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1.
The goals of this study were to assess the ability of ultrasonography (US) to assess uncomplicated fracture healing and to establish normal images. Twenty-two dogs, ranging in age from 6 to 180 months were studied. Body weight ranged from 2.2 to 60 kg. All fractures were treated by plate osteosynthesis. US (B-mode and power Doppler) and radiography were performed until both were consistent with complete healing. B-mode US was performed in all dogs, and power Doppler US in 14. Fracture healing was judged to be complete based on US earlier than when based on radiography. The tissue immediately adjacent to the plate appeared vascularized on power Doppler images at a time when the tissue at the fracture site had a negative power Doppler exam. US appears useful for assessment of primary fracture healing and power Doppler was useful for detecting vascularization at the fracture site in nonhealed fractures. Power Doppler interrogation should be performed away from any metal implant, as a result from an interrogation adjacent to an implant will not reflect actual vascularization at the fracture site.  相似文献   

2.
Objective-To evaluate fracture healing after minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF) of coexisting radius and ulna fractures in dogs via ultrasonography and radiography. Design-Prospective cohort study. Animals-16 dogs with radius-ulna fractures that underwent MIPO (n = 9; 2 dogs were subsequently not included in the analyses because of incomplete follow-up information) or ORIF (7). Procedures-Dogs in the 2 treatment groups were matched by age, body weight, and configuration of the fractures. Fracture healing was evaluated with ultrasonography, power Doppler ultrasonography, and radiography every 3 to 4 weeks until healing was complete; a semiquantitative score based on the number of Doppler signals was used to characterize neovascularization, and subjective B-mode ultrasonographic and radiographic scores were assigned to classify healing. Results-Fractures in dogs that underwent MIPO healed in significantly less time than did fractures in dogs that underwent ORIF (mean ± SD; 30 ± 10.5 days and 64 ± 10.1 days, respectively). Radiography revealed that fractures in dogs that underwent MIPO healed with significantly more callus formation than did fractures in dogs that underwent ORIF. Although Doppler ultrasonography revealed abundant vascularization in fractures that were healing following MIPO, no significant difference in neovascularization scores was found between groups. Conclusions and Clinical Relevance-For dogs with radius-ulna fractures, data indicated that bridging osteosynthesis combined with a minimally invasive approach contributed to rapid healing after MIPO. The MIPO technique may offer some clinical advantage over ORIF, given that complete radius-ulna fracture healing was achieved in a shorter time with MIPO.  相似文献   

3.
OBJECTIVE: To investigate the effectiveness of intramedullary xenograft cortical bone pins compared with stainless steel Kirschner wire for the repair of a standardized avian humeral fracture. STUDY DESIGN: Prospective randomized study. SAMPLE POPULATION: Thirty mature pigeons (Columba livia). METHODS: Birds were randomly assigned to 3 groups. Transverse mid-diaphyseal humeral fractures were created in 1 humerus in each bird. Fractures were stabilized with intramedullary ostrich or canine xenograft cortical bone pins or Kirschner wire. Radiographic, histological, and biomechanical assessments were used to compare fracture healing 6 weeks after fracture stabilization. The contralateral humerus of each bird was used as a control. RESULTS: All fractures healed regardless of intramedullary pin type. There were no statistically significant biomechanical differences among groups or within groups. Xenograft cortical bone pins induced a mononuclear inflammatory reaction that did not impair bone healing. Bones stabilized with intramedullary cortical bone pins had more periosteal callus and inflammation at the fracture site than bones stabilized with stainless steel Kirschner wires. CONCLUSIONS: Intramedullary xenograft cortical bone pins, derived from mammalian or avian sources, appear to represent an alternative for the repair of avian humeral fractures. CLINICAL RELEVANCE: Intramedullary xenograft cortical bone pins are biodegradable and may reduce the need for additional surgery to remove implants after fracture healing.  相似文献   

4.
Angiography during metatarsal fracture healing following simple coaptation, stainless steel plating, and allogeneic onlay bone plating was performed in 24 calves. Angiograms obtained during the early stage of fracture healing demonstrated enhanced extraosseous vascularity at and around the fracture site regardless of the technique used for immobilization. However, the increased soft tissue vascularity was more intense in animals with simple coaptation than with metallic or allogeneic onlay bone plating. From four to six weeks the fracture site was vascularized, with visualization of crossover vascular contacts and ramification of vessels supplying the bridging callus. These changes were observed earlier and were more intense following plating. Enhanced soft tissue vascularity persisted longer in animals with delayed union and infection, whereas it regressed to nearly normal by the tenth week in normally healing fractures.  相似文献   

5.
OBJECTIVE: To compare and correlate B-mode and color Doppler ultrasonographic characteristics with the histologic findings of benign and malignant mammary tumors in dogs. STUDY POPULATION: 49 mammary tumors in 26 dogs. PROCEDURES: Before excision, tumors were evaluated via B-mode and color Doppler ultrasonography to assess size, echogenicity, echopattern, acoustic transmission, invasiveness, and vascularity. Paraffin-embedded microsections of the tumors were stained with H&E and examined for presence of necrosis, cysts, cartilage, bone, mineralization, invasion of surrounding tissue, and tissue heterogeneity. To assess vascularity, the number and distribution of vessels that were stained by the Verhoeff van Gieson technique were recorded. RESULTS: Tumor echogenicity and echopattern on ultrasonographic images correlated with tissue heterogeneity detected histologically. Acoustic enhancement was correlated with the presence of necrotic or cystic areas. Tumor invasion into surrounding tissues as determined ultrasonographically did not correlate with the histologic findings. There was a significant correlation between the number of detected vessels and distribution of flow within the tumors determined via ultrasonographic and histologic examinations. CONCLUSIONS AND CLINICAL RELEVANCE: In canine mammary tumors, ultrasonographic characteristics appear to be correlated with histopathologic changes. Data suggest that ultrasonography may have an important role in the evaluation of mammary tumors in dogs, particularly in the evaluation of tissue composition and tumor vascularity.  相似文献   

6.
OBJECTIVES: To evaluate the use of ultrasonography (US) to detect bone healing in uncomplicated diaphyseal fractures of dogs and cats, and to compare these observations with detection of healing by radiography (RG). STUDY DESIGN: Clinical study. ANIMALS: Dogs (33) and cats (11). METHODS: RG and brightness mode US were used to follow uncomplicated secondary fracture healing. Fractures were examined at admission and then every 2-4 weeks until healed or implant removal. Temporal differences in definitive detection of healed fracture by imaging technique were examined by species, patient age, bone, and fracture type. RESULTS: US images obtained during uncomplicated secondary fracture healing were consistent with images of fracture healing described in humans. Mean time to US diagnosis of a healed fracture (mean 46 days) was significantly shorter than by RG (mean 66 days). Mean time until diagnosis of a healed fracture (US and RG) did not differ significantly between open and closed treatment. Patients 36 months (n=11), but there was no significant difference between the latter 2 groups. Diagnosis of a healed simple fracture by US was significantly quicker than for a comminuted fracture (P<.05), but no difference was noted when using RG. CONCLUSIONS: US can be used to evaluate secondary fracture healing in biologically treated fractures in dogs and cats. US permits detection of a healed fracture earlier than RG. CLINICAL RELEVANCE: Earlier diagnosis of a healed fracture by US can prevent unnecessarily long limb immobilization and allow earlier dynamization.  相似文献   

7.
OBJECTIVE: To investigate the use of ultrasonography to assess nonunion of fractures in dogs and to compare results of ultrasonography, radiography, and histologic examination. SAMPLE POPULATION: 8 nonunion fractures in 6 dogs (1 each in 5 dogs and 3 in 1 dog); dogs ranged from 7 to 94 months of age and weighed 6 to 30 kg. PROCEDURES: Diagnostic assessment consisted of complete clinical and orthopedic examinations, radiography, B-mode (brightness mode) ultrasonography, and power Doppler ultrasonography. Biopsy samples were obtained during surgery for histologic examination. They were stained with H&E and immunolabeled by use of anti-CD31 antibodies. Correlations of power Doppler score, power Doppler count, vessel area, and radiographic prediction with the mean number of vessels counted per hpf were derived. RESULTS: Radiographically, 7 of 8 nonunion fractures were diagnosed as atrophic and were therefore estimated to be nonviable. Vascularity of nonunion fractures during power Doppler ultrasonography ranged from nonvascularized to highly vascularized. Absolute vessel count during histologic examination ranged from 0 to 63 vessels/hpf; 5 nonunion sites had a mean count of > 10 vessels/hpf. Vascularity during power Doppler ultrasonography was highly correlated with the number of vessels per hpf, whereas the correlation between the radiographic assessment and histologic evaluation was low. CONCLUSIONS AND CLINICAL RELEVANCE: Radiographic prediction of the viability of nonunion fractures underestimated the histologically assessed vascularity of the tissue. Power Doppler ultrasonography provided a more accurate estimation of the viability of the tissue and therefore the necessity for debridement and autografts during revision surgery.  相似文献   

8.
The complications associated with bone plates and screws often are related to undersized or oversized implant selection, improper number of implants, inadequate or improper screw fixation, malpositioned plates or screws, poor plate contouring, and failure to use cancellous bone grafts when a gap is present at the fracture site. A thorough understanding of the principles of plate and screw application helps to avoid most problems. The surgeon must use an implant that will stabilize the fracture adequately during the healing process. The patient's activity levels must not exceed the mechanical limits of the implant. Methods to promote bone healing, such as using cancellous bone grafts when a deficit is present, help to protect the implant from fatiguing before the fracture is healed. Proper positioning and contouring of the implants are important to the successful application of plates and screws. It must be realized that even if all of these things are done, some complications still will occur. When that happens, the complication should be dealt within a manner that will allow the objectives of fracture treatment (a healed bone and normal limb function) to be achieved.  相似文献   

9.
The aims of this prospective study were to test the feasibility of assessing neovascularization with power Doppler ultrasonography and to investigate its usefulness to follow fracture healing of long bones in dogs and cats. A total of 51 patients (44 dogs and seven cats) were followed. Fracture types differed from simple to comminuted. Therapy ranged from external coaptation to plate osteosynthesis. Patients were followed with radiography, B-mode real time and power Doppler ultrasonography every 2-4 weeks until the fracture was healed. All fractures healed uneventfully. A semi-quantitative numerical score based on signal intensity, vessel area, and number of Doppler signals was assigned and the mean value was used to compare patients and examinations. Time postoperatively was divided into periods of 10 days. No Doppler signal was present during the first 10 days. The mean of the scores was highest between 11 and 20 days postoperatively and the median of the scores peaked between 21 and 30 days. A gradual decrease was seen thereafter. The mean of the scores was zero at 71-80 days and the median at 51-0 days postoperatively for the grouped results. In all positive power Doppler examinations, signals were present in and close to the callus. In seven patients (five dogs and two cats) signals were also present in the peripheral soft tissues in one of the follow up examinations. The normal healing process of fractured bones can be visualized using power Doppler ultrasonography and follows a distinctive time-dependent pattern.  相似文献   

10.
Fifteen clinical cases of gunshot fractures were studied. A radiographic classification of the fractures was developed to aid in fracture evaluation. Type I fractures involved a simple transverse or oblique fracture with minimal soft tissue damage. Type II fractures were severely comminuted with no cortical bone defect and minimal soft tissue damage. Type III fractures were "shatter" fractures, characterized by severe comminution, cortical bone defects, and extensive soft tissue damage. Type I and Type II fractures (combined 26.7%) healed in 8 weeks or less. Eleven of the 15 cases evaluated (73.3%) were found to be Type III fractures, requiring more than 14 weeks for complete cortical healing. Osteomyelitis was associated with 3 cases of Type III tibial fractures, 2 of which developed after a second surgical intervention. Management, complications, and prognosis of gunshot fractures are discussed.  相似文献   

11.
OBJECTIVE: To describe a surgical technique for treatment of biologically inactive nonunions using en bloc ostectomy and compression plate fixation and clinical outcome in 17 dogs. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Seventeen dogs. METHODS: A transverse ostectomy was performed adjacent and parallel to the nonunion to eliminate nonviable tissue and provide a new, viable fracture surface with a minimum circumferential contact area of 315 degrees. With most of the bony column anatomically reconstructed, compression plate fixation was used to stabilize the fracture. Autogenous cancellous bone grafting was used if a fracture gap was present (<45 degrees of missing circumferential bone contact). Resection of bone was limited so that bone shortening was less than 20% of the overall bone length. Clinical and radiographic follow-up evaluations were obtained whenever possible. RESULTS: Complete circumferential bone contact and compression plate fixation was achieved after ostectomy in 12 dogs; cancellous bone graft was used in 5 dogs. En bloc ostectomy sites were radiographically healed in a median time of 2.5 months after surgery in 11 dogs that returned for complete in-hospital follow-up, and progressive healing was observed in 3 other dogs, where in-hospital follow-up was obtained up to 2 months after surgery. These dogs had a median follow-up time of 2 months, at which time 6 dogs had no lameness, 4 had minimal lameness, and one had moderate lameness. No complications occurred, and no implants were removed. CONCLUSIONS: En bloc ostectomy with compression plate fixation was considered successful for the treatment of biologically inactive nonunions. A good to excellent prognosis can be expected with minimal complications. CLINICAL RELEVANCE: Use of an en bloc ostectomy technique for the treatment of biologically inactive nonunions permits easy resection of nonviable tissue. Subsequent fracture stabilization with compression plate fixation resulted in rapid bone healing without complications.  相似文献   

12.
The aim of this study was to use radiography to assess and characterise naturally occurring keel bone fractures in laying hens and monitor live birds over several weeks to examine the healing process. Twenty-four Lohmann brown commercial laying hens with varying degrees of keel bone fracture were used in the study. Birds were radiographed regularly over six weeks and the radiographic features and changing appearance of keel bone fractures were evaluated. The radiographic characteristics of old and new fractures were categorised and indicated that 80 per cent of birds entering the study with new fractures had healed after 35 days and five birds had incurred new fractures irrespective of their original fracture status.  相似文献   

13.
Nuclear scintigraphy was used to evaluate healing of third metacarpal bone (MC III) fractures in 2 horses (horses 1 and 2) and a third metatarsal bone fracture in 1 horse (horse 3) after stabilization of each fracture with 2 broad dynamic compression plates. In horse 1, the fracture had uniform uptake of 99mTc methylene diphosphonate on days 1, 15, and 30 after surgery. The fracture healed, and the horse was discharged from the clinic on day 52. In horse 2, a 6-cm photopenic region (ie, area of low radioactivity) was seen over the diaphysis of MC III on day 3. The region persisted and became more distinct by day 32. The diaphysis of MC III sequestered, and horse 2 was euthanatized on day 44. In horse 3, vascularity was seen bridging the fracture on day 5, with a 3-cm photopenic region over the dorsal diaphysis of the third metatarsal bone. By days 18 and 32, uptake of 99mTc methylene diphosphonate in the region had increased, indicating vascularization of the site. the fracture healed, and horse 3 was discharged from the clinic on day 47. Our findings indicated that serial nuclear scintigraphy can be used to evaluate fracture vascularization after surgery in horses.  相似文献   

14.
Objectives: To compare fracture healing in diaphyseal tibial fractures stabilized using either minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF). Methods: Dogs in each group were matched for type of fracture, age and body weight. Stage of healing was measured blindly every four weeks postoperatively until complete healing. Outcome variables including fracture length, plate length, plate bridging ratio, plate working length, healing grading, and fracture reduction were compared between groups using the Mann-Whitney test. Significant difference was set at p <0.05. Results: Based on the definition of clinical union, at 30 days five out of eight dogs managed with MIPO had healed, while two of the eight of dogs managed with ORIF had healed. We did not find any significant differences in the other outcome measures. No complications were reported in the MIPO group whereas one major complication was reported in the ORIF group. Clinical significance: All dogs treated by MIPO healed rapidly without any complications, nevertheless the difference in radiographic healing between the two groups was not significant.  相似文献   

15.
Twenty-eight consecutive fractures of the canine radius and tibia were treated with external skeletal fixation as the primary method of stabilization. The time of fixation removal (T1) and the time to unsupported weight-bearing (T2) were correlated with: (1) bone involved; (2) communication of the fracture with the external environment; (3) severity of the fracture; (4) proximity of the fracture to the nutrient artery; (5) method of reduction; (6) diaphyseal displacement after reduction; and (7) gap between cortical fragments after reduction. The Kruskal-Wallis one-way analysis of variance was used to test the correlation with p less than .05 set as the criterion for significance. The median T1 was 10 weeks and the median T2 was 11 weeks. None of the variables correlated significantly with either of the healing times; however, there was a strong trend toward longer healing times associated with open fractures and shorter healing times associated with closed reduction. Periosteal and endosteal callus uniting the fragments were observed radiographically in comminuted fractures, with primary bone union observed in six fractures in which anatomic reduction was achieved. Complications observed in the treatment of these fractures included: bone lysis around pins (27 fractures), pin track drainage (27 fractures), pin track hemorrhage (1 fracture), periosteal reaction around pins (27 fractures), radiographic signs consistent with osteomyelitis (12 fractures), degenerative joint disease (2 dogs), and nonunion (1 fracture). Valgus or rotational malalignment resulted in 16 malunions of fractures. One external fixation device was replaced and four loose pins were removed before the fractures healed. One dog was treated with antibiotics during the postoperative period because clinical signs of osteomyelitis appeared.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

16.
An in vivo evaluation of isobutyl-2-cyanoacrylate as an osseous adhesive was performed to determine its effect on bone healing. Oblique cortical fractures were induced at the tibial-fibular junctions of adult rabbits. Forty-eight fractures were repaired by the use of isobutyl-2-cyanoacrylate and a full cerclage wire. The opposite control fracture was repaired with a full cerclage wire only. One hundred percent of the glued fractures were not united through the glue interface, although normal periosteal new bone formation (secondary bone healing) took place around the glue. One hundred percent of the nonglued fractures healed by secondary bone union. Reactions were not seen in the bone or soft tissue adjacent to the adhesive material.  相似文献   

17.
OBJECTIVES: The aim of the here described case series was to develop and evaluate the minimally invasive percutaneous osteosynthesis for the plate fixation of tibial fractures in dogs and cats. METHODS: Six dogs and four cats with shaft fractures of the tibia were treated using minimally invasive percutaneous osteosynthesis. Follow-up radiographs four to six weeks after fracture fixation were evaluated for fracture healing. For the long-term follow-up (minimum 2.4 years), owners were contacted by phone to complete a questionnaire. RESULTS: All fractures healed without the need for a second procedure. Follow-up radiographs obtained after four to six weeks in seven cases showed advanced bony healing with callus formation and filling of the fracture gaps with calcified tissue in all seven. All the patients had a good to excellent long-term result with full limb function. The time needed for regaining full limb use was two to three months. CLINICAL SIGNIFICANCE: Minimally invasive percutaneous osteosynthesis seems to be a useful technique for the treatment of tibial shaft fractures in dogs and cats.  相似文献   

18.
The frequent need for removal of metallic implants after fracture healing, has stimulated research into biodegradable osteosynthesis materials. The ideal biodegradable implant should support the fracture during healing and would slowly lose strength as the bone became able to resist the distracting forces. Decades of research into biodegradable materials has given much information on biocompatibility, degradation rates and processability of resorbable polyglycolides and polylactides. This has aided the development of an ultra high strength self-reinforcing composite construction allowing the manufacture of implants for several purposes. This study tested the use of self-reinforced poly-1-lactic acid rods for the fixation of cancellous fractures and osteotomies in 20 fixations in dogs and cats. The operating technique, callus formation, healing pattern, and functional and radiological end result, were evaluated. Two fixations failed but the functional end result was judged to be excellent in all but one of the healed cases. There was no need for surgery to remove the implants.  相似文献   

19.
Six middle and distal humeral shaft fractures in dogs were repaired by the application of a bone plate along the medial shaft of the humerus. In all animals, clinical and radiographic evidence of normal bone healing was observed. The bone plate and ancillary implants were removed from five dogs by 10 months. In none of the six dogs were any untoward effects of placing the bone plate along the medial shaft of the humerus detected nor were there any difficulties encountered with the medial humeral soft tissues.  相似文献   

20.
In fracture treatment, several adverse effects of metal, especially its excessive rigidity, often require the removal of the implants after a fracture has healed. Recent research with biodegradable polymers has contributed to the development of totally biodegradable polylactic acid implants with very high initial bending and shear strengths, but a modulus of elasticity comparable to that of bone. These implants were originally intended for use in fractures involving cancellous bone. Encouraging results from treating experimentally produced diaphyseal fractures led the authors to use these implants in a clinical trial on shaft fractures in dogs and cats. In this study, a total of 11 dogs and 14 cats had 28 diaphyseal fractures treated with one or several intramedullary pins of self-reinforced left isomeric polylactic acid. Of the 25 treated cases, 23 healed. Four of these had an unsatisfactory end result attributed to the implants used and one developed an osteomyelitis. Thus, out of 25 fractures, 23 united (92 per cent] and 18 [72 per cent) had a good or excellent outcome.  相似文献   

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