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1.
Open Vet J ; 9(4): 335-338, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32042656

RESUMO

Background: During tibial plateau leveling osteotomy (TPLO), a TPLO jig is often used. For placement of the jig, one of the pins is placed slightly distal to the joint line. Erroneous pin placement may lead to intra-articular damage; however, the path of the pin tract has not been thoroughly investigated. Aim: To document the rate and identify potential risk factors of intra-articular jig pin placement in dogs undergoing TPLO with the use of a TPLO jig. Methods: Medical records and pre- and postoperative radiographs (2007-2017) of 696 dogs with TPLO performed with a jig were reviewed. Primary surgeon and tibial plateau angles (TPA) were recorded. Postoperative radiographs were evaluated and classified according to intra-articular jig pin placement. Medial tibial plateau jig pin placement was defined as a radiolucent tract on the osteochondral junction of the medial tibial plateau. Lateral tibial plateau placement was defined as a radiolucent tract within 3 mm of the medial tibial plateau with a pin trajectory penetrating the lateral tibial plateau. Rates of intra-articular jig pin placement were calculated, and associations between intra-articular jig pin placement and surgeon experience and TPA were assessed with a chi-squared test. Results: Thirty-seven (5.32%) dogs had intra-articular placement of the jig pin. Seven dogs had medial tibial plateau jig placement, and 30 had lateral tibial plateau placement. There was no relationship between the TPA or surgeon level of experience and intra-articular placement of the pin. Conclusion: This study serves as a reminder to be cautious when placing the proximal jig pin during TPLO to avoid intra-articular placement. In addition, guidelines for evaluating proximal jig pin placement on postoperative radiographs are provided.

2.
Vet Surg ; 49(1): 187-199, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31777975

RESUMO

OBJECTIVE: To determine the ability of tibial plateau leveling osteotomy (TPLO) to address abnormal femorotibial kinematics caused by cranial cruciate ligament (CCL) rupture during walking in dogs. STUDY DESIGN: Prospective, clinical. ANIMALS: Sixteen dogs (20-40 kg) with unilateral complete CCL rupture. METHODS: Lateral view fluoroscopy was performed during treadmill walking preoperatively and 6 months after TPLO. Digital three-dimensional (3D) models of the femora and tibiae were created from computed tomographic (CT) images. Gait cycles were analyzed by using a 3D-to-2D image registration process. Craniocaudal translation, internal/external rotation, and flexion/extension of the femorotibial joint were compared between preoperative and 6-month postoperative time points for the affected stifle and 6-month postoperative unaffected contralateral (control) stifles. RESULTS: In the overall population, CCL rupture resulted in 10 ± 2.2 mm (mean ± SD) cranial tibial translation at midstance phase, which was converted to 2.1 ± 4.3 mm caudal tibial translation after TPLO. However, five of 16 TPLO-treated stifles had 4.1 ± 0.3 mm of cranial tibial subluxation during mid-to-late stance phase, whereas 10 of 16 TPLO-treated stifles had 4.3 ± 0.4 mm of caudal tibial subluxation throughout the gait cycle. Overall, postoperative axial rotational and flexion/extension patterns were not different from control, but stifles with caudal tibial subluxation had more external tibial rotation during mid-to-late stance phase compared with stifles with cranial tibial subluxation. CONCLUSION: TPLO mitigated abnormal femorotibial kinematics but did not restore kinematics to control values in 15 of 16 dogs during walking. CLINICAL SIGNIFICANCE: Tibial plateau leveling osteotomy reduces cranial tibial subluxation during walking, but persistent instability is common.

3.
Vet Surg ; 49(1): 207-213, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31373719

RESUMO

OBJECTIVE: To quantitatively evaluate patellofemoral (PF) kinematics during walking in dogs with cranial cruciate ligament (CrCL) deficiency treated by tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Longitudinal observational study. ANIMALS: Dogs with unilateral CrCL deficiency treated by TPLO (n = 10). METHODS: Horizontal beam fluoroscopic images of the stifles during treadmill walking were acquired 6 months after TPLO. Computed tomography was performed, and digitized bone models of both femurs and patellae were created. These digital models were superimposed over the fluoroscopic images with shape-matching software, and sagittal plane PF kinematics for TPLO-treated and normal contralateral stifles were calculated. Patellofemoral kinematics were described according to phase of gait cycle as well as relative to femorotibial flexion angle. RESULTS: In TPLO-treated stifles, there was an approximately 1-mm increase in cranial displacement of the patella (P < .05) compared with the normal stifle at equivalent femorotibial flexion angles between 120° and 140° and predominately during the stance phase. Proximal-distal translation and patellar flexion angle were mostly unaffected by TPLO when they were assessed according to either equivalent phase of gait cycle or femorotibial flexion angles. CONCLUSION: In vivo PF kinematics in TPLO-treated stifles were subtly different from normal, characterized by slight cranial shifting of the patella relative to the trochlear groove. CLINICAL SIGNIFICANCE: The clinical significance of these results remains unknown. These results may provide further understanding into extensor mechanism abnormalities associated with TPLO.

4.
Vet Clin North Am Small Anim Pract ; 50(1): 241-261, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31653536

RESUMO

Arthrodesis is an elective surgical procedure that aims at eliminating pain and dysfunction by promoting deliberate osseous fusion of the involved joint(s). Percutaneous plating can be used to perform carpal and tarsal arthrodeses in dogs and cats. After cartilage debridement is performed, the plate is introduced through separate plate insertion incisions made remote to the arthrodesis site and advanced along an epiperiosteal tunnel, and screws are inserted through the 3 existing skin incisions. The primary advantage of this technique is a decreased risk of soft-tissue complications, including postoperative swelling, ischemia, and wound dehiscence. Preliminary clinical results have been promising.


Assuntos
Artrodese/veterinária , Placas Ósseas/veterinária , Fixação Interna de Fraturas/veterinária , Animais , Artrodese/métodos , Fixação Interna de Fraturas/métodos
5.
Vet Clin North Am Small Anim Pract ; 50(1): 101-121, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31653537

RESUMO

This article describes the technique of percutaneous pinning in dogs and cats. Only acute fractures evaluated within the first 48 hours after trauma are selected for percutaneous pinning. Reduction is performed with careful manipulation of the fracture to minimize the trauma to the growth plate. After ensuring the fracture is reduced anatomically, smooth pins of appropriate size are inserted through stab incisions or through large-gauge needles. Depending on the anatomic location, the pins are cut flush with the bone or bent over. The main advantages of this technique are the minimal surgical trauma and lower perioperative morbidity.


Assuntos
Pinos Ortopédicos/veterinária , Gatos/cirurgia , Cães/cirurgia , Fraturas Ósseas/veterinária , Animais , Gatos/lesões , Cães/lesões , Fraturas Ósseas/cirurgia , Procedimentos Cirúrgicos Reconstrutivos
6.
Case Rep Vet Med ; 2019: 1439237, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31827971

RESUMO

An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of the caudal aspect of the proximal tibial physis, secondary to the proximal physeal fracture, resulted in an excessively high tibial plateau angle (TPA) of 50° with a limb length discrepancy of 13% by 24 weeks of age. The deformity was addressed by performing a proximal tibial osteotomy and subsequent distraction osteogenesis to reduce the TPA while concurrently lengthening the crus. A radial osteotomy was performed in the proximal metaphyseal region and the hinged fixator was applied. Distraction was initiated the day following surgery at a rate of 1 mm per day as measured along the caudal cortex of the tibia with a rhythm of three distractions daily. Distraction was terminated 19 days postoperatively. Sequential distraction of the osteotomy resulted in 17 mm of tibial lengthening and a final TPA of 3°. The fixator was removed 52 days after application. Complications included wire tract inflammation involving the wires securing the proximal segment and a calcaneal fracture which required bone plate stabilization. The left pelvic limb was only 8% shorter than the right pelvic limb and the dog had only a subtle lameness 12 months after surgery. The hinged circular fixator construct allowed for both the reduction of the TPA and limb segment lengthening in this dog.

7.
Front Vet Sci ; 6: 292, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31555675

RESUMO

Large animal (non-rodent mammal) models are commonly used in ACL research, but no species is currently considered the gold standard. Important considerations when selecting a large animal model include anatomical differences, the natural course of ACL pathology in that species, and biomechanical differences between humans and the chosen model. This article summarizes recent reports related to anatomy, pathology, and biomechanics of the ACL for large animal species (dog, goat, sheep, pig, and rabbit) commonly used in ACL research. Each species has unique features and benefits as well as potential drawbacks, which are highlighted in this review. This information may be useful in the selection process when designing future studies.

8.
Vet Surg ; 48(6): 975-984, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31017722

RESUMO

OBJECTIVE: To evaluate the usefulness of a high-fidelity model for teaching ovariohysterectomy (OHE) to veterinary students. STUDY DESIGN: Longitudinal survey. SAMPLE POPULATION: Clinicians with ≥2 years postgraduate experience in small animal surgery and a sophomore veterinary student population at 1 institution. METHODS: Twelve clinicians evaluated the high-fidelity model for realism. Questionnaires were distributed to sophomore veterinary students prior to and after OHE training on the high-fidelity model (SynDaver Surgical Canine) and after performing OHE as primary surgeon with a live dog. Time for students to perform OHE (identify the first ovarian pedicle to transecting the uterine body) and number of technical errors (visceral injury, hemorrhage, loose ligatures) were compared between the model and live dog groups. RESULTS: Evaluators rated the high-fidelity model as moderate-to-highly realistic. Students' confidence improved after practicing on the model in all critical steps and additionally improved after performing an OHE on a live dog. Time to complete the OHE on the model (mean ± SD,73.4 ± 27.1 minutes) and live dogs (83.0 ± 24.7 minutes) did not differ (P = .20). Frequency of hemorrhagic events (P = .77) and accidental visceral injury (P = .30) did not differ between the model and live dogs. However, fewer loose ligatures were placed in live dogs (23/64) compared with the model (22/37; P = .02). CONCLUSION: The high-fidelity model improved the confidence of sophomore students. The duration of OHE did not differ between the model and live dogs. CLINICAL IMPACT: The high-fidelity model is valuable for improving confidence in veterinary students prior to live-dog OHE.


Assuntos
Educação em Veterinária , Histerectomia/veterinária , Modelos Anatômicos , Ovariectomia/veterinária , Animais , Competência Clínica , Cães , Feminino , Humanos , Estudantes , Inquéritos e Questionários
9.
Vet Surg ; 48(3): 437-443, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30820982

RESUMO

OBJECTIVE: To report the successful use of cerclage cables around the periprosthetic region of a femoral fracture after total hip replacement (THR) in a dog with bone stock too limited for other methods of fixation. STUDY DESIGN: Case report. ANIMAL: 6-year-old male neutered, golden retriever. METHODS: Locking plate fixation of a type-B1 diaphyseal periprosthetic femoral fracture (PFF) failed 14 days after cementless THR and 6 days after initial femoral fracture repair. Total hip replacement implants seemed unchanged on radiographs, but lateral retraction of the screw-plate construct from the proximal segment was evident. Bone stock was assessed as insufficient for adequate screw purchase, prompting revision of the fixation with cerclage cable fixation of the proximal segment; the cables were anchored to the original locking plate construct with threaded positioning pins that screwed into the locking holes. RESULTS: Acceptable union was documented on radiographs by 3 months after revision. No lameness and good range of motion of the hip were observed on clinical examination 13 months after surgery. Radiographs at 13 months documented static implant positioning and remodeling at the fracture site. CONCLUSION: Use of a cable-plate construct to stabilize a type-B1 PFF led to successful long-term outcome in this dog. CLINICAL SIGNIFICANCE: Use of a cable-plate construct may be considered to treat type-B1 PFF with limited bone stock.


Assuntos
Artroplastia de Quadril/veterinária , Fios Ortopédicos , Fraturas do Fêmur/veterinária , Fixação Interna de Fraturas/veterinária , Fraturas Periprotéticas/veterinária , Animais , Artroplastia de Quadril/métodos , Pinos Ortopédicos/efeitos adversos , Placas Ósseas/efeitos adversos , Cães , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/métodos , Masculino , Fraturas Periprotéticas/cirurgia
10.
Vet Surg ; 48(3): 343-351, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30637786

RESUMO

OBJECTIVE: To evaluate the perceived efficacy of a high-fidelity synthetic canine model for simulating common gastrointestinal surgical procedures. STUDY DESIGN: Survey of students and experienced clinicians. SAMPLE POPULATION: Twelve clinicians with >2 years of postgraduate experience in the field of small animal surgery and 102 senior year veterinary students. METHODS: The model was subjectively evaluated by 12 clinicians with >2 years of postgraduate experience in the field of small animal surgery. Senior year veterinary students (n = 102) were asked to complete questionnaires before and after a laboratory on common gastrointestinal surgical procedures that included rating of perceived proficiency, anatomical knowledge, and the use of synthetic models compared with live animals. RESULTS: Clinicians assessed most aspects of the model as moderately realistic and unanimously agreed that it would be helpful for students to train on this model prior to live surgery. Student survey response rates were 91% and 99% before and after the laboratory, respectively. The proportion of students that felt moderately-to-highly proficient with the procedures increased from 8% prior to the laboratories to 59% after the laboratories (P < .001). The proportion of students that felt that they had superior-to-excellent knowledge of abdominal surgical anatomy increased from 16% prior to the laboratories to 44% after the laboratories (P < .001). The proportion of students that were satisfied with synthetic models instead of live animals increased from 52% prior to the laboratories to 74% after the laboratories (P = .014). CONCLUSION: Experienced clinicians considered the model to have moderate realism. A positive shift in the students' self-perceived proficiency with gastrointestinal surgery was evident after the use of the model. CLINICAL IMPACT: This synthetic model should be considered for training of veterinary gastrointestinal surgery. However, comparison studies are recommended to ascertain the relative educational value of this model.


Assuntos
Competência Clínica , Procedimentos Cirúrgicos do Sistema Digestório/veterinária , Cães/cirurgia , Educação em Veterinária/métodos , Cirurgia Veterinária/educação , Cirurgia Veterinária/métodos , Animais , Coleta de Dados , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Humanos , Estudantes
11.
Vet Surg ; 47(8): 1009-1015, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30303540

RESUMO

OBJECTIVE: To identify possible biomechanical causes for the predominantly unilateral presentation of cranial cruciate ligament (CCL) insufficiency by comparing the computed tomographic (CT) features of the tibial plateau of CCL affected and contralateral sound stifles in dogs with unilateral CCL insufficiency. STUDY DESIGN: Cross-sectional study. ANIMALS: Eighteen dogs, 36 stifles. METHODS: Eighteen dogs with naturally occurring unilateral CCL insufficiency were included. Stifle CT and radiographs were performed at the time of diagnosis. Follow-up was performed at a minimum of 1 year from the original diagnosis to ensure that there was no evidence of contralateral CCL insufficiency. The medial tibial plateau angle (m-TPA), lateral TPA (and l-TPA), medial tibial plateau midsagittal radius of curvature (m-TPr), and lateral TPr (l-TPr) were measured from the CT images. Variables were compared with paired t tests. A Bonferroni correction was performed, and P < .006 was considered significant. RESULTS: Mean m-TPr was steeper (P = .002) and m-TPr:l-TPr ratio was greater (P < .001) in affected stifles compared with contralateral sound stifles. No other variables differed between groups. Mean l-TPA was steeper than mean m-TPA (P < .001). CONCLUSION: Tibial plateau convexity differed between the CCL affected and contralateral sound stifle in dogs with unilateral CCL insufficiency. CLINICAL SIGNIFICANCE: Medial tibial plateau convexity may play a role in the development of CCL insufficiency.


Assuntos
Lesões do Ligamento Cruzado Anterior/veterinária , Ligamento Cruzado Anterior/cirurgia , Cães/lesões , Tíbia/cirurgia , Animais , Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/cirurgia , Estudos Transversais , Cães/cirurgia , Feminino , Masculino , Joelho de Quadrúpedes/diagnóstico por imagem , Joelho de Quadrúpedes/cirurgia , Tíbia/diagnóstico por imagem , Tomografia Computadorizada por Raios X/veterinária
12.
Vet Surg ; 47(5): 722-728, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29697147

RESUMO

OBJECTIVE: To determine the ability of a polyacrylic acid-silicone radiolucent self-retaining gradual occlusion device (PAS-OD) to attenuate congenital extrahepatic portosystemic shunts (EHPSS) in dogs. STUDY DESIGN: Prospective clinical trial. ANIMALS: Six client-owned dogs with single, congenital EHPSS. METHODS: Serum bile acids (SBA), abdominal ultrasonography, and computed tomographic angiography (CTA) were performed preoperatively and at 4 and 8 weeks postoperatively. Each dog was treated for EHPSS by placement of a PAS-OD. RESULTS: PAS-OD were placed without complication an average of 4.3 seconds (range, 3-7) after isolation of the shunt. Median surgical time was 38.5 minutes (range, 28-84) including concurrent procedures. All dogs recovered from surgery without complications. SBA were normal in 5 of 6 dogs at 4 and 8 weeks after surgery. The shunt was completely attenuated in 2 of 6 dogs at 4 weeks and in 4 of 6 dogs at 8 weeks, without evidence of acquired shunt formation in any dog. The size and velocity of the portal vasculature were improved in 5 of 6 dogs according to 8-week postoperative CTA and ultrasonography results, respectively. The remaining dog had a persistently decreased portal vasculature size but a normal velocity according to 8-week postoperative CTA and ultrasound results, respectively. CONCLUSION: The PAS-OD led to complete attenuation in 4 of 6 dogs and partial attenuation with mild residual flow of 2 EHPSS over an 8-week period in dogs. CLINICAL SIGNIFICANCE: The PAS-OD is a new option for gradual occlusion of congenital EHPSS over 8 weeks.


Assuntos
Doenças do Cão/cirurgia , Sistema Porta/anormalidades , Silicones , Procedimentos Cirúrgicos Vasculares/instrumentação , Animais , Materiais Biocompatíveis , Doenças do Cão/congênito , Doenças do Cão/diagnóstico por imagem , Cães , Feminino , Masculino , Sistema Porta/cirurgia , Complicações Pós-Operatórias/veterinária , Estudos Prospectivos , Resultado do Tratamento
13.
BMC Vet Res ; 14(1): 85, 2018 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-29530093

RESUMO

BACKGROUND: Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause of pelvic limb lameness and osteoarthritis in dogs. Surgical therapies developed to treat dogs with naturally occurring CrCL insufficiency aim to address the resultant instability, but the in-vivo alterations in stifle kinematics associated with CrCL insufficiency have not been accurately defined. The objective of this study was to quantify the 3-dimensional femorotibial joint kinematics of dogs with naturally occurring cranial cruciate ligament (CrCL) insufficiency during ambulation. Eighteen client-owned dogs (20-40 kg) with natural unilateral complete CrCL rupture were included. Computed tomographic scans were used to create digital 3-dimensional models of the femur and tibia bilaterally for each dog. Lateral fluoroscopic images were obtained during treadmill walking and 3 complete gait cycles were analyzed. Stifle flexion/extension angle, craniocaudal translation, and internal/external rotation were calculated throughout the gait cycle using a previously described 3D-to-2D image registration process. Results were compared between the pre-operative CrCL-deficient and 6-month post-operative contralateral stifles (control). RESULTS: CrCL-deficient stifles were maintained in greater flexion throughout the gait cycle. Cranial tibial subluxation was evident in CrCL-deficient stifles at all time points throughout the gait cycle [9.7 mm at mid-stance (P < 0.0001); 2.1 mm at mid-swing (P < 0.0017)], and the magnitude of cranial tibial subluxation was greater at mid-stance phase than at mid-swing phase (P < 0.0001). Greater internal tibial rotation was present in CrCL-deficient stifles during stance phase (P < 0.0022) but no difference in axial rotation was evident during swing phase. CONCLUSIONS: Naturally occurring CrCL rupture causes profound craniocaudal translational and axial rotational instability, which is most pronounced during the stance phase of gait. Surgical stabilization techniques should aim to resolve both craniocaudal subluxation and axial rotational instability.


Assuntos
Ligamento Cruzado Anterior/diagnóstico por imagem , Doenças do Cão/diagnóstico por imagem , Fêmur/diagnóstico por imagem , Artropatias/veterinária , Tíbia/diagnóstico por imagem , Animais , Ligamento Cruzado Anterior/fisiopatologia , Fenômenos Biomecânicos , Doenças do Cão/fisiopatologia , Cães , Feminino , Fêmur/fisiopatologia , Fluoroscopia/métodos , Fluoroscopia/veterinária , Imagem Tridimensional/métodos , Imagem Tridimensional/veterinária , Artropatias/diagnóstico por imagem , Artropatias/fisiopatologia , Masculino , Joelho de Quadrúpedes/diagnóstico por imagem , Joelho de Quadrúpedes/fisiopatologia , Tíbia/fisiopatologia , Caminhada/fisiologia
14.
BMC Vet Res ; 13(1): 250, 2017 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-28818107

RESUMO

BACKGROUND: Complete rupture of the cranial cruciate ligament (CrCL) in dogs causes profound disturbance to stifle joint biomechanics. The objective of this study was to characterize the effects of cranial cruciate ligament (CrCL) insufficiency on patellofemoral (PF) kinematics in dogs during walking. Ten client-owned dogs (20-40 kg) with natural unilateral complete CrCL rupture were included. Dogs underwent computed tomographic scans to create digital bone-models of the patella and femur. Lateral projection fluoroscopy of the stifles was performed during treadmill walking. Sagittal plane PF kinematics were calculated throughout the gait cycle by overlaying digital bone models on fluoroscopic images using a previously described 2D-3D registration technique. For acquisition of kinematics in the contralateral (control) stifle, fluoroscopy was repeated 6-months after stabilizing surgery of the affected side. Results were compared between the pre-operative CrCL-deficient and 6-month post-operative control stifles. RESULTS: Craniocaudal PF translation was similar between CrCL-deficient and control stifles throughout the gait cycle. The patella was more distal and positioned in greater flexion throughout the gait cycle in CrCL-deficient stifles when compared to the control stifle at equivalent time points. There was no significant difference in PF poses between CrCL-deficient and control stifles at equivalent femorotibial flexion angles; however, common femorotibial flexion angles were only found over a small range during the swing phase of gait. CONCLUSIONS: CrCL insufficiency altered PF kinematics during walking, where the changes were predominately attributable to the femorotibial joint being held in more flexion. Abnormal PF kinematics may play a role in the development of osteoarthritis that is commonly observed in the PF joint CrCL-deficient stifles.


Assuntos
Ligamento Cruzado Anterior/fisiopatologia , Doenças do Cão/fisiopatologia , Artropatias/veterinária , Joelho de Quadrúpedes/fisiopatologia , Caminhada/fisiologia , Animais , Ligamento Cruzado Anterior/diagnóstico por imagem , Fenômenos Biomecânicos/fisiologia , Doenças do Cão/diagnóstico por imagem , Cães , Feminino , Fluoroscopia/veterinária , Artropatias/diagnóstico por imagem , Artropatias/fisiopatologia , Masculino , Joelho de Quadrúpedes/diagnóstico por imagem
15.
Vet Surg ; 46(7): 971-980, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28703857

RESUMO

OBJECTIVE: To compare the Minimally Invasive Reduction Instrumentation System (MIRIS) to a two-ring circular fixator construct (CFC) for indirect reduction during minimally invasive plate osteosynthesis. STUDY DESIGN: Cadaveric antebrachial fracture model. ANIMALS: Ten skeletally mature dog cadavers. METHODS: Simulated bilateral antebrachial fractures were reduced and stabilized with the MIRIS on one limb, and a CFC on the contralateral limb, prior to placing a 10 hole Locking Compression Plate. Time to satisfactory reduction and implant placement were compared. Difficulty of fracture reduction and plate application was subjectively scored (1 to 5) for each procedure. Prefracture and postoperative orthogonal antebrachial radiographs were compared to assess restoration of radial length and angulation in sagittal and frontal planes. A paired t test (P ≤ .05) was used to compare parameters between the two reduction techniques. RESULTS: Reduction was faster (P = .0191) and plate application was subjectively easier (P = .047) when using the MIRIS compared to the CFC. There were no differences in subjective difficulty of reduction or plate application time between techniques. Mean postoperative radial length was reduced by approximately 4-mm, and procurvatum were decreased by approximately 7° compared to prefracture measurements, regardless of reduction technique. CONCLUSION: The MIRIS allowed for faster fracture reduction, and simplified plate placement compared to a temporary application of a CFC in our simulated antebrachial fracture model.


Assuntos
Placas Ósseas/veterinária , Cães , Fixadores Externos/veterinária , Fixação Interna de Fraturas/veterinária , Fixação de Fratura/veterinária , Animais , Cadáver , Fixação de Fratura/métodos , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Fraturas Ósseas/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Radiografia
16.
Vet Surg ; 46(7): 933-941, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28640455

RESUMO

OBJECTIVE: To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2.7 mm reconstruction plate as adjunctive epicondylar stabilization in simulated comminuted lateral unicondylar humeral fractures stabilized with a transcondylar 4.5 mm cortical screw. STUDY DESIGN: Cadaveric biomechanical assessment. SAMPLE POPULATION: Paired humeri harvested from 9 young, skeletally mature dogs. METHODS: Simulated comminuted lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a 1.6 mm Kirschner wire on one side, and a 2.7 mm reconstruction plate on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and load to failure were obtained from the load-deformation curves. RESULTS: Stiffness (mean ± SD: 577 ± 245 vs 310 ± 71 N/mm; P = .01), yield load (mean ± SD: 2389 ± 572 vs 1017 N ± 292; P = .0002), and load at failure (mean ± SD: 3351 ± 358 vs 1693 ± 363 N; P = .009) were greater in constructs incorporating a reconstruction plate rather than a Kirschner wire. CONCLUSION: Our results support the recommendation for adjunct fixation of comminuted lateral unicondylar humeral fractures with an epicondylar plate.


Assuntos
Placas Ósseas/veterinária , Parafusos Ósseos/veterinária , Fios Ortopédicos/veterinária , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/veterinária , Fraturas do Úmero/cirurgia , Animais , Fenômenos Biomecânicos , Cadáver , Cães , Fixação Interna de Fraturas/métodos , Fraturas Cominutivas/cirurgia , Fraturas Cominutivas/veterinária
17.
Am J Vet Res ; 78(6): 712-717, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28541152

RESUMO

OBJECTIVE To compare stiffness and resistance to cyclic fatigue of two 3.5-mm locking system plate-rod constructs applied to an experimentally created fracture gap in femurs of canine cadavers. SAMPLE 20 femurs from cadavers of 10 mixed-breed adult dogs. PROCEDURES 1 femur from each cadaver was stabilized with a conical coupling plating system-rod construct, and the contralateral femur was stabilized with a locking compression plate (LCP)-rod construct. An intramedullary Steinmann pin was inserted in each femur. A 40-mm gap then was created; the gap was centered beneath the central portion of each plate. Cyclic axial loading with increasing loads was performed. Specimens that did not fail during cyclic loading were subjected to an acute load to failure. RESULTS During cyclic loading, significantly more LCP constructs failed (6/10), compared with the number of conical coupling plating system constructs that failed (1/10). Mode of failure of the constructs included fracture of the medial or caudal aspect of the cortex of the proximal segment with bending of the plate and pin, bending of the plate and pin without fracture, and screw pullout. Mean stiffness, yield load, and load to failure were not significantly different between the 2 methods of stabilization. CONCLUSIONS AND CLINICAL RELEVANCE Both constructs had similar biomechanical properties, but the conical coupling plating system was less likely to fail than was the LCP system when subjected to cyclic loading. These results should be interpreted with caution because testing was limited to a single loading mode.


Assuntos
Placas Ósseas/veterinária , Cães/lesões , Fraturas do Fêmur/veterinária , Fixação Interna de Fraturas/veterinária , Animais , Fenômenos Biomecânicos , Parafusos Ósseos/veterinária , Cadáver , Cães/cirurgia , Fraturas do Fêmur/cirurgia , Fêmur/cirurgia
18.
Vet Surg ; 46(6): 803-811, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28460422

RESUMO

OBJECTIVE: To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA). STUDY DESIGN: Retrospective case series. ANIMALS: Fifty-five dogs; 58 THAs. METHODS: Eighty cobalt-chromium BFX THAs were reviewed, 58 met inclusion criteria. Implant size, positioning, and major complications within 12 months of surgery were recorded. Femoral canal flare (FCF), canal fill, stem angle, and subsidence at 3 months were measured from postoperative radiographs. Appropriateness of final stem size was assessed with digital templates. Odds ratios for associations were calculated. RESULTS: Mean ± SD coronal canal fill (Fillcor ) was 75% ± 6, FCF was 2.0 ± 0.3, and subsidence was 1.7 mm ± 2.6. Stem angulation ranged from 7° varus to 6° valgus, and 7° cranial to 3° caudal. Appropriately sized stems (n = 45) had a mean Fillcor of 78%. Major stem complications occurred in 12% of THAs. Femora with subsidence > 3 mm were 45.3 times more likely to develop postoperative stem complications (P = .02). Stems with varus angulation ≥ 5° were 12.5 times more likely to sustain intraoperative fissures (P = .03). Stems considered undersized based on postoperative digital templating were 5.6 times more likely to develop stem complications (P = .04) and 5.7 times more likely to subside > 3 mm (P = .03). CONCLUSION: Varus stem angulation should be avoided to prevent fissures. Canal fill is a poor indicator of optimal stem size and the current recommendation of >85% is unnecessarily high. Postoperative templating may be useful for assessing appropriateness of stem size.


Assuntos
Artroplastia de Quadril/veterinária , Complicações Pós-Operatórias/veterinária , Animais , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Cães , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Radiografia , Estudos Retrospectivos
19.
Vet Surg ; 46(3): 441-447, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28198543

RESUMO

OBJECTIVE: To evaluate the change in geometry of the Zurich total hip arthroplasty (THA) acetabular component after implantation. ANIMALS: Hemipelves from adult mix-breed dogs weighing between 20 and 25 kg. METHODS: Digital image correlation imaging was performed prior to, immediately after, and 24 hours after impaction of Zurich THA acetabular component, and after removal of the cup from the specimen. Patterns of deformation were qualitatively described, and maximal deformations were compared between time points. RESULTS: All cups deformed after implantation into the hemipelves by "pinching" in a cranial-caudal direction and dorsoventral expansion, resulting in an ellipsoid configuration to the peripheral rim. The mean ± SD maximum deformation at the rim immediately post-impaction was 0.202 ± 0.052 mm, or approximately 0.4 mm of diametrical deformation. Deformation did not change after the 24-hour saline bath. Impaction and subsequent extraction had a marginal effect on the original cup geometry, as maximum deformation at the rim after cup extraction was 0.074 ± 0.032 mm, relative to prior to impaction. CONCLUSIONS: The original Zurich cup geometry is distorted as a consequence of the press-fit mechanism. Further studies are required to determine whether deformation induced by impaction has any association with polyethylene wear rates or other prosthesis-related complications.


Assuntos
Acetábulo/cirurgia , Artroplastia de Quadril/veterinária , Prótese de Quadril/veterinária , Animais , Artroplastia de Quadril/instrumentação , Artroplastia de Quadril/métodos , Fenômenos Biomecânicos , Cadáver , Cães , Modelos Animais , Desenho de Prótese , Falha de Prótese
20.
Vet Surg ; 46(1): 103-110, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27925240

RESUMO

OBJECTIVE: To report complications and clinical outcome of dogs and cats that underwent fluoroscopic-assisted percutaneous pinning (FAPP) of physeal fractures. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 37) and cats (n = 4). MATERIALS AND METHODS: Records (August 2007-August 2014) of physeal fractures treated with FAPP in 3 hospitals were evaluated. Data collected included signalment, fracture characteristics (etiology, location, duration, Salter-Harris classification, preoperative and postoperative displacement), surgical information (implant size, surgical duration), and outcome assessment information (functional outcome, radiographic outcome, and complications). RESULTS: The majority of animals (92%) were classified as full functional outcome. No significant predictors of functional outcome were identified. The overall complication rate was 15% (n = 6). Elective pin removal rate was 41% (n = 17). Goniometry and limb circumference measurements of the affected and contralateral limbs were not significantly different in dogs for which measurements were obtained. Seventeen of 18 animals (16 dogs, 2 cats) measured had bone length changes on follow-up radiographs. CONCLUSION: FAPP is associated with an excellent functional outcome in a narrow selection of fracture configurations, specifically those with minimal displacement and for which anatomical alignment can be achieved with closed reduction.


Assuntos
Pinos Ortopédicos/veterinária , Gatos/lesões , Cães/lesões , Fraturas do Fêmur/veterinária , Fixação Intramedular de Fraturas/veterinária , Animais , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/cirurgia , Florida , Fluoroscopia/veterinária , Georgia , Masculino , Registros Médicos , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
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