RESUMO
OBJECTIVE: To describe patient characteristics, etiology, treatment outcomes and complications of caudoventral hip luxation (CvHL) in a large cohort of dogs and investigate factors associated with nonsurgical treatment outcomes. STUDY DESIGN: Multicenter retrospective case series. ANIMAL POPULATION: A total of 160 client-owned dogs (170 limbs). METHODS: Medical records from 2003 to 2023 were reviewed for signalment, history, treatment outcomes and complications. Logistic regression was performed to investigate factors associated with nonsurgical treatment outcome. RESULTS: Low-trauma accidents accounted for 82.9% of cases. Over-represented breeds included poodles (38.1%) and poodle crosses (11.3%). On a per-treatment basis, success rates of closed reduction alone, closed reduction/Ehmer sling, closed reduction/hobbles were 9.1%, 15.2% and 48.8%, respectively. When accounting for repeated attempts using closed reduction alone, Ehmer sling, or hobbles, eventual success rate increased to 10.3%, 18.5% and 61.8%, respectively. Success rate for toggle rod stabilization was 88.2%. Complication rate of hobbles was 31.9% versus 60.6% for Ehmer slings. Use of hobbles (OR:7.62, p = .001, CI:2.23-26.05), treatment by specialist surgeons (OR:2.68, p = .047, CI: 1.01-7.08) and increasing age (OR:1.15, p < .005, CI: 1.08-1.23) were associated with successful nonsurgical treatments. CONCLUSION: Low-trauma etiology, and poodles and their crosses were over-represented in cases of CvHL. Success rate of nonsurgical treatments was lower than previously reported. Hobbles were 7.6 times more likely to be successful when compared to dogs treated without hobbles and remains a viable noninvasive first-line treatment. CLINICAL SIGNIFICANCE/IMPACT: Hobbles are recommended as a low-morbidity first-line treatment for CvHL. An Ehmer sling is not recommended. Toggle rod stabilization is an effective surgical treatment for CvHL.
Assuntos
Luxação do Quadril , Animais , Cães/lesões , Estudos Retrospectivos , Feminino , Masculino , Luxação do Quadril/veterinária , Resultado do Tratamento , Doenças do Cão/terapiaRESUMO
The canine and feline carpus is a complex arrangement of bones, ligaments, and joint spaces that functions as a ginglymus joint to provide carpal flexion and extension. Given the demanding biomechanical demands on the carpus during weight bearing, a variety of region-specific pathology, often secondary to trauma, are reported. This review details carpal anatomy, biomechanical understandings, and current evidence surrounding carpal pathology and its management. Partial carpal arthrodesis and pancarpal arthrodesis outcomes are reviewed in detail.
Assuntos
Carpo Animal/lesões , Cães/lesões , Fraturas Ósseas/veterinária , Instabilidade Articular/veterinária , Animais , Artrodese/veterinária , Cães/cirurgia , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/cirurgia , Instabilidade Articular/diagnóstico , Instabilidade Articular/cirurgia , Amplitude de Movimento ArticularRESUMO
OBJECTIVE: To identify a repeatable anatomic landmark for pin insertion and to describe the technique for placement of a distal normograde intramedullary (IM) pin of approximately 35% of the IM diameter using this approach combined with a locking compression plate (LCP) on the medial aspect of the canine humerus. STUDY DESIGN: Ex vivo anatomic study. SAMPLE POPULATION: Canine cadavers (n=10 Greyhounds). METHODS: An anatomic landmark for pin insertion was identified based on three-dimensional reconstructions of previous elbow computed tomography studies and cadaveric dissection of the medial aspect of the humeral condyle. Bilateral distal normograde IM pin and LCP placement were performed and confirmed radiographically and by disarticulation and sagittal sectioning. RESULTS: The anatomic landmark for pin insertion was consistently identified in each specimen using the technique described. Distal normograde insertion of a 3.5 mm IM pin was possible in Greyhound cadaveric humeri at the described location in conjunction with a 3.5 mm LCP with fixed angle, locked screws. A monocortical locking screw was required to avoid interference with the IM pin in 28 of 60 of the 3 proximal screw holes. No pin interference was encountered in any of the distal screw holes. CONCLUSION: The anatomic landmark and technique described in our study enabled repeatable successful placement of a distal normograde IM pin of approximately 35% of the IM diameter combined with an LCP on the medial aspect of the canine humerus. This technique may be useful for locking plate-rod fixation of distal humeral diaphyseal fractures.
Assuntos
Pinos Ortopédicos/veterinária , Placas Ósseas/veterinária , Cães/cirurgia , Úmero/cirurgia , Animais , Cadáver , Tomografia Computadorizada por Raios X/veterináriaRESUMO
Loss of the metacarpal or metatarsal pad requires reconstruction with other pad tissue to allow functional weight-bearing on the limb. This report describes the use of a bilateral phalangeal fillet technique to reconstruct a weight-bearing surface in a dog following complete excision of its right metacarpal pad for malignant melanoma. This resulted in a functional weight-bearing limb.
Technique du filet phalangien bilatéral pour la reconstruction d'un coussinet métacarpien chez un chien. La perte d'un coussinet métacarpien ou métatarsien exige une reconstruction avec d'autres tissus du coussinet afin de permettre une mise en appui fonctionnelle du poids sur le membre. Ce rapport décrit l'utilisation d'une technique de filet phalangien bilatéral pour reconstruire une surface de mise en appui chez un chien après l'excision complète du coussinet métacarpien droit pour un mélanome malin. Cette technique a créé un membre de mise en appui fonctionnel.(Traduit par Isabelle Vallières).
Assuntos
Doenças do Cão/cirurgia , Melanoma/veterinária , Metacarpo/cirurgia , Procedimentos de Cirurgia Plástica/veterinária , Falanges dos Dedos do Pé/cirurgia , Animais , Cães , Masculino , Melanoma/cirurgiaRESUMO
OBJECTIVE: To compare the biomechanical properties of a 10-hole 3.5 mm locking compression plate (LCP) with 2 proximal and 2 distal bicortical locked screws reinforced with either a Steinmann pin of 30-40% the medullary diameter or a poly-ether-ether-ketone (PEEK) rod of â¼75% the medullary diameter in a cadaveric tibia gap model. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Cadaveric canine tibias (n = 8 pair). METHODS: Each construct had a 10-hole 3.5 mm LCP with 2 screws per fracture fragment using a comminuted tibia gap model. The Steinmann pin constructs had a 2.4 mm intramedullary pin whereas the PEEK-rod constructs had a 6 mm intramedullary PEEK rod placed. Biomechanical testing included non-destructive bi-planar 4 point bending, torsion testing, and destructive axial compression. Testing produced the responses of failure load (N) in axial compression, stiffness (N/mm or N/°) in axial compression, torsion, lateral-medial, and caudal-cranial 4 point bending. Screw position within the PEEK-rods was determined after explantation. RESULTS: The PEEK-rod constructs were significantly stiffer in axial compression (P < .005), lateral-medial 4 point bending (P < .001), and in torsional loading (P < .031) than the Steinman pin constructs. There was no significant difference between the constructs for stiffness in caudal-cranial 4 point bending (P = .32). The PEEK-rod constructs failed at a significantly higher load than the Steinmann pin constructs (P < .001). All constructs failed by yielding through plastic deformation. Each screw penetrated the PEEK rod in all constructs but the position of the screw varied. CONCLUSION: PEEK-rod constructs failed at significantly higher loads and were significantly stiffer in 4 point lateral-medial bending, axial compression, and torsion when compared with Steinmann pin constructs.