Radiographic quantitative assessment of caudal proximal tibial angulation in 100 dogs with cranial cruciate ligament rupture.

OBJECTIVE: To evaluate inter- and intraobserver variability in the measurement of distal tibial axis/proximal tibial axis angle (DPA) from lateral radiographs of canine tibia in dogs with cranial cruciate ligament rupture (CCLR). STUDY DESIGN: Retrospective clinical study. ANIMALS: Dogs (n=100) with cranial cruciate ligament rupture. METHODS: Medical records of dogs diagnosed with CCLR were reviewed. In addition to signalment and TPA measurements, measured DPA (mDPA) was calculated for each lateral view of the tibia in each animal, twice, by 3 blinded observers. Subjective scoring of DPA (sDPA) was also recorded, twice, by 3 additional blinded observers from lateral views of the proximal half of the tibia in each dog. Inter- and intraobserver variability was measured by intraclass correlation coefficient (ICC) for each measurement. Correlation between mDPA and sDPA was also determined. RESULTS: Median tibial plateau angle (TPA) of the subject population was 27.9° (range 18.8-41.3°; IQR: 25.5-30.75°). Mean ± SD mDPA was 6.50 ± 2.81° (confidence intervals [CI]: 5.94-7.06°; range 0-13.33°). There was no correlation between age and weight of dogs and the mDPA (P=.58 and .12). There was a moderate correlation between mDPA and TPA (r(2)=0.49, P<.0001). There was a moderate correlation between sDPA and mDPA (r(2)=0.27, P<.0001). Good inter- and intraobserver agreement was found in the measurement of mDPA. CONCLUSION: mDPA is a reproducible measurement of caudal angulation of proximal tibia. Furthermore, mDPA of dogs with cranial cruciate ligament disease in this report are in concordance with previous reports.

Use of a four pin and methylmethacrylate fixation in L7 and the iliac body to stabilize lumbosacral fracture-luxations: a clinical and anatomic study.

OBJECTIVES: To describe the clinical outcome of a 4 pin lumbosacral fixation technique for lumbosacral fracture-luxations, and to refine placement technique for iliac pins based on canine cadaver studies. STUDY DESIGN: Retrospective and anatomic study. SAMPLE POPULATION: Dogs (n=5) with lumbosacral fracture-luxations and 8 cadaveric canine pelvi. METHODS: Lumbosacral fracture-luxations were stabilized with a 4 pin (positive-profile threaded) and bone cement fixation. Caudal pins were inserted in the iliac body and cranial pins were inserted into the L7 or L6 pedicle and body. Follow-up examinations and radiographs were performed to assess patient outcome. Intramedullary pins were inserted into the iliac bodies of 8 cadaver pelvi. Radiographs were taken to measure pin insertion angles and define ideal insertion angles that would maximize pin purchase in the ilium. RESULTS: Follow-up neurologic examination was normal in 4 dogs. Radiographic healing of the fracture was evident in 5 dogs. One implant failure occurred but did not require re-operation. For cadaver iliac pins, mean craniocaudal insertion angle was 29 degrees and mean lateromedial insertion angle was 20 degrees. CONCLUSIONS: Four pin and bone cement fixation effectively stabilizes lumbosacral fracture luxations. The iliac body provides ample bone stock, which can be maximized using an average craniocaudal pin trajectory of 29 degrees and an average lateromedial pin trajectory of 20 degrees. CLINICAL RELEVANCE: Lumbosacral fracture-luxations can be stabilized with 4 pin and bone cement fixation in the lumbar vertebrae and iliac body, using 29 and 20 degrees as guidelines for the craniocaudal and lateromedial pin insertion angles in the ilium.