RESUMEN
Monteggia fractures (MFs) are proximal ulnar fractures with concurrent dislocation of the radial head. This retrospective study aims to report the clinical findings and discuss the treatments and outcomes in MFs cases of 9 cases. Previous medical records of the animals were reviewed for history, clinical features, radiographic findings and choice of treatment. Treatment follow-up was evaluated over the telephone by discussion with the owners. Six animals included in the study were presented 2 days after the initial trauma. Five dogs were presented after common road traffic accidents and two after unknown traumas. All dogs had type I MFs, while the cat had a type III MF. Radiographical findings showed that six animals had extra-articular ulnar fractures, while three animals had intra-articular ulnar fractures. All animals were treated with open reduction of the ulna and internal fixation surgical methods. Six ulnar fractures were stabilized with intramedullary pin(s) with cerclage wire. The clinical outcome was assessed by the owners as full function in 3 dogs, acceptable function in 2 dogs and unacceptable function in 2 dogs with intraarticular ulnar fractures. The cat case was rated as full function. One dog died from a pulmonary fat embolism. The findings presented here provide some support that cerclage wire placement could be a satisfactory method for annular ligament reconstruction as a simple and economical treatment option. Also, to the authors' knowledge, this is the third report of MFs with intraarticular ulnar fractures. In this series, comminuted, intraarticular fractures were related to major postoperative complications.
Asunto(s)
Fractura de Monteggia , Animales , Perros/lesiones , Estudios Retrospectivos , Gatos/lesiones , Masculino , Femenino , Fractura de Monteggia/veterinaria , Fractura de Monteggia/cirugía , Enfermedades de los Perros/cirugía , Resultado del Tratamiento , Enfermedades de los Gatos/cirugía , Fijación Interna de Fracturas/veterinaria , Radiografía/veterinaria , Fracturas del Cúbito/veterinaria , Fracturas del Cúbito/cirugíaRESUMEN
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.
Asunto(s)
Trasplante Óseo , Eritropoyetina , Fracturas no Consolidadas , Animales , Perros/lesiones , Femenino , Trasplante Óseo/veterinaria , Enfermedades de los Perros/cirugía , Eritropoyetina/uso terapéutico , Fracturas no Consolidadas/veterinaria , Fracturas no Consolidadas/cirugía , Fracturas del Radio/veterinaria , Fracturas del Radio/cirugía , Fracturas del Cúbito/veterinaria , Fracturas del Cúbito/cirugíaRESUMEN
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.
Asunto(s)
Análisis de Elementos Finitos , Fracturas del Radio , Fracturas del Cúbito , Animales , Perros/fisiología , Fracturas del Cúbito/veterinaria , Fracturas del Cúbito/diagnóstico por imagen , Fracturas del Radio/veterinaria , Fenómenos Biomecánicos , Miembro Anterior/fisiología , Tomografía Computarizada por Rayos X/veterinaria , Estrés MecánicoRESUMEN
Background: Minimally invasive plate osteosynthesis (MIPO) is an emerging fracture management modality in small animal orthopedics. Although cranial plate application has been consistently advocated when performing radial MIPO, medial plating affords several purported advantages including improved screw purchase through the wider medial-to-lateral dimension of the radius, the potential to use smaller plates allowing more screws per unit length, and avoidance of extensor tendons which can complicate cranial plate placement in distal diaphyseal or metaphyseal fractures. Aim: To compare cranial versus medial MIPO applications for the stabilization of diaphyseal radius and ulna fractures in dog cadavers. Methods: Simulated bilateral antebrachial fractures were stabilized with cranial MIPO on one forelimb and medial MIPO on the contralateral limb, facilitated by a two-ring circular fixator construct. Procedure times and ease, number of fluoroscopic images obtained, and post-procedural frontal and sagittal alignment and radial length were compared between plating groups. The ease of construct placement, fracture reduction, radial approach, and plate application, were subjectively scored 1-5 for each procedure. Paired t-tests were performed to identify significant differences (p < 0.05) between the two plating groups. Results: There was no difference in total or incremental procedural times, subjective ease scores, or the number of fluoroscopic images obtained between plating groups. Both plating groups had comparable post-procedural frontal and sagittal plane alignment. There was a significant difference between plating groups for final radial length (p = 0.004) and change in radial length compared to the intact radii, (p = 0.002). Medial-plated radii measured longer than cranial-plated radii. Conclusion: The only outcome measure significantly different between plating groups was the post-procedural radial length. The change in length compared to intact radii was <1%, regardless of the plating group, and unlikely to be clinically relevant.
Asunto(s)
Enfermedades de los Perros , Procedimientos Ortopédicos , Fracturas del Cúbito , Perros , Animales , Radio (Anatomía)/cirugía , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/veterinaria , Miembro Anterior , Cadáver , Procedimientos Ortopédicos/veterinariaRESUMEN
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.
Asunto(s)
Enfermedades de los Perros , Fracturas Conminutas , Fracturas del Radio , Fracturas del Cúbito , Animales , Placas Óseas/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/cirugía , Perros , Fracturas Conminutas/veterinaria , Fracturas del Radio/veterinaria , Estudios Retrospectivos , Infección de la Herida Quirúrgica/veterinaria , Resultado del Tratamiento , Fracturas del Cúbito/veterinariaRESUMEN
Several methods have been reported for treating avian antebrachial fractures, yet the quantitative information regarding their success is limited. This retrospective study applied data from raptors admitted to a wildlife rehabilitation center to provide metrics associated with the treatment of ulna fractures with an intact radius by either conservative management or a single surgical method: a type I external skeletal fixator tied in to an intramedullary pin (ESF IMP tie-in). Postfledging wild raptors with an ulna fracture admitted to The Raptor Center at the University of Minnesota College of Veterinary Medicine (St Paul, MN, USA) between January 1, 2007, and December 31, 2017, that survived for at least 7 days after admission were included in the study. Information regarding signalment, fracture characteristics, treatment method, outcome, and complications were recorded. The study included 110 raptors representing 15 species. The majority of birds (69%, 76/110) were treated with conservative management. Conservative management was used more often in cases of chronic (P = .02) and closed (P = .02) fractures, whereas fractures with poor alignment at the time of admission were frequently treated through surgical means (P=.001). Alignment was more likely to improve with an ESF IMP tie-in (P=1.01 ×10-9). The majority of cases (65%, 72/110) had a successful outcome. Birds with closed fractures were more likely to have a successful outcome (P=.03). Birds in which fracture alignment became exacerbated with either treatment method were more likely to have a poor outcome (P=.002). The results of this retrospective study found that conservative management and surgical fixation by the ESF IMP tie-in technique are both viable treatment options for ulna fractures with an intact radius in raptors. The choice of treatment method is dependent on the clinician's assessment of the fracture characteristics and individual patient.
Asunto(s)
Rapaces , Fracturas del Cúbito , Animales , Tratamiento Conservador/veterinaria , Radio (Anatomía) , Estudios Retrospectivos , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/veterinariaRESUMEN
OBJECTIVES: To evaluate the effectiveness and complication rate of a 1.5- and 2.0-mm titanium locking plate for the treatment of radial and ulnar fractures in small dog breeds and cats without peri-operative antibiotic prophylaxis in a prospective case series. MATERIALS AND METHODS: Medical records and radiographs of closed radial and ulnar fractures treated using internal fixation with a 1.5- or 2.0-mm titanium locking plate without antibiotic prophylaxis were collected prospectively. Patients were clinically followed up until radiographical fracture healing was complete. RESULTS: Thirty-two fractures in small breed dogs and cats with an average bodyweight of 3.9 kg met the inclusion criteria. The follow-up time radiographically and clinically was 4-35 weeks. All fractures showed radiographical fracture union, and all patients had a good clinical outcome. The superficial infection rate in this case series was 0%; the deep infection rate involving the implant/bone was 3.1%. CLINICAL SIGNIFICANCE: The novel 1.5- and 2.0-mm titanium locking plate system was successfully used to treat simple closed radial and ulnar fractures in small breed dogs and cats without peri-operative antibiotic prophylaxis, resulting in good clinical outcome and a low infection rate.
Asunto(s)
Enfermedades de los Gatos , Enfermedades de los Perros , Fracturas Óseas , Fracturas del Cúbito , Animales , Profilaxis Antibiótica/veterinaria , Placas Óseas/veterinaria , Enfermedades de los Gatos/diagnóstico por imagen , Enfermedades de los Gatos/cirugía , Gatos , Enfermedades de los Perros/cirugía , Perros , Fijación Interna de Fracturas/métodos , Fijación Interna de Fracturas/veterinaria , Fracturas Óseas/cirugía , Fracturas Óseas/veterinaria , Titanio , Resultado del Tratamiento , Fracturas del Cúbito/diagnóstico por imagen , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/veterinariaRESUMEN
OBJECTIVE: This study aimed to evaluate implant-induced osteoporosis (IIO) development in toy breed dogs treated using internal fixation with digital radiographs as the index of pixel values. STUDY DESIGN: There were 226 cases (236 limbs) of toy breed dogs with radial-ulnar fractures. Pixel values were measured on radiographs immediately, 2 weeks and 1 to 12 months after surgery. The ratio of pixel values (PVR) represented the bone mineral areal density based on the humeral condyle in the same image. The dogs were grouped based on the fixation methods, age and status of destabilization. RESULTS: There was a significant decrease in the PVR at 1 to 12 months postoperatively for all cases. There were not any significant differences in PVR of antebrachial fractures between those repaired with plates using locking head screws, cortex screws or a combination of locking and cortex screws. Implant-induced osteoporosis persisted at 1 to 12 months postoperatively in dogs aged â§6 months, while the PVR increased after 3 months in dogs aged <6 months. Based on the destabilization method, there was a significant increase in the PVR at 3 months in the plate removal group. CONCLUSION: This study suggests that IIO occurs in small dogs treated with plates and screws. Moreover, patients aged < 6 months showed an early postoperative recovery of bone mineral areal density. Further, screw and plate removal could contribute to the recovery of bone mineral areal density.
Asunto(s)
Enfermedades de los Perros , Osteoporosis , Fracturas del Radio , Fracturas del Cúbito , Animales , Placas Óseas/efectos adversos , Placas Óseas/veterinaria , Tornillos Óseos/efectos adversos , Tornillos Óseos/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/etiología , Enfermedades de los Perros/cirugía , Perros , Fijación Interna de Fracturas/veterinaria , Osteoporosis/veterinaria , Fracturas del Radio/veterinaria , Estudios Retrospectivos , Fracturas del Cúbito/veterinariaRESUMEN
OBJECTIVES: To describe the results of orthogonal plating (OP) as a treatment for fractures of the radius and ulna in toy-breed dogs. MATERIALS AND METHODS: The medical records (June 2011 to April 2019) of toy-breeds in which the OP technique using non-locking cuttable plates was employed to treat radial and ulnar fractures were reviewed. The inclusion criteria included a bodyweight of 3.5 kg or less, fracture of the diaphysis of the radius and ulna of one or both forelimbs, and the availability of follow-up radiographs. Revision surgeries were also included. RESULTS: Fifteen limbs that underwent initial fracture repair and five that underwent revision surgery met the inclusion criteria. The radial and ulnar fractures healed in 19 limbs at the final follow-up. Synostosis of the radius and ulna at the fracture sites was observed in one limb. Re-fracture after cranial plate removal was observed in one case. All dogs exhibited successful return of normal limb function at the final clinical and radiographic follow-up (mean, 104.7 ± 67.1 days; median, 79.5 days; range: 35 to 248 days). Long-term follow-up data obtained via telephone interviews to owners or referring veterinarians were available for 15 cases and confirmed maintenance of normal limb function in all dogs (mean, 32.5 ± 17.6 months; median, 26 months; range: 11 to 69 months). CLINICAL SIGNIFICANCE: OP allowed the successful open reduction of radial and ulnar fractures, facilitating bone union in both the radius and ulna and a return to normal limb function in a series of toy-breed dogs.
Asunto(s)
Enfermedades de los Perros , Fracturas del Radio , Fracturas del Cúbito , Animales , Placas Óseas/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Perros , Fijación Interna de Fracturas/veterinaria , Radio (Anatomía)/diagnóstico por imagen , Radio (Anatomía)/cirugía , Fracturas del Radio/diagnóstico por imagen , Fracturas del Radio/cirugía , Fracturas del Radio/veterinaria , Estudios Retrospectivos , Resultado del Tratamiento , Fracturas del Cúbito/diagnóstico por imagen , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/veterinariaRESUMEN
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.
Asunto(s)
Autoinjertos/trasplante , Matriz Ósea/química , Hueso Esponjoso/trasplante , Fijación de Fractura/veterinaria , Fracturas Conminutas/veterinaria , Fracturas Mal Unidas/veterinaria , Placenta/química , Animales , Técnica de Desmineralización de Huesos/veterinaria , Perros/anomalías , Femenino , Fijación de Fractura/métodos , Fracturas Conminutas/cirugía , Fracturas Conminutas/terapia , Fracturas Mal Unidas/cirugía , Fracturas Mal Unidas/terapia , Humanos , Fracturas del Húmero/cirugía , Fracturas del Húmero/terapia , Fracturas del Húmero/veterinaria , Masculino , Embarazo , Fracturas del Radio/cirugía , Fracturas del Radio/terapia , Fracturas del Radio/veterinaria , Sepsis/veterinaria , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/terapia , Fracturas del Cúbito/veterinariaRESUMEN
OBJECTIVE: Olecranon process fractures are rare in bovines. The aim of the study was to put on record satisfactory limb usage in cattle and buffaloes suffering from olecranon fractures and treated conservatively, primarily for carpal contracture or to prevent it, using aluminum splints incorporated within a fiberglass cast along with stall confinement. STUDY DESIGN: This one year study included 19 olecranon fractures in bovines (15 buffaloes and 4 cattle). Out of 19, 12 bovines (9 buffaloes and 3 cattle) were treated primarily to manage the associated carpal contracture, using external coaptation of aluminium splints incorporated within a fiberglass cast for 6 to 8 weeks. The owners of the remaining 7 bovines (6 buffaloes and 1 bullock) were only advised to keep their animal in stall-confinement, due to various reasons. RESULTS: Slipping and falling on hard surfaces was the primary aetiology of olecranon fractures (17/19). Most of the fractures (14/19) were presented more than 10 days after a traumatic event, with a mean duration of 24.0 ± 26.6 days. On follow up, all the treated bovines showed satisfactory limb usage whereas all stall-confined buffaloes showed no improvement. CONCLUSION: Slipping and falling on hard surfaces is a common cause of olecranon fracture in bovines. Olecranon fractures associated carpal contracture can be successfully treated/prevented by applying full limb cast (if possible including elbow) along with aluminum splints leading to satisfactory limb usage in bovines. Further it is concluded that stall confinement alone is insufficient to prevent limb contracture (which usually develops with olecranon fracture in bovines) leading to permanent non-weight bearing disability.
Asunto(s)
Moldes Quirúrgicos/veterinaria , Enfermedades de los Bovinos/terapia , Fijación de Fractura/veterinaria , Olécranon , Férulas (Fijadores)/veterinaria , Fracturas del Cúbito/veterinaria , Accidentes por Caídas , Aluminio , Animales , Bovinos/lesiones , Femenino , Fijación de Fractura/métodos , Masculino , Fracturas del Cúbito/etiología , Fracturas del Cúbito/terapiaRESUMEN
CASE DESCRIPTION: A 3-year-old 2.5-kg (5.5-lb) sexually intact male Pomeranian was presented with a 1-day history of non-weight-bearing lameness of the right forelimb. CLINICAL FINDINGS: Signs of pain were localized to the proximal portion of the right antebrachium. Radiography revealed a minimally displaced fracture of the proximal portion of the radius that had propagated from a well-demarcated, ovoid, osteolytic lesion within the cortex of the caudolateral aspect of the radius. Computed tomographic findings supported the radiographic findings and did not reveal lesions in other evaluated body sites. TREATMENT AND OUTCOME: At surgery, the lateral aspect of the radial cortex appeared expanded, and tenacious fibrous tissue filled the gap between the fracture fragments. Fibrous tissue was resected and submitted for histologic examination, and the fracture was reduced and stabilized with a bone plate and a positional screw. Histologic examination revealed the presence of viable bone, fibrous tissue, and areas of coagulative necrosis. Imaging and histologic findings were consistent with radioulnar ischemic necrosis (RUIN). The patient ambulated normally at reexamination 12 days after surgery. At reexamination 15 weeks after surgery, the patient continued to ambulate normally, and radiography and CT indicated healing of the fracture and resolution of the RUIN lesion. CLINICAL RELEVANCE: RUIN should be considered as a differential diagnosis for a dog with forelimb lameness and radiographic focal osteolysis between the proximal and middle thirds of the diaphysis of the radius or ulna. Prognosis for dogs with RUIN may be good with surgical intervention.
Asunto(s)
Enfermedades de los Perros , Fracturas del Radio , Fracturas del Cúbito , Animales , Placas Óseas , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Perros , Masculino , Necrosis/veterinaria , Radio (Anatomía)/diagnóstico por imagen , Radio (Anatomía)/cirugía , Fracturas del Radio/complicaciones , Fracturas del Radio/diagnóstico por imagen , Fracturas del Radio/cirugía , Fracturas del Radio/veterinaria , Fracturas del Cúbito/diagnóstico por imagen , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/veterinariaRESUMEN
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.
Asunto(s)
Fijación de Fractura/veterinaria , Fracturas Cerradas/veterinaria , Fracturas Conminutas/veterinaria , Macropodidae , Fracturas del Radio/veterinaria , Fracturas del Cúbito/veterinaria , Animales , Fracturas Cerradas/cirugía , Fracturas Conminutas/cirugía , Masculino , Fracturas del Radio/cirugía , Resultado del Tratamiento , Fracturas del Cúbito/cirugíaRESUMEN
OBJECTIVE: To identify characteristics of antebrachial fractures associated with a successful outcome (ie, bird released back into the wild after regaining normal flight ability, without being returned to the rehabilitation program within 1 month afterward) for free-ranging birds of prey admitted to a rehabilitation program. ANIMALS: 620 birds of prey (representing 24 species) with antebrachial fractures admitted alive to a rehabilitation program from August 1986 through December 2015. PROCEDURES: The medical record of each bird was reviewed to obtain information on species, age, sex, year of admission, fracture characteristics, and treatments administered. Outcome was classified as successful or unsuccessful on the basis of available data. Multivariable logistic regression was used to identify fracture characteristics associated with outcome. RESULTS: 519 of 620 (84%) birds received treatment, and a successful outcome was recorded for 245 (47%) treated birds. Birds with closed (vs open) fractures were significantly more likely to have a successful outcome. Birds with concomitant radial and ulnar fractures involving the same third of the antebrachium (vs other types of antebrachial fractures) were significantly less likely to have a successful outcome, although birds with this type of fracture were significantly more likely to have a successful outcome when the fracture was localized to the middle or distal (vs proximal) third of the antebrachium. CONCLUSIONS AND CLINICAL RELEVANCE: The characteristics of antebrachial fractures associated with a successful or unsuccessful outcome in this study may be useful in the development of triage protocols for birds of prey in other rehabilitation centers.
Asunto(s)
Fracturas Óseas/veterinaria , Fracturas del Radio/veterinaria , Fracturas del Cúbito/veterinaria , Animales , Aves , Resultado del TratamientoRESUMEN
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.
Asunto(s)
Miembro Anterior/lesiones , Fracturas Óseas/veterinaria , Rapaces/lesiones , Animales , Eutanasia Animal/estadística & datos numéricos , Fracturas Óseas/complicaciones , Fracturas Óseas/rehabilitación , Fracturas Óseas/terapia , Hospitales Veterinarios , Hospitales de Enseñanza , Modelos Logísticos , Pronóstico , Fracturas del Radio/mortalidad , Fracturas del Radio/rehabilitación , Fracturas del Radio/terapia , Fracturas del Radio/veterinaria , Estudios Retrospectivos , Fracturas del Cúbito/mortalidad , Fracturas del Cúbito/rehabilitación , Fracturas del Cúbito/terapia , Fracturas del Cúbito/veterinariaRESUMEN
CASE DESCRIPTION: An 11-month-old sexually intact male red kangaroo (Macropus rufus) was examined because of bilateral radial and ulnar fractures. CLINICAL FINDINGS: Radiography of the forelimbs revealed bilateral, short oblique fractures in the proximal to mid diaphyses of the radii and ulnae. Fractures were overriding and moderately displaced. Wider than expected gaps were evident in the humeroulnar and humeroradial joints bilaterally. Although several physes remained open, no proximal radial physis was radiographically evident. TREATMENT AND OUTCOME: Dual bone fixation was performed bilaterally, and dynamic luxation of the left radial head was identified and stabilized intraoperatively. Although satisfactory function of both forelimbs was evident at 8 weeks and 26 months after surgery, a persistent gait abnormality affecting the right forelimb was noted. Twenty-six months after surgery, radiography revealed bilateral proximal radial physes and resolution of the abnormally wide gaps in the humeroradial and humeroulnar joints. Despite dual bone fixation, synostoses formed bilaterally and may have contributed to the persistent lameness in the kangaroo's right forelimb. CLINICAL RELEVANCE: Veterinarians treating kangaroos should be aware of difficulties in determining skeletal maturity and planning fracture stabilization because of potential differences in skeletal growth and fracture healing, compared with other species. We described critical issues observed in the treatment and outcome of the kangaroo of the present report and provided lessons learned as well as potential explanations of these issues to facilitate future treatment of kangaroos with forelimb fractures.
Asunto(s)
Luxaciones Articulares/veterinaria , Fracturas del Radio/veterinaria , Fracturas del Cúbito/veterinaria , Animales , Miembro Anterior , Fijación Interna de Fracturas/veterinaria , Macropodidae , Masculino , Radio (Anatomía) , Resultado del TratamientoRESUMEN
OBJECTIVE: The aim of this study was to evaluate the biomechanical properties of three different miniature locking plate systems used to fixate radial and ulnar fractures in toy breed dogs. Implant size, shape, material and locking systems differ, and their influence on the fracture healing process is unknown. In the present study, we aimed to investigate this matter in vivo using rabbit radial and ulnar fracture models. STUDY DESIGN: Eighteen rabbits were randomly divided into three groups, and the left radius and ulna were osteotomized to create fracture models. The osteotomies were then fixated using either the TITAN LOCK 1.5, Fixin micro or LCP 1.5 system. Radiographs were obtained 2, 3 and 4 weeks after surgery. Four weeks after surgery, the radiuses were collected and used for biomechanical testing or histological examinations. RESULTS: During the 4 weeks of observation, no adverse effects due to the implants occurred. The radiographic scores in each group did not differ significantly at any time point. The maximum load in the LCP group was significantly higher than that in the TITAN and Fixin groups. There was no significant difference in bending stiffness or work to failure among the groups. Initial fracture healing via woven bone was evident at histological evaluation. CONCLUSIONS: All three miniature locking plate systems provided adequate fracture stabilization 4 weeks after surgery, despite their differences, in rabbit models.
Asunto(s)
Placas Óseas/veterinaria , Conejos , Fracturas del Radio/veterinaria , Fracturas del Cúbito/veterinaria , Animales , Fenómenos Biomecánicos , Placas Óseas/efectos adversos , Modelos Animales de Enfermedad , Perros , Curación de Fractura , Masculino , Miniaturización , Periodo Posoperatorio , Radiografía/veterinaria , Fracturas del Radio/tratamiento farmacológico , Fracturas del Radio/patología , Fracturas del Radio/cirugía , Distribución Aleatoria , Fracturas del Cúbito/diagnóstico por imagen , Fracturas del Cúbito/patología , Fracturas del Cúbito/cirugíaRESUMEN
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.
Asunto(s)
Tamaño Corporal , Enfermedades de los Perros/cirugía , Fijación de Fractura/veterinaria , Fracturas del Radio/veterinaria , Fracturas del Cúbito/veterinaria , Animales , Placas Óseas/veterinaria , Remoción de Dispositivos , Perros , Femenino , Fijación de Fractura/métodos , Luxaciones Articulares , Masculino , Fracturas del Radio/cirugía , Estudios Retrospectivos , Férulas (Fijadores) , Resultado del Tratamiento , Fracturas del Cúbito/cirugíaRESUMEN
OBJECTIVES: The purpose was to compare the biomechanical properties of a 1.5 mm locking compression plate (1.5 LCP) to the 1.5 mm straight plate (1.5 P), 1.5 mm straight plate stacked (1.5 PSt) and 2.0 mm straight plate (2.0 P) in compression and torsion. We hypothesized that biomechanical properties of the 1.5 LCP would be equivalent to properties of the 1.5 P and would represent an alternative for the treatment of radial fractures in miniature breed dogs in which those plates would be used. MATERIALS AND METHODS: A 1 mm fracture gap model was created with a bone surrogate stabilized with a six-hole plate. Sixteen constructs were built for each of the four plate configurations. Eight constructs from each group were tested in compression to failure and eight constructs were tested in torsion to failure. RESULTS: In compression testing, the 1.5 LCP was stiffer than the 1.5 P, and had similar stiffness than the 1.5 PSt and the 2.0 P. The load at yield of the 1.5 LCP was slightly lower than the 1.5 P. In torsion, the 1.5 LCP and 1.5 P had similar stiffness, but 1.5 LCP was slightly stronger than 1.5 P. The 1.5 PSt and 2.0 P were overall superior to the 1.5 LCP but only marginally so for the 1.5 PSt. CLINICAL RELEVANCE: The 1.5 LCP can be considered biomechanically equivalent to the 1.5 P under the present experimental conditions. The use of the 1.5 LCP can be considered as an option for radial fracture repair in dogs in which a 1.5 P would have otherwise been used. The use of a locking plate to improve overall success rate, in these fractures, remains to be confirmed clinically.
Asunto(s)
Placas Óseas/veterinaria , Animales , Fenómenos Biomecánicos , Tornillos Óseos/veterinaria , Perros/lesiones , Fijación Interna de Fracturas/instrumentación , Fijación Interna de Fracturas/veterinaria , Fracturas del Radio/cirugía , Fracturas del Radio/veterinaria , Estrés Mecánico , Torsión Mecánica , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/veterinariaRESUMEN
OBJECTIVE: Study included surgical management of radius and ulna fracture in a 2-year-old, 220 kg crossbred heifer presented with a 2-day-old history of injury resulting in severe, non-weight bearing lameness of the left forelimb. METHODS: The condition was diagnosed clinically and confirmed radiographically as a middle third oblique comminuted fracture of the left radius and ulna. Static intramedullary interlocking nailing was performed for fracture fixation. An interlocking nail of 12-mm diameter and 26-cm length was introduced in a retrograde manner from the distal aspect of the radius. RESULTS: The animal was able to bear weight on the affected limb within 7 days post surgery. Good callus formation and complete weight bearing were observed by 35th day. Bending of the screws and osteophytic reaction were the major postoperative complications observed radiographically. CLINICAL SIGNIFICANCE: From this case study, it was established that static intramedullary interlocking nailing can be used as an alternative technique for fracture repair of the radius and ulna in cattle where stable fracture fixation by bone plating is questionable.