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1.
A 405-kg heifer sustained a compound fracture of the distal portion of the radius and ulna after being hit by a car. The fracture was thoroughly debrided, lavaged, and reduced with the heifer under general anesthesia. The fracture was immobilized with a modified walking cast, using 2 fully threaded 6.4-mm (outside diameter) Steinmann pins placed through the proximal portion of the radius. The pins were incorporated into a full-limb fiberglass cast, and a 0.5-cm X 2.25-cm aluminum walking bar was positioned medially and laterally on the limb. The modified walking cast was removed after 7 weeks, and the fracture healed without complication. The transfixation pins and aluminum walking bar helped reduce the strong compressive and rotational forces at the fracture site. The modified walking cast can potentially be used for fixation of a variety of fractures in large animals.  相似文献   

2.
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   

3.
Fractures of the proximal tibial physis are uncommon in dogs, and are rarely associated with marked instability and lateral displacement of the proximal tibial epiphysis. Three dogs with proximal tibial physeal fractures demonstrating marked instability and lateral displacement were treated with two different principles of fixation. Healing of the physeal fracture was achieved with rigid internal fixation in one case, and with adaptational osteosynthesis supplemented with a temporary transarticular external skeletal fixator in two cases. Duration of surgery and technical difficulty was reduced using a modified adaptational osteosynthesis approach, suggesting that surgical treatment of these uncommon and challenging fractures may be more appropriately achieved by this technique.  相似文献   

4.
The study compares the efficiency of a new bone fixator combining periostal and intramedullary osteosynthesis to bone plating in treatment of tibial fractures in sheep. Experimental osteotomies were performed in the middle third of the left tibia. Animals were divided into two groups: in one group (four animals) combined osteosynthesis (rod‐through‐plate fixator, RTP fixator) was applied, and in the other group (three animals) bone plating was used. The experiments lasted for 10 weeks during which fracture union was followed by radiography, and the healing process was studied by blood serum markers reflecting bone turnover and by histological and immunohistochemical investigations. In the RTP fixator group, animals started to load body weight on the operated limbs the next day after the surgery, while in the bone plating group, this happened only on the seventh day. In the RTP fixator group, consolidation of fractures was also faster, as demonstrated by radiographical, histological, and immunohistochemical investigations and in part by blood serum markers for bone formation. It can be concluded that application of RTP fixation is more efficient than plate fixation in the treatment of experimental osteotomies of long bones in sheep.  相似文献   

5.
A Robert Jones bandage modified to include a steel walking bar frame and, in one case, side-supporting bars, was applied as a splinting device in 4 horses with hindlimb fractures (3 tarsal and 1 middle phalangeal). The modification was used as an adjunct to previous casting therapies or as a means for handling casting failures or soft tissue problems encountered during the casting period. This means of stabilization is easily adapted to replace a problematic cast in various clinical settings, is easily applied in the standing patient, is easily changed and adjusted on a regular basis, has minimal complications, is comfortable, and can be used for support for a long period.  相似文献   

6.
Minimally displaced condylar fractures propagating into the third metatarsal diaphysis were treated conservatively in one thoroughbred and two Arabian racehorses. In each case a neuroleptanalgesic protocol provided adequate pain relief for a rigid fibreglass cast to be applied in a weight-bearing position. The fractures healed completely and the three horses recovered uneventfully. Two of them returned successfully to racing and the third was used for breeding.  相似文献   

7.
The goal of this retrospective study was to describe dowel pinning, and to compare the results of osteosynthesis and external coaptation of metacarpal and metatarsal fractures in cats. Evaluation of the medical records of 351 cats yielded 63 cats treated with dowel pinning, 35 cats treated with external coaptation and 14 cats treated with both methods within the same limb. All of the cats had been re-evaluated at an average of 2.8 years (six months - 15 years) postoperatively. Dowel pinning was superior to external coaptation when all fractured bones of a limb could be pinned. When internal fixation of multiple fractures was not feasible in all fractured bones due to comminution or fragments that were too short to pin, the outcome was not significantly different from cases treated with external coaptation alone. Malunion was seen in 16% of fractured bones in cats treated with external coaptation and occurred secondary to implant bending in 3% of fractured bones treated with dowel pinning. The latter refers to one operated cat, which had four metacarpal fractures in the same limb. Radiographs taken at re-evaluation showed implant migration within the medullary canal in two cats, although neither showed any signs of non-union or lameness. Non-union was seen in one operated cat, in which the fracture (MC IV) could not be completely reduced with a K-wire. Osteomyelitis did not occur. Dowel pinning is an easy, inexpensive and effective technique for repair of metacarpal and metatarsal fractures in cats.  相似文献   

8.
OBJECTIVE: To evaluate clinical findings, complications, and outcome of horses and foals with third metacarpal, third metatarsal, or phalangeal fractures that were treated with transfixation casting. DESIGN: Retrospective case series. Animals-29 adult horses and 8 foals with fractures of the third metacarpal or metatarsal bone or the proximal or middle phalanx. PROCEDURES: Medical records were reviewed, and follow-up information was obtained. Data were analyzed by use of logistic regression models for survival, fracture healing, return to intended use, pin loosening, pin hole lysis, and complications associated with pins. RESULTS: In 27 of 35 (77%) horses, the fracture healed and the horse survived, including 10 of 15 third metacarpal or metatarsal bone fractures, 11 of 12 proximal phalanx fractures, and 6 of 8 middle phalanx fractures. Four adult horses sustained a fracture through a pin hole. One horse sustained a pathologic unicortical fracture secondary to a pin hole infec-tion. Increasing body weight, fracture involving 2 joints, nondiaphyseal fracture location, and increasing duration until radiographic union were associated with horses not returning to their intended use. After adjusting for body weight, pin loosening was associated with di-aphyseal pin location, pin hole lysis was associated with number of days with a transfixation cast, and pin complications were associated with hand insertion of pins. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that transfixation casting can be successful in managing fractures distal to the carpus or tarsus in horses. This technique is most suitable for comminuted fractures of the proximal phalanx but can be used for third metacarpal, third metatarsal, or middle phalanx fractures, with or without internal fixation.  相似文献   

9.
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   

10.
OBJECTIVE: To determine the clinical applications, short and long-term survival, and complications of using transfixation pin casts for treatment of comminuted phalangeal fractures in adult horses. DESIGN: Retrospective case series. ANIMALS: 20 horses. PROCEDURES: Medical records were reviewed to obtain information regarding signalment, fracture location, treatment methods, complications, and short-term survival (discharge from hospital). Long-term follow-up information was obtained via contact with owners or trainers. RESULTS: 12 fractures were in a hind limb, and 8 were in a forelimb. Fourteen fractures occurred in a middle phalanx, and 6 occurred in a proximal phalanx. Eleven fractures were treated with internal fixation combined with transfixation pin casts, and 9 fractures were treated with transfixation pin casts alone. Transfixation pin casts were maintained for a mean of 52 days (median, 49 days; range, 1 to 131 days). Fourteen (70%) horses were discharged from the hospital, whereas 6 (30%) were euthanized during the treatment period. Reasons for euthanasia included secondary fracture of the third metacarpal or metatarsal bone, avascularity of the distal aspect of the limb associated with an open fracture, and displacement of the fracture after transfixation pin cast removal. A significantly greater number of horses was discharged from the hospital when the transfixation pin cast was maintained for > 40 days, compared with those in which the transfixation pin cast was maintained for < 40 days. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that horses should be maintained in a transfixation pin cast for a minimum of 40 days, as this was associated with an increase in short-term survival without an increased risk of catastrophic failure.  相似文献   

11.
REASONS FOR PERFORMING STUDY: Complications of osteosynthesis including superficial and deep infections continue to affect adversely outcome in equine surgery of the lower limb. OBJECTIVE: To describe a technique for minimally invasive plate fixation in horses and evaluate clinical results of the technique. HYPOTHESIS: Lower complication rates would occur in horses treated with a minimally invasive approach compared with conventional techniques. METHODS: Cases of minimally invasive plate fixation from January 1999 to December 2003 were evaluated. Case records, radiographs and race records for horses that sustained distal third metacarpal/metatarsal (Mc/tIII) condylar fractures were assessed. Follow-up information was obtained and results analysed. In addition, results for horses that received arthrodesis by a conventional, open approach during the same period were evaluated and statistical analysis was performed. RESULTS: Thirty-two cases of minimally invasive plate fixation were identified (22 incomplete distal Mc/tIII condylar fractures with a spiralling or diaphyseal component, 10 metacarpophalangeal arthrodeses and 4 pastern arthrodeses). For both types of arthrodesis, surgery times and infection rates were lower and survival rates higher in the minimally invasive group, but no statistical difference was found. Spiralling condylar fractures were successfully managed, without catastrophic fracture. CONCLUSIONS AND POTENTIAL RELEVANCE: Minimally invasive percutaneous plate osteosynthesis (MIPPO) can be successfully used for select applications in horses, and may reduce morbidity and mortality in equine fracture repair.  相似文献   

12.
Comminuted first phalanx fractures were diagnosed in 30 horses. One leg was involved in each horse. Five horses were presented with open fractures. Nine horses had a portion of intact cortex (strut) extending from the proximal to distal joint. Ten horses were euthanized, including one with an open fracture, without treatment. The remaining 20 horses were treated by open reduction with a neutralization plate (8 horses, including one with an open fracture), open reduction with lag screw fixation (3 horses), lag screw fixation through stab incisions (2 horses), external coaptation with a cast (3 horses), and external skeletal fixation using a weight supporting shoe (4 horses, including 3 with open fractures).
Thirteen horses were euthanized following treatment because of persistent infection (9), chronic lameness (2), and third metacarpal bone fractures (2). Seven horses survived longer than 1 year after treatment. Six were lame and used as breeding animals, and one horse went on to race successfully. All four horses with open fractures that were treated were subsequently euthanized.
Significantly more horses with an intact strut of bone survived after treatment (4 of 7 [57%]) when compared to horses without an intact strut of bone that were treated (3 of 13 [23%]) (p < 0.05).
Invasive surgical approaches used for the repair of comminuted first phalanx fractures in this study were associated with an unacceptable infection rate (55%). Techniques involving less trauma to the compromised soft tissue around the fracture should afford a better chance for a successful outcome.  相似文献   

13.
Comminuted metatarsal fractures in a dog were treated using intramedullary pins externally connected and stabilized by epoxy resin putty and application of a fibreglass cast. Two weeks later the cast was removed. After further 2 weeks application of a Robert-Jones bandage the dog could stand and walk with the pin-putty apparatus in position. The pin-putty apparatus was removed 3 months postoperatively, and the dog resumed normal activity. This fixation method could be an easy, economical and effective alternative treatment for managing comminuted fractures of the metatarsal and possibly metacarpal bones in selected cases.  相似文献   

14.
Over the past decade, many improvements to small animal internal fracture fixation have been developed, including improved fixation techniques and a more diverse selection of implants. The understanding that appropriate fixation selection is based on a plethora of biologic, mechanical, and clinical factors has also emerged. Classically, the methods of internal fracture fixation have used pins, wires, screws, and plates to rigidly stabilize fractures that have been anatomically reduced with significant disruption to the biologic fracture environment. Newer methods attempt to minimize trauma to the soft tissues surrounding a fracture and promote biologic osteosynthesis using such implants as interlocking nails and plate-rod fixations. This review provides an overview of both the traditional and current principles of small animal internal fracture fixation.  相似文献   

15.
Objective —This study evaluates the technique of medial bone plating in the repair of radius fractures in dogs and cats.
Study Design —A retrospective study was made of patients diagnosed with fractures of the radius that were stabilized by application of a bone plate to the medial side of the bone.
Animal Population —Sixteen client-owned dogs and 4 client-owned cats. The animals' ages varied from 5 months to 8 years, and their weight varied from 1.3 to 49 kgs.
Methods —Animals were evaluated using radiography or client assessment, or both.
Results —Medial plate application was technically easier to do than cranial plate application, the technique avoided the extensor tendons, and permitted greater versatility in the selection of smaller plates for the fixation of distal radius fractures. All fractures repaired by this method healed with no postoperative complications.
Conclusions —Medial plate application may be used for osteosynthesis of distal or middiaphy-seal radius fractures. Further studies are needed to evaluate the use of this technique in morphologically complex fractures. In patients with fractures of the proximal radius, cranial plate application is considered more appropriate.
Clinical Relevance —Medial plating of radial fractures has significant advantages compared with conventional plate application; it provides the surgeon with an alternative method of fixation for selected radius fractures in dogs and cats.  相似文献   

16.
Metacarpal (22) and metatarsal (11) fractures in 33 dairy cattle were treated by application of short or full limb casts. Twelve fractures involved the distal physis (6 closed, 6 open) and 21 fractures were nonphyseal (17 closed, 4 open). All physeal fractures were noncomminuted and 11/12 were classified as Salter-Harris type II. Eleven (52%) of nonphyseal fractures were comminuted. Closed fractures were reduced and a cast was applied after manual restraint, sedation with xylazine (along with use of ropes), or general anesthesia. Open fractures were best treated with the cow under general anesthesia. These fractures were carefully debrided, lavaged, and reduced, and a cast was applied. Antibiotics and analgesics were given parenterally. All cattle were restricted to a box stall during fracture healing. Fracture healing generally was rapid and uncomplicated. No closed fracture perforated the skin. Fracture healing was characterized radiographically by extensive circumferential periosteal new bone growth, closure of the distal physis, and preservation of articulations adjacent to the fracture site. Follow-up ranged from 6 to 78 months (mean, 32 months). Thirty of 33 (91%) cattle survived for a long period. All cows with closed (23) and 7 of 10 (70%) with open fractures survived. Three cows were euthanatized; 2 developed severe osteomyelitis and one fractured her metatarsus above a short cast. All 30 surviving cattle were considered by their owners not lame on the previously injured limb, with no noticeable angulation, bowing, or shortening. No deleterious effects on milk production were detected.  相似文献   

17.
OBJECTIVE: To report the outcome of surgical treatment of comminuted fractures of the proximal phalanx in horses. DESIGN: Retrospective study. ANIMALS: 64 horses. PROCEDURE: Medical records and radiographs were reviewed to obtain information regarding signalment, fracture classification, and treatment. Follow-up information was obtained by telephone conversation or evaluation of production records. RESULTS: Thirty-eight horses had moderately comminuted fractures of the proximal phalanx. Two horses were euthanatized immediately. Fractures of the proximal phalanx in 36 horses were repaired with open reduction and internal fixation with a successful outcome in 33 (92%) horses. Reconstruction of the fracture was performed in most horses by use of a long curved incision, transection of the collateral ligament of the metacarpophalangeal or metatarsophalangeal joint, and open exposure of the proximal articular surface of the proximal phalanx. Twenty-six horses had severely comminuted fractures of the proximal phalanx. Six horses were euthanatized immediately. One horse was euthanatized after 9 days of treatment with a cast alone. Severely comminuted fractures of the proximal phalanx in 13 horses were treated with an external skeletal fixation device, and fractures healed in 8 of those horses. Six horses with severely comminuted fractures of the proximal phalanx were treated with transfixation pins incorporated into a fiberglass cast, and fractures healed in 4 horses. CONCLUSIONS AND CLINICAL RELEVANCE: Moderately comminuted fractures of the proximal phalanx can be successfully repaired; however, fractures that are too severe to permit accurate reconstruction of the fragments remain difficult to treat and horses have only a fair prognosis for survival.  相似文献   

18.
Two sequential fractures in the left hind leg of a deer and their treatments are described. The first, a tibial fracture was treated using an intramedullary pin with full cerclage wires supported by a plaster cast. This fracture healed uneventfully. A subsequent second fracture involving the distal metatarsus was stabilized by external fixation. This fracture healed with the formation of a periosteal involucrumlike structure which encased the full length of the metatarsal bone. This involucrum was thought to be due to a sub-periosteal hematoma.  相似文献   

19.
Orthopedic clinical techniques femur fracture repair   总被引：2，自引：0，他引：2  
Femur fractures occur commonly in cats and dogs following substantial trauma. Fractures of the femur may be categorized as capital physeal, femoral neck, trochanteric, subtrochanteric, diaphyseal, supracondylar or condylar or distal physeal. Most femur fractures are closed due to the heavy overlying muscle, unless due to a penetrating injury such as a gunshot wound. Femur fractures are generally not amenable to conservative repair, and some kind of internal fixation is generally required. Implant systems suitable for repair of femur fractures include bone plates, interlocking nails, plate-rod construct, lag screws, pins and wires and external fixators. Fractures may be repaired using anatomic reduction and rigid fixation or using the principles of biologic osteosynthesis. Biologic osteosynthesis is particularly effective for highly comminuted fractures because vascular supply and soft tissue attachments to bone fragments are preserved, speeding the formation of bone callus. Articular fractures should be anatomically reduced and rigidly stabilized to reduce the chance of progressive osteoarthritis.  相似文献   

20.
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   

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