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1.
A 233 kg, 4‐year‐old Welsh pony stallion presented with a unilateral coxofemoral luxation and a history of previous upward fixation of the patella. This condition was surgically managed by femoral head ostectomy using a craniodorsal approach to the luxated coxofemoral joint, without greater trochanteric osteotomy. Immediate improvement in weightbearing was observed after surgery and primary intention healing was recorded. Long‐term outcome, 4 years after surgery, was assessed by radiographic, ultrasonographic and lameness examination. The pony was in good body condition and the initial weight of this patient was restored. Despite fetlock hyperlaxity of the contralateral hindlimb, amyotrophy and mechanical lameness of the affected hindlimb, the pony showed evident comfort without apparent signs of pain and was able to trot and gallop. Bone callus was observed at imaging examination.  相似文献   

2.
Traumatic, unilateral coxofemoral luxation was diagnosed in 22 female dairy cattle (12 calves less than or equal to 13 months old, 10 adults). Physical examination differentiated between dorsal and ventral luxations, but could not distinguish luxations from fractures of the proximal aspect of the femur that occurred in 2 additional adults. Luxations were confirmed by radiography in 5 animals. Closed reduction was accomplished in only 1 calf. A craniolateral surgical approach to the hip, using mechanically assisted traction, was successful in reducing 95% (20/21) of the luxations. Craniodorsal luxations (16) were most common. Ninety-four percent of the animals were ambulatory before surgery. None had concomitant musculoskeletal injuries and 75% (12/16) survived for a long period. Five of 6 animals with ventral luxations arrived recumbent, with serious complicating musculoskeletal injuries, and only 2 of these animals survived for a long period. Calves had a better long-term survival rate (75% vs 50%) and a lower reluxation rate (17% vs 40%), compared with adults.  相似文献   

3.
A 4-year-old castrated male Miniature Horse was evaluated because of severe right hind limb lameness of 5 days' duration. The diagnosis of craniodorsal luxation of the right coxofemoral joint was made by physical examination and radiographic imaging. Closed reduction was attempted but was unsuccessful. Surgical reduction was successfully performed, using toggle pin, synthetic capsular reconstruction, and trochanteric transposition techniques. No postoperative complications were observed. Follow-up 26 months after surgery revealed no recurrence of the luxation and no evidence of lameness. These surgical techniques are used successfully for repair of coxofemoral luxations in small animals. To our knowledge, there has been no report of these techniques attempted in horses. These surgical techniques may have merit for the treatment of coxofemoral luxations in small equine patients.  相似文献   

4.
Femoral head ostectomy was performed in six horses, three ponies, and four cattle for treatment of fractures of the femoral capital physis, coxofemoral luxation, fractured acetabulum, or severe degenerative joint disease. The procedures were performed via a cranial approach that did not involve osteotomy of the greater trochanter. A dorsal approach for femoral head ostectomy via osteotomy of the greater trochanter was evaluated in three healthy adult ponies. Three animals (2 ponies, 1 calf) were euthanatized within a month and one horse was euthanatized at year 2 due to postoperative complications. Nine animals were discharged to owners and six of them fulfilled their intended functions of breeding, milking, and being kept as companions. One horse was lost to follow-up and two horses died of causes unrelated to the surgery. All surviving animals had a residual lameness that was described by owners as mild to moderate. None of the horses were used as riding animals. The mean age and weight of 10 animals that regained weight-bearing locomotion was 3.1 months and 84 kg; for three unsuccessful cases it was 34 months and 174 kg. We concluded that femoral head ostectomy was a viable salvage procedure for large animals with capital femoral physeal fracture, chronic coxofemoral luxation, or acetabular fracture. Surgical prognosis appeared to be favorable in young cattle and fair in young horses or ponies weighing less than 100 kg. Osteotomy of the greater trochanter resulted in superior exposure of the intact coxofemoral joint and allowed easier, less traumatic surgical luxation of the joint to facilitate femoral head ostectomy.  相似文献   

5.
O bjectives : The objective of this study was to describe initial and long-term results of open reduction and transarticular pinning for treatment of coxofemoral luxations in cats.
M ethods : Cats were treated by open reduction and transarticular pinning for coxofemoral luxation over a five year period at two institutions. Follow-up assessment included orthopaedic examination, radiography and owner questionnaires.
R esults : Twenty cats were included in the study (14 males and six females). One cat was affected bilaterally. Mean time to follow-up was 21 months. Seventeen joints were stabilised with a 1·6 mm pin, three with 2·0 mm pins and a 1·2 mm pin was used in the remaining joint. An Ehmer sling was not utilised in any case. All transarticular pins except one were removed (mean 3·5 weeks), with all hips still in reduction The overall success rate was 77 per cent, with two reluxations and one resorbed femoral head noted on radiographs of 13 joints followed long term. All 20 owners reported good to excellent long-term functional outcome for their cats.
C linical S ignificance : Results from this study indicate that transarticular pinning for stabilisation of coxofemoral luxation in cats can provide a good long-term outcome without sacrificing the integrity of the coxofemoral joint.  相似文献   

6.
Hip luxations have been reported in many ruminants, and several treatments have been described for them. However, successful closed reduction of hip joint luxation has not been reported in goats to date. This case report describes the closed reduction of coxofemoral luxation in a three-month-old male Saanen dairy goat. The goat showed non-weightbearing lameness and abnormal mobility of the proximal right hindlimb. Luxation of the right coxofemoral joint in craniodorsal direction was diagnosed by radiography. The femoral head was repositioned under sedation, and physiotherapy including non-weightbearing hindlimb movement and supported walking exercise was performed. Fifteen days after closed reduction the animal was discharged from the clinic. At that time the animal was sound at a slow walk but lameness was still present at faster gaits. Follow-up examinations revealed normal development of the animal, which subsequently showed no lameness and served successfully as a breeding goat.  相似文献   

7.
Objective: To report open reduction and joint stabilization using a prosthetic capsule technique for treatment of a craniodorsal coxofemoral luxation in a lightweight pony. Study Design: Clinical report. Animals: Pony stallion (8 years old, 113 kg). Methods: A craniodorsal approach to the coxofemoral joint was performed under general anesthesia. After open reduction, a prosthetic capsule technique was used. Four 3.5 mm self‐tapping cortical anchor screws were implanted: 2 screws were inserted above the cranial aspect of the dorsal acetabular rim, and 2 screws were inserted into the femoral neck. Subsequently, a #5 USP ultra‐high molecular weight polyethylene suture was placed through these anchor screws in figure‐8 fashion to serve as a prosthetic capsule. Routine closure and a medial patellar desmotomy completed the surgical procedure. Postoperatively, the pony was cross tied for 4 weeks to prevent it from lying down. Results: Neither short‐term nor long‐term complications occurred and the pony was sound at the follow‐up examination performed 15 months postoperatively. Conclusions: A prosthetic capsule technique can be used successfully to stabilize the coxofemoral joint after open reduction of a craniodorsal luxation in a lightweight pony.  相似文献   

8.
Objective— To assess agreement between ultrasonography (transcutaneous and transrectal) and standing radiography in horses with fractures in the pelvic region and disorders of the coxofemoral joint.
Study Design— Case series.
Animals— Warmblood horses (n=23) and 2 ponies.
Methods— Medical records (1999–2008) of equids with pelvic or coxofemoral disorders that had pelvic radiography and ultrasonography were retrieved and results of both techniques compared.
Results— Radiography and ultrasonography each identified equal numbers of fractures of the tuber coxa (n=4), ilial shaft (2), ischium (3), femoral neck (2), and osteoarthritis/osis of the coxofemoral joint (6). Fractures of the ilial wing (4) were only identified by ultrasonography not by standing radiography. Of 9 acetabular fractures, 3 were identified on radiographs only, 5 were identified with both modalities. One pubic fracture was identified using ultrasonography and radiography. One acetabular and 1 pubic fracture were only diagnosed on necropsy.
Conclusions— We found reasonable agreement (73%; 24/33) between ultrasonography and standing radiography for diagnosis of pelvic–femoral disorders. Ultrasonography was more useful for ilial wing fractures and radiography for acetabular fractures.
Clinical Relevance— Ultrasonography is a rapid, safe imaging technique for detecting disorders of the pelvic region with a high diagnostic yield and is a preferred initial approach in horses with severe hindlimb lameness.  相似文献   

9.
Objective— To report use of a cementless total hip prosthesis in an alpaca.
Study Design— Case report.
Animals— Alpaca (n=1) with chronic craniodorsal coxofemoral luxation.
Methods— A 2.5-year-old Suri alpaca, 3 months pregnant, was admitted for evaluation of acute onset severe left hind limb lameness (grade 4/5) of 6 weeks duration. After diagnosis of craniodorsal luxation of the left femoral head, total hip replacement (THR) using a cementless implant was performed because of the poor prognosis for reduction of a chronic luxation.
Results— A press-fit prosthesis was used and the alpaca delivered a live cria 8 months later. Persistent mild mechanical lameness remained after surgery, with moderate reduction in mobility of the coxofemoral joint. The prosthesis was stable and correctly positioned at 7 weeks and at 9 months. There was mild exostosis surrounding the proximal aspect of the femur at 9 months, and Steinmann pins used to repair the trochanteric osteotomy were removed because of migration. At 1 year, the alpaca has a slight gait abnormality, remains with the herd on pasture and has been re-bred.
Conclusion— Chronic coxofemoral luxation in an alpaca can be managed by THR.
Clinical Relevance— THR is a viable treatment option in alpacas with severe coxofemoral disease.  相似文献   

10.
Of the pet rabbits presented at one private practice between August 2011 and August 2016 (n=1369), 5·6% presented with a traumatic orthopaedic injury. Of these, 7·8% (n=6) presented with traumatic coxofemoral luxation, the most frequently observed type of luxation. Three cases of non‐traumatic coxofemoral luxation in pet rabbits are also discussed. Eight rabbits presented with craniodorsal luxation and one with caudoventral luxation. Five rabbits were initially treated using closed reduction and an Ehmer sling under sedation. Two rabbits responded satisfactorily to closed reduction; their bandages remained in place for 10 and 14 days, and movement was cage‐limited for 1 month after bandage placement. The bandage did not prevent re‐luxation in three cases. Therefore, two rabbits received iliofemoral nylon sutures, and three rabbits received a femoral neck and head ostectomy. One rabbit was treated directly using open reduction and an iliofemoral nylon suture due to fractures in the same limb. One rabbit was presented in shock, coxofemoral luxation was noticed as an incidental finding and euthanasia was elected by the owner. In conclusion, of the three rabbits treated via femoral neck and head ostectomy one rabbit had an unsatisfactory outcome and two rabbits have non‐assessable outcomes. The three rabbits treated with iliofemoral sutures showed satisfactory long‐term outcomes and the two rabbits treated with closed reduction and an Ehmer sling showed satisfactory medium and long‐term outcomes.  相似文献   

11.
An 8-month-old male Pekingese was admitted with a 1-month history of right hindlimb lameness and crepitation in the right coxofemoral joint. There was radiographic evidence of a focus of subchondral osteolysis of the right femoral head. The tentative diagnosis was avascular necrosis of the femoral head. The problem was corrected by femoral head ostectomy. Gross and microscopic examination of the femoral head resulted in a diagnosis of osteochondritis dissecans. Osteochondritis dissecans is an uncommon diagnosis both in small breeds of dogs and in the coxofemoral joint.  相似文献   

12.
Objective: To report repair of a coxofemoral joint luxation in an Alpaca using a toggle‐pin technique. Study Design: Case report. Animals: An 11‐month intact male Alpaca with luxation of the right coxofemoral joint. Methods: The Alpaca was anesthetized and an open repair and reduction of the luxation was performed using a toggle‐pin technique. Results: The luxation was successfully reduced. An Ehmer sling was used for the initial 3 days after surgery and the Alpaca was discharged 7 days postoperatively without complications. Follow‐up examinations confirmed maintained reduction of the coxofemoral joint, as well as no evidence of lameness or muscle atrophy. Conclusions: Coxofemoral joint luxations in Alpacas can be successfully repaired using a toggle‐pin technique alone, without the need for other techniques such as capsular reconstruction or greater trochanter transposition. Use of an Ehmer sling for the immediate postoperative period provided additional protection to the repair and was tolerated well.  相似文献   

13.
Abstract

CASE HISTORY: A 6-week-old German Holstein heifer calf (Case 1) and a 4-week-old Charolais bull calf (Case 2) were referred because of unilateral hind limb lameness. Both had been treated with systemic antibiotics by the referring veterinarian.

CLINICAL FINDINGS AND DIAGNOSIS: Based on the results of clinical, radiographic and ultrasonographic examination, a diagnosis of chronic purulent septic gonitis with subchondral osteolysis of the lateral femoral condyle was made in both calves. In Case 2 the lateral tibial condyle also showed osteolysis.

TREATMENT AND OUTCOME: Treatment consisted of arthrotomy with debridement of abnormal bone and cartilage via a craniolateral and a caudolateral approach. Case 1 was discharged from with grade 1/5 lameness 60 days after surgery. In a follow-up 15 months postoperatively, the owner reported that it had been bred at 14 months, was not lame and the affected stifle joint appeared normal. Case 2 had grade 2/5 lameness 52 days after surgery, but was sound at the time of slaughter at 22 months of age.

CLINICAL RELEVANCE: Arthrotomy via a caudolateral approach is a suitable method for the treatment of septic purulent gonitis with osteolysis of the lateral femoral and tibial condyles in calves. In these cases, this treatment resulted in the elimination of localised inflammation, prevented clinically relevant spread of infection to other organs, and restored normal joint function.  相似文献   

14.
Transcutaneous and transrectal ultrasonographic examination of the hip joint region and the pelvis was carried out in 7 cadavers, transcutaneous ultrasonography in 17 healthy young and adult cattle, and transrectal sonography was performed in 12 healthy cows in order to study the normal ultrasonographic appearance of these regions. 7.5 MHz linear-, 5.0 MHz and 3.5 MHz convex transducers and a 7.5 MHz rectal probe were used. The bone surfaces of the greater trochanter, the femoral neck and head, the acetabulum and the other pelvic bones were visualised as hyperechoic contours. The coxofemoral joint space was identified in all cadavers and live cattle. The joint pouch could not be visualised, neither in cadavers nor in live cattle. After experimental filling of the coxofemoral joint pouch by injection of 35-45 ml eosin-solution it appeared as a large anechoic zone between the articular surface and the echogenic joint capsule. The inner contours of the pelvic girdle, both iliosacral joint spaces, the abdominal aorta and the external iliac arteries were depicted clearly by transrectal ultrasonography. The practical application of diagnostic ultrasound in these regions is demonstrated in clinical patients suffering from a septic coxarthritis and a sequestration of a part of the tuber coxae following an open fracture. These results serve as reference data for ultrasonographic investigation of disorders of the hip joint and the pelvic region in cattle.  相似文献   

15.
An external fixator consisting of two Ellis pins connected by a flexible band was developed and evaluated as a treatment for craniodorsal coxofemoral luxations in dogs. The technique for closed application of the fixator without injury to the coxofemoral joint or sciatic nerve was developed in six dog cadavers. The coxofemoral joints were then surgically destabilized and the limbs were manipulated through a full range of motion to assess the efficacy of the fixator in maintaining joint reduction. The fixator maintained joint reduction and stability after a surgically created craniodorsal luxation except when the femur was externally rotated 90d?. A flexible external fixator was then applied unilaterally in four healthy dogs. The dogs tolerated the fixator well and were bearing weight on the limb within 2 days after surgery; the range of motion was not limited by the fixator. The efficacy of a flexible external fixator in maintaining joint reduction after craniodorsal coxofemoral luxation was then evaluated in eight large dogs. The right coxofemoral joint in each dog was luxated surgically by removal of the dorsal joint capsule and transection of the ligament of the head of the femur and deep gluteal muscle. The joint was reduced and the fixator pins were applied in a closed fashion. In four dogs, a flexible external band was applied to the pins. Luxation did not reccur in these four dogs. The bands were not applied initially in four control dogs. Luxation occurred in three of the four control dogs within 24 hours of surgery. The joints that luxated were reduced and the flexible bands applied. Luxation did not recur after the bands were in place. The dogs tolerated the external fixators well, were bearing weight within 2 days of surgery, and walking with only minimal lameness 5 days after surgery. Luxation of the coxofemoral joints did not occur during the 2-week period in which the fixators were in place. The joints remained stable 1 week after removal of the fixators, at which time the dogs were euthanatized. Necropsy evaluation identified inflammation surrounding the pins and fibrous thickening of the dorsal joint capsule. The flexible external fixators were applied closed, maintained reduction of the coxofemoral joint after replacement of a craniodorsal luxation, and allowed weight bearing and limb usage soon after surgery. The flexible external fixator has several advantages over other methods of treating craniodorsal coxofemoral luxations. Complications noted in this study included pin tract drainage, pin loosening, and disruption of the flexible bands.  相似文献   

16.
An arthroscopic procedure for examination of the coxofemoral joint was developed in nine foals (four cadavers, five anesthetized) to determine if access was sufficient for evaluation and surgical treatment of intra-articular lesions. The joint was distended and the arthroscope inserted through the notch (incisura trochanterica) between the cranial and caudal parts of the greater trochanter. This portal allowed examination of the cranial, lateral, and caudal aspects of the joint. Mechanical distraction of the joint through an instrument portal located 2 to 4 cm cranial and 1 to 2 cm ventral to the arthroscope portal allowed examination of the ligament of the head of the femur, the femoral head, and articular and nonarticular surfaces of the acetabulum. Adduction and rotation of the limb improved visualization of the craniomedial and caudomedial portions of the femoral head. Traction applied to the distal limb allowed visualization of the same structures that were observed when mechanical distraction was used. Traction also created space for placement of surgical instruments into the joint through the instrument portal. Access to most regions of the joint was adequate, but access to the caudal and medial aspects of the joint was limited. Three foals were killed while they were anesthetized, and their coxofemoral joints were dissected. Two foals were allowed to recover from anesthesia and were observed for 30 days after surgery. One foal was mildly lame for 2 days after surgery. The other foal was not lame after surgery. The incisions healed, and the coxofemoral joints were radiographically normal by postoperative day 30.  相似文献   

17.
OBJECTIVE: To quantify, using radiographic and computed tomographic (CT) techniques, the effects of surgical procedures most commonly combined to treat dogs with medial patellar luxation (MPL). STUDY DESIGN: Prospective study. METHODS: Six dogs with 8 MPL were studied. Radiographs and CT of the pelvic limbs were obtained before and immediately after soft-tissue reconstruction, trochlear wedge recession, and tibial crest transposition. Radiographic measurements included angle of inclination, Norberg angle, quadriceps angle (QA), anteversion angle, ratio of the length of the patellar tendon (PT) to the length of the patella, and change in patella tendon angle. CT measurements included angle of inclination, Norberg angle, QA, anteversion angle, depth of the femoral trochlear groove, ratio of the middle femoral trochlear groove depth to the patella thickness, and tibial crest alignment. RESULTS: Conformation of the coxofemoral joint was not affected by surgery. Surgical treatment corrected the QA by 33-58%. Trochlear wedge recession was most effective in deepening the proximal trochlea by 103.5%. The ratio of the middle femoral trochlear groove depth to the thickness of the patella postoperatively resulted in 50% coverage of the patella. Tibial crest transposition resulted in caudalization of the PT by 8.5+/-3.0 degrees, with lateralization of the tibial tuberosity of 11.3 degrees. CONCLUSION: The effects of surgery for MPL can be quantified with radiographic and CT measurements. Surgical correction restored the alignment of the quadriceps and adequately deepened the femoral trochlear groove. Tibial crest transposition resulted in caudalization of the patella tendon and lateralization of the tibial tuberosity. CLINICAL RELEVANCE: These pilot data quantified the effects of surgical procedures most commonly combined to treat MPL. We hope to use these measurements to correlate surgical treatment with functional outcome and postoperative occurrence of luxation.  相似文献   

18.
Radiographic evaluation of the pelvis in standing horses has been used to diagnose fractures of the pelvis, head and greater trochanter of the femur, and luxations of the coxofemoral joint. Coxofemoral luxation injuries are more common in smaller horse breeds and donkeys, but, due to their size, the standing ventrodorsal projection is not possible, as there is insufficient space to place the radiography equipment under the animal's abdomen. The objective of the study was to report the advantages and limitations of the use of an oblique radiographic projection to diagnose unilateral craniodorsal coxofemoral luxation in 3 ponies and a donkey performed with the animals standing under light sedation. All cases had severe unilateral hindlimb lameness and asymmetry of the gluteal region; 2 also had concurrent intermittent upward fixation of the patella. A standing dorsolateral 20–30° ventral oblique radiograph of the affected coxofemoral joint was performed in all cases to obtain a definitive diagnosis. Radiography of the coxofemoral joint in standing ponies and donkeys can be carried out to identify craniodorsal coxofemoral luxation avoiding the need for general anaesthesia.  相似文献   

19.
Bilateral degenerative coxofemoral joint disease and noninflammatory osteonecrosis in the femoral heads were diagnosed in a 5-month-old Standardbred colt. Cytologic evaluation and bacterial cultures of coxofemoral synovial fluid, and radiographic and pathologic examination of the coxofemoral joints were conducted. The cause was not determined; however, a thrombus found in association with 1 focus of osteonecrosis was suspected as an etiologic factor.  相似文献   

20.
Six cases of mechanical lameness involving the coxofemoral joint are presented. All dogs had a history of chronic rear leg pain and lameness, and decreased range of motion of the hip. On physical examination, ventral subluxation of the coxofemoral joint during extension was present in three dogs. A radiographic diagnosis of subluxation was made in five dogs. In each dog, surgical exploration of the area caudal to the coxofemoral joint revealed a fibrous mass between the lesser or third trochanters and the ischium, diagnosed as a nonneoplastic fibrous reaction by microscopic examination. The clinical, radiographic, and histopathologic signs were similar to previously described cases of myositis ossificans. Five dogs returned to normal function after excision of the soft tissue mass, and one dog was normal when lost to follow-up 4 weeks postoperatively.  相似文献   

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