Minimally invasive tarsal arthrodesis in 15 dogs.

OBJECTIVE: The aim of the present study was to report the outcomes and complications of minimally invasive tarsal arthrodesis (MITA) in dogs. STUDY DESIGN: Bi-institutional retrospective study. SAMPLE POPULATION: A total of 15 client-owned dogs. METHODS: Medical records of dogs undergoing MITA were reviewed to determine outcome and complications. Radiographs were recommended every 4 weeks until clinical union and reviewed to evaluate tibiotarsometatarsal alignment, implant position, subsequent osseous union of the debrided articulations. Time to clinical union and complications were recorded. Clinical union was defined as functional weightbearing limb use with at least 50% of osseous union. Final limb function was defined as full, acceptable, or unacceptable. RESULTS: Partial tarsal arthrodesis was performed in 10 cases and pantarsal arthrodesis in five cases. Postoperative swelling was minimal. Most complications, 26% major and 40% minor, were implant-related, and explant was required in three dogs. No catastrophic complications occurred. Mean (±sd) radiographic follow-up was 11.4 (±13.1) months Mean (±sd) time to radiographic osseous union was 1.8 (±0.5) months. Mean (±sd) time to clinical union was 3.7 (±0.8) months. Physiological alignment was restored in 12/15 dogs. Complete radiographic union occurred in 46% while in the remaining 54% obtained partial radiographic union, but clinical instability was not observed. Limb function was considered full in six and acceptable in eight dogs. Function was unacceptable in one dog, but the cause was not related to MITA. CONCLUSION: MITA resulted in restoration of alignment, which was accomplished using MITA techniques. Furthermore, MITA appeared to result in faster healing times and reduced soft tissue complications compared to conventional open approach arthrodesis. CLINICAL SIGNIFICANCE: MITA may be considered as an option to obtain functional arthrodesis in dogs.

Comparison of cranial versus medial minimally invasive plate osteosynthesis applications for the stabilization of simulated radius and ulna fractures in dog cadavers.

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.

Surgical repair of a proximal patellar tendon avulsion in a dog utilizing triple patellar bone tunnels and modified tendon repair technique.

A three-and-a-half-year-old neutered male Standard Schnauzer presented with a 5-week history of inability to bear full weight on the right pelvic limb following a traumatic injury to the right stifle. Clinical, radiographic, and ultrasound findings were consistent with a proximal patellar tendon rupture with a distal patellar avulsion fragment. A proprietary Achilles repair jig system was used to reattach the patellar tendon to the patella, allowing for direct approximation of the tissues. The primary repair was supported with a protective patella-to-tibia suture, and the dog was fitted with an orthosis to restrict range of motion of the stifle. Primary tendon repair using alternative suture materials and suture placement, in conjunction with a protective suture loop and transient stifle immobilization, allowed for a successful outcome without appreciable lameness at a final evaluation 3.6 years after presentation. The dog in this report was successfully treated with a modified proprietary Achilles' tendon repair system using previously undescribed paired axial patellar bone tunnels in conjunction with a patello-tibial protective ultrahigh molecular weight polyethylene suture. This technique allowed apposition of the tendon to the bone and a stable tenorrhaphy to the patella.