinary specialists in a U.K. small animal referral hospital.

BACKGROUND: A 2011 RCVS report published following review of veterinary referral and specialisation suggested that the general public may have a lack of understanding of what constitutes specialisation. Our questionnaire study evaluated client understanding of the term 'Specialist' and the information obtained prior to referral. METHODS: Questionnaires were completed prior to consultation. Client age, medical knowledge, how referral was initiated, options discussed by the primary care practice for treatment, expectations of the referral appointment, understanding of the term Specialist and what constitutes specialist training were assessed. RESULTS: A total of 241 questionnaires were completed: 6.2% (15/241) of clients were working in the veterinary/medical industry; 52% (104/200) of clients assumed they were seeing a Specialist for consultation but only 49% (51/104) saw a Specialist; 0.4% (1/232) of owners correctly identified a Specialist as a clinician with a diploma, and incorrect definitions included having experience with a procedure or a postgraduate certificate; 13.6% (31/228) of clients identified that an internship and residency constituted Specialist training; and 66.8% (155/232) of clients had not researched the referral process. CONCLUSIONS: From the population sampled, a minority of clients understand the term Specialist and the postgraduate training this entails. Clients may erroneously assume they are receiving Specialist consultation.

Three-Dimensional-Printed Patient-Specific Osteotomy Guides, Repositioning Guides and Titanium Plates for Acute Correction of Antebrachial Limb Deformities in Dogs.

OBJECTIVE: The aim of this study was to describe the use of patient-specific three-dimensional (3D)-printed osteotomy guides, repositioning guides and custom-printed titanium plates for acute correction of antebrachial limb deformities in four dogs. METHODS: Retrospective review of antebrachial limb deformities in small breed chondrodystrophic dogs that were surgically corrected using a closing wedge ostectomy of the radius at a predetermined site using patient-specific osteotomy guides. Reduction was achieved without the need for intraoperative measurements using patient-specific 3D-printed repositioning guides secured and manipulated using temporary Kirschner wire fixation. The ostectomy of the radius was stabilized with a patient-specific 3D-printed titanium plate. RESULTS: All limbs were corrected to within 3.5 degrees (standard deviation [SD]: 1 degree) and 7.5 degrees (SD: 3 degrees) of the pre-planned deformity correction in the frontal and sagittal planes, respectively. No complications were encountered. Owners completed a canine orthopaedic index survey at a median postoperative follow-up time of 19 months. Surgery eliminated the main presenting complaint of buckling over of the manus in all cases. CLINICAL SIGNIFICANCE: The 3D-printed osteotomy repositioning guides and titanium plates facilitated accurate acute correction of antebrachial deformities in this case series. The methodology described simplifies intraoperative surgical decision-making on limb position with good clinical outcomes seen in a small number of clinical cases.

Outcome following surgical stabilization of distal diaphyseal and supracondylar femoral fractures in dogs.

Signalment, clinical features, fixation techniques, complications, and outcome for dogs presenting with distal diaphyseal and supracondylar femoral fractures were retrospectively reviewed. A total of 45 dogs with unilateral femoral fractures were included. Supracondylar femoral plates were the most popular method of fixation. However, various fixation techniques resulted in favorable outcomes in most dogs with 19/45 cases achieving full function and 22/45 achieving acceptable function. Degree of fracture comminution did not appear to affect complication rate or be a surrogate for worse clinical outcome.

Résultats de stabilisation chirurgicale de fractures fémorales diaphysaires distales et supracondylaires chez le chien. Une étude rétrospective portant sur le signalement, la présentation clinique, les techniques de réduction de fracture, les complications et les résultats de chiens atteints de fractures fémorales supracondyliennes et diaphysaires distales a été réalisée. Quarante-cinq chiens présentant une fracture fémorale unilatérale ont été inclus au total. Les plaques fémorales supracondyliennes représentaient la méthode d'ostéosynthèse la plus courante. Diverses techniques de fixation ont abouti à des résultats favorables dans la majorité des cas, avec 19/45 cas récupérant une fonction complète et 22/45 une fonction considérée acceptable. Le degré de comminution de la fracture n'apparaissait pas comme étant un facteur de risque de complication ou étant associé à des résultats défavorables.(Traduit par Emilie Fauchon et Emilie Hanot).

Evaluation of the milling technique on the component-bone interface in the TATE elbow.

OBJECTIVE: To determine whether the surgeon can influence the accuracy of milling during the TATE elbow arthroplasty by applying force to the milling arm during the milling procedure. STUDY DESIGN: In vitro study on Sawbone specimens. SAMPLE POPULATION: Thirty identical solid foam models of the canine right humerus, elbow joint, and antebrachium (size large). METHODS: TATE elbow arthroplasty was performed on 30 elbows equally divided into 3 types of forces applied to the milling arm: (1) no force, (2) a maximally converging force, and (3) a maximally diverging force using the center of rotation post as a reference point. The resulting component-bone interface and post fit were quantified with digital photography. RESULTS: The component-bone interface gap differed between techniques for most angles. The application of convergent or divergent milling forces frequently increased the component-bone interface gap. Post fit was also influenced by the milling technique, application of a convergent or divergent milling force affecting the fit of multiple posts. Interface gaps tended to be greater on the lateral aspect, an area that is not visible to the surgeon intraoperatively. CONCLUSION: In this bone model study, application of convergent or divergent forces during milling frequently resulted in greater component-bone interface gaps and poorer post fit than when a neutral position was maintained. CLINICAL SIGNIFICANCE: Surgeons may affect implant fit within the constraints of the current arthroplasty system if they do not maintain a neutral position during milling. Greater component-bone interface gaps and poorer post fit may affect component osseointegration and lead to aseptic implant loosening.

Radiological Evaluation of TATE Elbow Cartridge Position in Dogs.

OBJECTIVE: The main purpose of this study was to evaluate the effect of varying elbow flexion angle and elbow orientation on the radiological measurement of component position for first (1G) and second-generation (2G) TATE elbow cartridges, and to test intra/inter-observer variability of measurements. MATERIALS AND METHODS: A cadaveric thoracic limb was implanted with a 1G then 2G cartridge, and mounted in lateral recumbency on an acrylic platform. The platform was tilted by set increments up to 10° in both planes, and radiographs were performed at each angle before repeating with the limb in caudocranial positioning. A deterministic trigonometric model was used to show how component angles should vary with changes in orientation, and these were compared with those measured by two observers. Humeral component angle (HCA), radioulnar component angle, varus/valgus cartridge alignment angle and the cartridge height:isthmus width ratio (CIR) were evaluated. Angles within 5° of the zero degrees inclination angle and ratios within 0.2 of the zero degrees inclination ratio were defined as acceptable. RESULTS: Observer component angles for both cartridges were accurate and precise for inclinations up to 10° except for HCA during adduction/abduction. The CIR values were within the acceptable limit for inclinations up to 7.5° in both planes. CLINICAL SIGNIFICANCE: Acceptable limits of limb inclination during positioning for TATE elbow replacement cartridge assessment were defined. All component measurements were sufficiently accurate and precise to be considered for evaluation of component position in clinical cases.

Effect of monocortical and bicortical screw numbers on the properties of a locking plate-intramedullary rod configuration. An in vitro study on a canine femoral fracture gap model.

OBJECTIVES: To evaluate the effect of varying the number and configuration of locking bicortical and monocortical screws on a plate-rod construct using a mid-diaphyseal femoral ostectomy model. METHODS: Thirty Greyhound femurs were assigned to six groups (A-F). An intramedullary pin was placed in each bone following which a 3.5 mm locking plate was applied with six differing locking screw configurations. Groups A to C had one bicortical screw in the most proximal and distal plate holes and one to three monocortical locking screws in the proximal and distal fragments. Groups D to F had no bicortical screws placed and two to four monocortical locking screws in proximal and distal fragments. Each construct was axially loaded at 4 Hz from a preload of 10 Newtons (N) to 72 N, increasing to 144 N and 216 N, each of 6000 cycles with a further 45,000 cycles at 216 N to simulate a three to six week postoperative convalescence period. Constructs were then loaded to failure. RESULTS: No construct suffered screw loosening or a significant change in construct stiffness during cyclic loading. There was no significant difference in load to failure of any construct (p = 0.34), however, less variation was seen with monocortical constructs. All constructs failed at greater than 2.5 times physiological load, and failure was by bending of the intramedullary pin and plate rather than screw loosening or pull-out. CLINICAL SIGNIFICANCE: Axially loaded locking monocortical plate-rod constructs applied to the canine femur may confer no difference biomechanically to those employing locking bicortical screws.

Colored Indicator Undergloves Increase the Detection of Glove Perforations by Surgeons During Small Animal Orthopedic Surgery: A Randomized Controlled Trial.

OBJECTIVE: To determine whether use of colored indicator gloves affects perforation detection rate and to identify risk factors for glove perforation during veterinary orthopedic surgery. STUDY DESIGN: Prospective randomized controlled trial. SAMPLE POPULATION: 574 double pairs of gloves worn during 300 orthopedic surgical procedures (2,296 gloves). METHODS: Primary and assistant surgeons double-gloved for all orthopedic surgical procedures. Type of inner glove (standard or colored indicator) was randomized for the first 360 double pairs of gloves worn by surgeons during 180 procedures. Perforations detected by surgeons were recorded and gloves changed if requested. For a further 120 procedures, indicator gloves were used exclusively. All gloves were leak-tested after surgery to identify perforations. Association between potential risk factors and perforation was explored using multivariate logistical regression analysis. RESULTS: Glove perforations occurred during 43% of surgeries with a mean of 2.3 holes/surgery. Inner gloves were intact in 63% of glove pairs where an outer perforation occurred. Intraoperative perforation detection was improved when colored indicator gloves were worn (83% sensitivity) vs. standard gloves (34% sensitivity; P<.001). Independent risk factors for perforation were placement of plates and/or screws (P=.001; OR=2.4; 95% CI, 1.4-4.0), placement of an external skeletal fixator (P=.002; OR=7.0; 95% CI, 2.1-23.8), use of orthopedic wire (P=.011; OR=2.4; 95% CI, 1.2-4.7), and primary surgeon being board-certified (P=.016; OR=1.9; 95% CI, 1.1-3.1). CONCLUSION: Increased surgeon recognition of glove perforations through use of colored indicator gloves enables prompt change of gloves if perforation occurs and may reduce potential contamination of the surgical site.

Radiographic, Surgeon and Owner Assessment of the BioMedtrix TATE(®) Elbow Arthroplasty.

OBJECTIVE: To report the long-term radiographic and clinical outcome of the BioMedtrix TATE elbow arthroplasty system in dogs. Assessment was via radiographs, a surgeon-based questionnaire, and owner assessment of outcome using the Liverpool osteoarthritis in dogs (LOAD) and canine brief pain inventory (CBPI) questionnaires. STUDY DESIGN: Retrospective multicenter, case series. ANIMALS: Client-owned dogs undergoing TATE elbow arthroplasty. METHODS: Questionnaires were distributed to surgeons in the United Kingdom performing TATE elbow arthroplasty and to the owners of the dogs operated on. Owners completed the LOAD and CBPI questionnaires. All completed questionnaires from surgeons and owners, and radiographs of the dogs were collated and analyzed. RESULTS: Surgeon questionnaires and radiographs were obtained for 33 elbows from 32 dogs, with owner questionnaires obtained for 19 dogs. Perioperative, short-term, and mid-term complication rates were 60%, 15%, and 15%, respectively. Radiographic assessment of component alignment showed 62% of cartridges were valgus or varus malaligned and 56% of cartridges were either translated medially or laterally relative to the long axis of the ulnar. There was no significant association between component alignment and final clinical outcome. Surgeon assessment reported 24% of dogs to have full, 52% acceptable, and 24% unacceptable outcome. Owner assessment showed significant decreases in pain severity and pain interference from preoperative to final status but no change in mobility scores. CONCLUSIONS: A high complication rate and variability in component placement was recorded with TATE athroplasty. However, component malalignment did not negatively impact clinical outcome. Final clinical outcome was favorable for most cases with significant reductions in pain severity and interference scores despite no changes in mobility scores.

Canine Elbow Realignment Osteotomy (CERO): Validation of the Accuracy of Acute Radial Lengthening in a Cadaveric Incongruency Model.

OBJECTIVE: To verify the ability of a novel Canine Elbow Realignment Osteotomy (CERO) system for acute axial radial or ulnar lengthening to restore normal elbow congruency in a shortened radius cadaver model using assessment by computed tomography (CT). STUDY DESIGN: In vitro cadaver study. ANIMALS: Five pairs of greyhound forelimbs from animals euthanatized for reasons unrelated to the study. METHODS: CT of each elbow was performed (1) pre-operatively (pre-op), (2) after placement of a linear motor IMEX™ external skeletal fixator (ESF) on the radius with diaphyseal ostectomy and radial shorting of 1-5 mm (post-ESF), and (3) after CERO surgery to lengthen the radius proximal to the ostectomy site by an amount equal to the degree of radial shortening (post-CERO). The joint space at 7 loci on dorsal plane and 6 loci on sagittal plane reconstructions was measured to assess changes in joint congruity between pre-op, post-ESF, and post-CERO. Repeated measures ANOVA with post hoc comparisons were performed to compare measurements between the 3 groups. RESULTS: Mean joint space measurements at most loci in the dorsal and sagittal planes were significantly different post-ESF compared with pre-op, confirming development of joint incongruency with the model. Post-CERO joint space measurements did not differ significantly compared with pre-op measurements, demonstrating the return to normal joint congruency using the CERO procedure. CONCLUSION: CERO surgery restored humeroradioulnar congruency in our cadaver model and may have application for acute correction of axial radial or ulnar incongruency in canine elbows secondary to elbow dysplasia or premature growth plate closure.

Patellar ligament rupture in the cat: repair methods and patient outcomes in seven cases.

The medical records of cats receiving surgical treatment for unilateral patellar ligament rupture between 1999 and 2012 at 12 referral centres in the UK and Ireland were reviewed. Seven cases were identified: six were caused by trauma and one was iatrogenic, occurring as a complication following surgical stabilisation of a tibial fracture. All cases were treated by sutured anastomosis of the ruptured ligament, with six of the repairs protected by a circumpatellar and/or transpatellar loop of suture. The stifle was immobilised by transarticular external skeletal fixation in three cases. No cases required revision surgery. No complications were reported. Final evaluation, performed at a median time of 31 days, determined five patients to have returned to acceptable or good limb function; two cases were lost to follow-up. The data suggest that, in cats, the current surgical techniques extrapolated from their canine counterparts for repair of a completely or partially ruptured patellar ligament are successfully used and result in acceptable limb function.

Topographic bone density of the radius and ulna in greyhounds and labrador retrievers with and without medial coronoid process disease.

OBJECTIVE: To quantify, using computed tomography (CT), cross-sectional ulnar bone density (UBD), and regional radial bone density (RRBD) at the level of the medial coronoid process (MCP) in elbows with and without medial coronoid process disease (MCPD) and with and without fragmentation of MCP (FCP). STUDY DESIGN: Retrospective clinical case-control and ex vivo study. SAMPLE POPULATION: Labrador Retriever elbows (n = 54) and normal cadaveric Greyhound elbows (11) undergoing elbow CT. MATERIALS AND METHODS: Labrador Retriever elbows were divided into 2 groups: (1) clinically unaffected and (2) MCPD-affected elbows. This 2nd group was subdivided based on the presence of a displaced FCP. UBD was measured linearly, in Hounsfield units (HU) across the widest part of the ulna incorporating the MCP. The radial head was divided into 6 zones, with mean RRBD (HU) calculated for each group. RESULTS: MCPD-affected Labrador Retriever elbows had significantly lower UBD within the MCP with a higher UBD in the cranial ulnar medulla. Lower RRBD was also seen in the radial head adjacent to the MCP in MCPD-affected Labrador Retriever elbows with FCP compared with Labrador Retriever elbows without FCP. Greyhounds had consistently lower RRBD and UBD at the apex of the MCP compared with clinically unaffected Labrador Retriever elbows. CONCLUSIONS: Our results suggest a caudolateral load-transfer shift through the ulna in MCPD-affected elbow joints, unloading the MCP. Changes in regional radial head bone density suggest that the radial head is involved in the pathogenesis of MCPD.

Evaluation of osteotomy accuracy and rotational and angular alignment for cranial closing wedge ostectomy performed with and without alignment aids.

OBJECTIVE: To (1) investigate the use of K-wires as alignment aids for cranial closing wedge ostectomy (CCWO) and (2) evaluate their effect on osteotomy accuracy and angular/rotational alignment. STUDY DESIGN: Cadaveric study. ANIMALS: Cadaveric pelvic limbs (n = 20). METHODS: CCWO was performed with and without alignment aids on 20 cadaveric pelvic limbs. CT scans were performed pre- and post-operatively to evaluate tibial torsion and valgus/varus deformity. Digital photographs of the ostectomized bone wedges were used to assess divergence of the 2 osteotomies, and the area of the medial and lateral aspects measured to assess osteotomy angulation within the dorsal plane. RESULTS: Osteotomy divergence angle, the difference between the area of the medial and lateral aspects of the ostectomized wedges, and the difference between the pre- and post-operative angles of valgus/varus deformity were all significantly smaller for the alignment aid group. The difference in pre- and post-operative tibial torsion was not significantly different between groups. CONCLUSIONS: K-wires can be used successfully as alignment aids during CCWO and help to create a significantly more orthogonal osteotomy. This allows a significant reduction in the difference between the preoperative and postoperative angles of valgus or varus, which may reduce the risk of developing a clinically important iatrogenically introduced valgus/varus deformity postoperatively.

Evaluation of cut accuracy and cis cortical damage for tibial plateau leveling osteotomy performed with and without aid of a novel saw guide: an in vitro study.

OBJECTIVES: To compare osteotomy orientation relative to the sagittal and transverse planes of the tibia, and cis cortical damage for tibial plateau leveling osteotomy (TPLO) performed with the following aids: (1) Synthes TPLO jig and saw guide, (2) Slocum TPLO jig with ancillary Kirschner wires (SlocumK), and (3) Slocum jig alone. STUDY DESIGN: In vitro study on Synbone(®) bone models and canine cadavers. ANIMALS: Cadaveric pelvic limbs pairs (n = 30). METHODS: TPLO was performed on 30 Synbone tibias with either the Slocum jig (n = 10), SlocumK (10), or Synthes jig (10). Synbones were analyzed to quantify osteotomy inclination, torsion, craniocaudal positioning, and medial cortical bone damage. Osteotomies were performed on cadaveric tibias and CT reconstruction used to assess the same osteotomy parameters. RESULTS: Significant differences in Synbone tibial osteotomy inclination (P < .001), medial cortical bone damage (P < .001) and craniocaudal osteotomy position (P < .05) were observed between the Synthes and Slocum jigs. CT analysis revealed significant differences in osteotomy inclination (P < .001) and torsion (P < .001). The use of the SlocumK resulted in osteotomies with minimal torsional malalignment however with high levels of metal debris and accelerated blunting of the TPLO blade. CONCLUSION: TPLO osteotomy inclination, torsion, and craniocaudal positioning are improved and the degree of iatrogenic medial cortical bone damage is minimal with the Synthes TPLO jig compared to the Slocum TPLO jig.

Inverse dynamics analysis evaluation of tibial tuberosity advancement for cranial cruciate ligament failure in dogs.

OBJECTIVE: To evaluate, using inverse dynamic analysis, the biomechanical outcome from tibial tuberosity advancement (TTA) surgery in dogs affected by unilateral cranial cruciate ligament failure (CCLF). STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 13) 11-20 months after surgery. METHODS: Kinematic and force data were collected from 13 dogs 11-20 months after TTA and inverse dynamics analysis of the dogs' pelvic limb mechanical function performed. Angle, moment, and power were calculated for each joint. Total support moment (TSM) was calculated. RESULTS: Six dogs were affected on the right side (Raff) and 7 on the left (Laff). Peak stifle flexor moment was significantly larger for the right stifle compared with the left in Laff dogs, but similar in Raff dogs. Peak stifle extensor moment was significantly larger for the left stifle compared with the right in Raff dogs, and was also larger for the left stifle compared with the right in Laff dogs. Stifle power in early stance was larger on the left in Raff dogs and significantly larger on the right in Laff dogs. TSM was larger on the right in Raff dogs and significantly larger on the right in Laff dogs. CONCLUSIONS: Affected limbs had a reduction in power of the stifle flexors. Irrespective of the side of CCLF, TSM was larger on the right side and the stifle extensor moment in late stance was larger on the left, perhaps indicating a mechanical limb dominance effect.

Conservative versus arthroscopic management for medial coronoid process disease in dogs: a prospective gait evaluation.

OBJECTIVE: To investigate, using objective gait analysis, the long-term outcome of dogs with medial coronoid process disease (MCPD) treated with conservative management (CM) versus arthroscopic treatment (AT). STUDY DESIGN: Prospective clinical trial. ANIMALS: Dogs (n = 20) with unilaterally confirmed MCPD. METHODS: Eleven dogs were treated arthroscopically with removal of coronoid fragments and burring of any associated chondromalacic cartridge and 9 dogs were managed conservatively. All dogs were administered a 6-week course of oral tepoxalin on enrollment. Inverse dynamics gait analysis was performed at initial presentation and at 4, 8, 26, and 52 weeks. The gait variables analyzed were elbow moment (EM), elbow power (EP), total support moment (TSM), and total support moment ratio (TSMR) as a measure of forelimb asymmetry. RESULTS: Affected peak EM increased from 0.58 to 0.76 Nm/kg in the AT dogs, and from 0.66 to 0.81 Nm/kg in the CM dogs and there was no significant difference between groups. Affected peak EP increased marginally in the AT dogs, but was unchanged in the CM dogs and there was no significant difference between groups. TSM increased from 1.49 to 1.92 Nm/kg in the AT dogs and from 1.52 to 2.06 Nm/kg in the CM dogs and there was no significant difference between groups. TSMR was statistically different between treatment groups at 1 (P = .003) and 2 months (P = .048) with the AT group more asymmetric and hence more lame. TSMR at 12 months was 0.83 (AT) and 0.86 (CM) implying a failure of return to soundness by either group. CONCLUSIONS: AT dogs had increased mechanical asymmetry at 4 and 8 weeks compared to the CM group revealing surgery worsened limb function. There was no significant difference in mechanical symmetry between groups at 26 and 52 weeks.

Composite fixation of comminuted ilial wing fractures in cats: three cases.

UNLABELLED: CLINICAL SUMMARY: The surgical repair of comminuted ilial wing fractures (comprising a long oblique fracture with ventral multiple fragmentation) in three cats using composite internal fixation is reported. The technique comprised the use of pins, screws, wire and polymethylmethacrylate. All cases had an excellent outcome with uneventful bone healing. One case had a very mild reduction in pelvic canal diameter postoperatively. There was no evidence of implant loosening or migration in any cat on follow-up radiographs. PRACTICAL RELEVANCE: This technique provided a quick and highly adaptable means of stabilising this fracture configuration, as well as restoring pelvic symmetry, when limited buttressing support and bone stock were available cranial and ventral to the acetabulum. This method of fixation may have biomechanical advantages over lateral or dorsal plating techniques for this particular type of fracture configuration.