Evaluation of post-operative complications, outcome, and long-term owner satisfaction of elbow arthrodesis (EA) in 22 dogs.

The objective of this study was to report post-operative complications and outcomes in canines undergoing elbow arthrodesis (EA) with fixation techniques including bone plate fixation with a non-locking dynamic compression plate (DCP), bone plate fixation with a locking plate (LCP), and external skeletal fixator (ESF). Medical records of twenty-two cases that underwent EA between January 2009-December 2019 from 8 referral hospitals including both private practice and academic institutions were reviewed. Post-operative complications were classified as either minor or major, surgical evaluations were performed 8 weeks post operatively, and a follow-up questionnaire was sent to owners. Of the total 22 cases that met inclusion criteria, a total of 19/22 cases had complications, 12 major and 7 minor. Complications reported in 8/9, 7/9, and 4/4, for the DCP, LCP, and ESF fixation groups, respectively. Mild to moderate mechanical lameness was identified at surgical evaluation in 16/22 cases. Complete radiographic bone healing was achieved after 9 weeks in 19/22 cases. Long term owner follow up was available in 14/22 cases. Owners reported a good to normal quality of life in 13/14 cases and poor in one case. The majority of owners (11/14) reported good to excellent satisfaction with the outcome irrespective of persistent lameness. This study demonstrates that successful EA can be achieved using a variety of fixation methods, but persistent lameness is expected and complication rate is high.

Percutaneous Tibial Fracture Reduction Using Computed Tomography Imaging, Computer Modelling and 3D Printed Alignment Constructs: A Cadaveric Study.

OBJECTIVE: The main aim of this study was to evaluate a percutaneous method of bone alignment using a diaphyseal tibial fracture model. MATERIALS AND METHODS: Mid-shaft diaphyseal fractures were created in 12 large-breed canine tibiae. Interaction pins were inserted into the proximal and distal bone segments. Computed tomography scans of the fractured tibiae and pins were imported into three-dimensional (3D) modelling software and the fractures were virtually reduced. A multi-component 3D printed alignment jig was created that encompassed the pins in their aligned configuration. Orthogonal radiographs were taken after alignment jig application. Intact and post-alignment tibial lengths and joint angles were compared. Rotational alignment was subjectively evaluated. RESULTS: Post-alignment tibial lengths differed on the mediolateral and craniocaudal radiographs by an average of 1.55 and 1.43% respectively. Post-alignment mechanical medial proximal tibial angle, mechanical medial distal tibial angle and mechanical caudal proximal tibial angle had an average difference of 1.67°, 1.92° and 2.17° respectively. Differences in tibial length and joint angles were not significant (p > 0.05). CLINICAL SIGNIFICANCE: While in vivo evaluation is necessary, this technique to align diaphyseal fractures percutaneously using computer modelling and 3D printing is technically feasible and may facilitate the clinical use of minimally invasive osteosynthesis techniques.