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3.
Vet Clin North Am Small Anim Pract ; 50(1): 17-21, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31627990

RESUMO

Minimally invasive fracture repair (MIFR) is the ultimate culmination of current osteosynthesis concepts that emphasize the preservation and enhancement of the biologic components of fracture healing. Although the "less is more" approach to tissue dissection and fracture exposure and handling that defines MIFR has numerous reported advantages over more traditional open surgical treatments, it does present some unique challenges and important considerations for the surgeon. This article describes some of the general MIFR challenges a surgeon may encounter.


Assuntos
Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
4.
Vet Clin North Am Small Anim Pract ; 50(1): 23-47, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31635912

RESUMO

Indirect fracture reduction is used to align diaphyseal fractures when using minimally invasive fracture repair. Indirect reduction achieves functional fracture reduction without opening the fracture site. The limb is restored to length and spatial alignment is achieved to ensure proper angular and rotational alignment. Fracture reduction can be accomplished using a variety of techniques and devices, including hanging the limb, manual traction, distraction table, external fixators, and fracture distractors.


Assuntos
Placas Ósseas/veterinária , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Mesas Cirúrgicas/veterinária
5.
Vet Clin North Am Small Anim Pract ; 50(1): 263-271, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31635913

RESUMO

As the saying goes, "cats are not small dogs." Throughout veterinary medicine history, most of the literature focus has been on the canine. Feline patients, however, now constitute a larger proportion of the pet population and are unique in many aspects. They differ anatomically and biomechanically from canines and have specific recovery needs and different pain-related behaviors. It is important that veterinary surgeons understand these differences and improve their knowledge base in the treatment of cats. This article highlights the differences in cats relevant to minimally invasive fracture repair and how they affect a surgeon's approach to fractures in cats.


Assuntos
Placas Ósseas/veterinária , Doenças do Gato/cirurgia , Gatos/lesões , Fraturas Ósseas/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fraturas Ósseas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Especificidade da Espécie
6.
Vet Clin North Am Small Anim Pract ; 50(1): 213-230, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31635914

RESUMO

Articular fractures are common injuries in veterinary medicine. The principles of articular fracture repair are anatomic reduction and rigid fixation in order to optimize joint function. Fluoroscopy and arthroscopy are tools commonly used to allow for anatomic reduction with a minimally invasive approach. Minimally invasive techniques can decrease morbidity and promote an early return to function. Different types of articular fractures and options for minimally invasive repair are reviewed in this article.


Assuntos
Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Articulações/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Articulações/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
7.
Vet Clin North Am Small Anim Pract ; 50(1): 135-153, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31635915

RESUMO

Minimally invasive plate osteosynthesis (MIPO) is a biologically friendly approach to fracture reduction and stabilization that is applicable to many radius and ulna fractures in small animals. An appropriate knowledge of the anatomy of the antebrachium and careful preoperative planning are essential. This article describes the MIPO technique, which entails stabilization of the fractured radius with a bone plate and screws that are applied without performing an extensive open surgical approach. This technique results in good outcomes, including a rapid time to union and return of function.


Assuntos
Gatos/cirurgia , Cães/cirurgia , Membro Anterior/cirurgia , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Gatos/lesões , Cães/lesões , Membro Anterior/lesões , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia
8.
Vet Clin North Am Small Anim Pract ; 50(1): 1-15, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31635916

RESUMO

This article reviews the biomechanical parameters of fracture repair that influence construct stiffness and strength. The stiffness influences the relative motion between fracture fragments, known as gap strain, and, thus, callus development. Construct strength determines the magnitude and number of load events that the repair can resist before failure. Surgeons must optimize these parameters in order to achieve satisfactory outcomes for the patients.


Assuntos
Fixação de Fratura/veterinária , Fraturas Ósseas/veterinária , Animais , Fenômenos Biomecânicos , Osso e Ossos/fisiologia , Consolidação da Fratura/fisiologia
9.
Vet Clin North Am Small Anim Pract ; 50(1): 123-134, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31635917

RESUMO

A thorough knowledge of humeral anatomy is critical to performing minimally invasive techniques. Fluoroscopy, when available, is invaluable in optimizing fracture repair with minimally invasive techniques. Minimally invasive approaches decrease morbidity and allow an earlier return to function. Minimally invasive fracture repair is performed using implant systems similar to open approaches.


Assuntos
Gatos/cirurgia , Cães/cirurgia , Membro Anterior/cirurgia , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Gatos/lesões , Cães/lesões , Membro Anterior/lesões , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia
10.
Vet Clin North Am Small Anim Pract ; 50(1): 207-212, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31648818

RESUMO

A concise review of the history of meta-bone fracture repair is provided. The relevant surgical anatomy, available instrumentation, and execution of preoperative, intraoperative, and postoperative surgical care using minimally invasive plate osteosynthesis are discussed in detail. A short discussion that touches on future directions for care of meta-bone fractures follows.


Assuntos
Placas Ósseas/veterinária , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Ossos Metacarpais/cirurgia , Ossos do Metatarso/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Ossos Metacarpais/lesões , Ossos do Metatarso/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
11.
Vet Clin North Am Small Anim Pract ; 50(1): 231-239, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31653535

RESUMO

Sacroiliac fracture-luxation is a common injury that is associated with ilial and acetabular fractures of the opposite hemipelvis. Sacroiliac fracture-luxation results in an unstable pelvis and potentially collapse of the pelvic canal. A minimally invasive approach to the reduction and insertion of a screw for fixation of sacroiliac fracture-luxation using fluoroscopic guidance is viable. The advantages of using this technique are that a small incision is made with minimal soft tissue disruption and the surgical time is short. Recent publications have documented that this technique provided superior repair of sacroiliac fracture-luxations.


Assuntos
Fixação Interna de Fraturas/veterinária , Luxações Articulares/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Articulação Sacroilíaca/cirurgia , Animais , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Fraturas Ósseas/veterinária , Luxações Articulares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Articulação Sacroilíaca/patologia
12.
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
13.
Vet Clin North Am Small Anim Pract ; 50(1): 67-100, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31668598

RESUMO

Reviews of clinical outcomes led to the foundation of a new approach in fracture management known as biological osteosynthesis. As intramedullary rods featuring cannulations and locking devices at both extremities, interlocking nails are well suited for bridging osteosynthesis. Unique biological and mechanical benefits make them ideal for minimally invasive nail osteosynthesis and an attractive, effective alternative to plating, particularly in revisions of failed plate osteosynthesis. Thanks to a new angle-stable locking design, interlocking nailing indications have been expanded to osteosynthesis of epi-metaphyseal fractures, including those with articular involvement and angular deformities such as distal femoral varus and associated patellar luxations.


Assuntos
Pinos Ortopédicos/veterinária , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fenômenos Biomecânicos , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
14.
Vet Clin North Am Small Anim Pract ; 50(1): 155-182, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31668599

RESUMO

A thorough working knowledge of the anatomic landmarks of the femur facilitates anatomic alignment during minimally invasive osteosynthesis (MIO). A variety of fixation techniques, including plate, plate-rod, and interlocking nail, are well suited for stabilization of femoral shaft fractures with MIO techniques. Axis and torsional alignment can be assessed with various intraoperative techniques to ensure that anatomic alignment is obtained.


Assuntos
Fêmur/cirurgia , Fraturas Ósseas/veterinária , Membro Posterior/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Animais , Fêmur/lesões , Fraturas Ósseas/cirurgia , Membro Posterior/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
15.
Vet Clin North Am Small Anim Pract ; 50(1): 183-206, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31733670

RESUMO

Fractures of the tibia and fibula are common in dogs and cats and occur most commonly as a result of substantial trauma. Tibial fractures are particularly amenable to treatment using minimally invasive fracture repair (MIFR) techniques that preserve blood supply to comminuted fracture fragments, accelerating bone callus production and speeding fracture healing. Treatment of tibial fractures using MIFR techniques has been found to reduce surgical time, reduce the time for fracture healing, and to decrease patient morbidity, while at the same time reducing complications compared with traditional open reduction and internal fixation.


Assuntos
Fíbula/cirurgia , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Membro Posterior/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Tíbia/cirurgia , Animais , Fíbula/lesões , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Membro Posterior/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Tíbia/lesões
16.
Poult Sci ; 98(11): 5234-5240, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31581757

RESUMO

Assessing keel bone damage reliably and accurately is a requirement for all research on this topic. Most commonly, assessment is done on live birds by palpation and is therefore prone to bias. A 2-day Training School of the COST Action "Identifying causes and solutions of keel bone damage in laying hens" with 16 participants of variable experience was held where palpation of live hens was followed by consulting corresponding radiographic images of keel bones. We hypothesized that the inter-observer and intra-observer repeatabilities as well as the agreement between palpation and assessment from the radiograph (considered as the accuracy) would increase from day 1 to 2. Repeatability estimates were calculated using the R-package rptR and the change in level of accuracy on day 1 and 2 was analyzed with generalized linear models. As predicted, the inter-observer repeatabilities of the assessments of the fractures and deviations were improved by training, but this improvement differed for fractures and deviations between the cranial, middle, and caudal parts of the keel bone. Intra-observer repeatabilities before training also differed between the different parts of the keel bone and were highest for fractures at the caudal part of the keel bone. The training affected the accuracy of palpation to different degrees for the different parts of the keel bone. A training effect was found for the caudal part of the keel bone in regard to fractures and deviations, but for fractures the training effect was missing for the cranial part and for deviations it was missing for the middle part of the keel bone. In conclusion, the training school involving radiographs improved inter-observer repeatabilities in the diagnosis of fractures and deviations of keel bones and thus had the potential to lead to more comparable results among research groups.


Assuntos
Criação de Animais Domésticos/métodos , Galinhas , Coleta de Dados/métodos , Fraturas Ósseas/veterinária , Palpação/veterinária , Doenças das Aves Domésticas/diagnóstico , Radiografia/veterinária , Esterno/patologia , Animais , Feminino , Fraturas Ósseas/diagnóstico , Variações Dependentes do Observador
17.
J S Afr Vet Assoc ; 90(0): e1-e7, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31588759

RESUMO

A definitive diagnosis of extensive suture line exostoses affecting the nasofrontal, nasolacrimal, nasomaxillary, frontolacrimal, lacrimozygomatic and lacrimomaxillary suture lines in a 7-year-old Thoroughbred mare with chronic bilateral epiphora and facial deformation was achieved using standing computed tomography (CT) examinations. Positive contrast dacryocystorhinography using CT revealed partial bilateral obstruction of the nasolacrimal ducts. Minimally displaced depression fractures of the right nasal bone, the right maxillary bone and right frontal bone were also demonstrated. The cosmetic appearance of the periosteal reaction associated with the suture line exostosis and epiphora significantly improved within 3 months of diagnosis and treatment.


Assuntos
Exostose/veterinária , Fraturas Ósseas/veterinária , Traumatismos Cranianos Fechados/veterinária , Doenças dos Cavalos/etiologia , Cavalos/lesões , Obstrução dos Ductos Lacrimais/veterinária , Animais , Exostose/etiologia , Exostose/terapia , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/etiologia , Fraturas Ósseas/terapia , Traumatismos Cranianos Fechados/complicações , Doenças dos Cavalos/diagnóstico por imagem , Doenças dos Cavalos/terapia , Obstrução dos Ductos Lacrimais/complicações , Obstrução dos Ductos Lacrimais/diagnóstico por imagem , Ducto Nasolacrimal/lesões , África do Sul , Resultado do Tratamento
18.
Schweiz Arch Tierheilkd ; 161(9): 509-521, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31488392

RESUMO

INTRODUCTION: The present retrospective study investigated the localization, cause, treatment and healing of long bone fractures in cattle. Over a period of ten years, medical records of 194 cattle of all ages with a long bone fracture, presented at the Clinic for Ruminants with Ambulatory and Herd Health Services at LMU Munich, were evaluated. The majority of patients (n = 131, 67.5%) were younger than two weeks of age. Of these, 118 calves sustained the fracture on the day of birth (60.8%). An obstetrical assistance was found in 57.4% (n = 58) of birth-related cases as a fracture cause. The femur was most frequently affected in calves aged up to two weeks (n = 35; 26.7%). The second most frequent fractures occurred in the metacarpus (n = 31; 22.9%) in this age group, followed by metatarsus (n = 28; 21.4%) and tibia (n = 27; 20.6%). Fractures of the antebrachium (n = 9; 6.9%) and the humerus were rare (n = 1; 0.8%). A total of 194 patients were diagnosed with 50 femur fractures (25.8%), 53 metacarpal fractures (27.3%), 43 metatarsal fractures (22.2%), 30 tibial fractures (15.5%), 11 antebrachial fractures (5.7%) and 7 humeral fractures (3.6%). Of the 194 animals, 78 (40.2%) had to be euthanized, 42 of them (53.8%) without treatment. In 150 patients, treatment was initiated, of which 110 patients (73.3%) were dismissed healthy from the clinic. Among the conservative treatment methods were stall rest, casts, casts combined with a U-shaped metal rail (walking casts) and the Thomas splint. Surgical therapy (internal fixation with plates or screws, transfixation pin casts) was used to treat 65 animals (33.5%). While 86.9% (74 out of 85) of the conservatively treated animals left the clinic alive, it were only 58.1% (36 out of 65) animals after surgical treatment. In the newborn calves, colostrum supply had a significant effect on the success of the treatment. If the gamma-glutamyl transferase concentration was below 200 IU/L in the calves aged under 4 days, the healing rate was significantly different from the cure rate of sufficiently immunized patients (26.9% (7 out of 26) vs. 65.3% (47 out of 72), P = 0.001).


Assuntos
Ossos da Extremidade Inferior/lesões , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/veterinária , Animais , Ossos da Extremidade Inferior/cirurgia , Bovinos , Fraturas Ósseas/cirurgia , Fraturas Ósseas/terapia , Alemanha , Estudos Retrospectivos , Resultado do Tratamento
19.
Vet Surg ; 48(7): 1181-1187, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31456256

RESUMO

OBJECTIVE: To describe the presence of fragments in the dorsal proximal interphalangeal (PIP) joint and to report flat racing performance after surgical treatment. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Thirty-nine affected thoroughbred flat racehorses and 169 age- and sex-matched maternal siblings. METHODS: Medical records from 2000 to 2015 were reviewed for thoroughbred horses that underwent arthroscopic removal of osteochondral fragments in the dorsal aspect of the PIP joint. The horses' 2-year-old year, 3-year-old year, and career athletic performances were compared with their matched siblings. RESULTS: Thirty-nine thoroughbred horses were included, varying in age from 4 months to 4 years, with osteochondral fragments in 42 PIP joints. Hind limbs (92%) were more commonly affected than forelimbs (8%). Fragments were located within the origin of the collateral ligament of the distal sesamoid (navicular) bone. After surgery, the likelihood of starting a race did not differ between treated horses (27/39 [69%]) and maternal siblings (129/169 [76%], P = .15). Race earnings did not differ between treated horses and their siblings during their 2-year-old year (P = .66), 3-year-old year (P = .43), or career (P = .60). CONCLUSION: Removing osteochondral fragments from the origin of the collateral ligament of the distal sesamoid bone did not impair the ability to race or earning potential for affected thoroughbred racehorses compared with their maternal siblings. CLINICAL SIGNIFICANCE: Fragments from the dorsal aspect of the PIP joint in racehorses can be removed arthroscopically resulting in a good clinical outcome and future flat racing performance comparable to matched controls.


Assuntos
Ligamentos Colaterais , Fraturas Ósseas/veterinária , Doenças dos Cavalos/cirurgia , Articulações/cirurgia , Ossos Sesamoides/patologia , Animais , Artroscopia/veterinária , Feminino , Membro Anterior/cirurgia , Fraturas Ósseas/cirurgia , Membro Posterior/cirurgia , Cavalos , Masculino , Estudos Retrospectivos , Ossos Sesamoides/cirurgia , Resultado do Tratamento
20.
Vet Comp Orthop Traumatol ; 32(5): 351-361, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31279326

RESUMO

OBJECTIVES: The Targon Vet System (TVS) is a 2.5-mm interlocking nail that can be applied minimally invasively. The purpose of this study was to test if the TVS could be safely applied percutaneously to different feline long bones without fluoroscopic guidance. METHODS: A gap fracture was created in 96 feline humeri, femora and tibiae (n = 32/group). Paired bones were randomly assigned to two treatment groups: (1) TVS inserted percutaneously with fluoroscopy and (2) TVS inserted percutaneously without fluoroscopy. Intraoperative evaluation (complications, procedure time, attempts), radiographs (pre-/postoperative alignment, length) and anatomical dissection (neurovascular injury, rotational alignment) were compared between treatment groups. RESULTS: The use of fluoroscopy did not lead to significant differences in any of the outcome measures. Intraoperative complications predominantly occurred in the distal humerus (12/32) and the proximal femur (7/32). In total, 20/96 complications occurred with no complications for the tibia. Neurovascular structures were only damaged at the medial side of the distal humerus (10/32). CLINICAL SIGNIFICANCE: We conclude that the TVS can be safely applied percutaneously to the tibia and with limitations to the femur in normal cadaveric cats without fluoroscopy. Despite the limitations of a cadaveric study, the high number of complications is leading us to consider the humerus not safe for the TVS. A learning curve has to be expected and technical recommendations should be respected to decrease complications.


Assuntos
Pinos Ortopédicos/veterinária , Gatos/cirurgia , Fraturas Ósseas/veterinária , Animais , Cadáver , Fêmur/cirurgia , Fluoroscopia/veterinária , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Úmero/cirurgia , Radiografia/veterinária , Tíbia/cirurgia
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