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1.
The paper presents observations made on hip luxation in cats in general practice over a four-year period. Attention is drawn to some previous reports of this common injury, and discusses the use of the De Vita pin when reluxation follows a closed reduction. The possibility of sciatic nerve injury following this technique is mentioned.  相似文献   

2.
Objective: To investigate whether preexisting coxofemoral subluxation/luxation predisposes to postoperative total hip replacement (THR) luxation. Study Design: Case series. Animals: Dogs (n=100) that had cemented THR (n=109); 23 normal controls. Methods: A preliminary study was performed to validate our methods of assessing luxation and laxity by comparing dogs with severe hip dysplasia with a control population of normal dogs. For the main study, the records and radiographs of all dogs that had primary THR were reviewed. Measurements taken from preoperative radiographs to quantify hip subluxation/laxity included the Norberg angle, subluxation index, and 2 new measures: acetabular depth ratio (ADR) and dorsal acetabular rim ratio (DARR). Differences between groups that had luxation within 8 weeks and those that did not were investigated. Results: Postoperative luxation occurred in 13 dogs (12%) within 8 weeks of surgery. Luxation was significantly associated with various measurements (including Norberg angle, ADR, DARR) thought to reflect degree of subluxation/soft tissue tension. Conclusion: Luxation after canine THR is a multifactorial problem but preexisting subluxation/soft tissue laxity is a significant risk factor for this complication.  相似文献   

3.
Unilateral medial patellar luxation was diagnosed in 10, and bilateral medial patellar luxation in six, large and giant-breed dogs (22 stifles). Lameness occurred in five dogs after trauma or surgery, and 11 dogs had no known predisposing history. The mean age at presentation was 25 months, and the mean time from initial onset of clinical signs to diagnosis was 13 weeks. All traumatic or iatrogenic luxations (five dogs) were unilateral. Luxations presumed to be congenital were unilateral in five dogs and bilateral in six. The grades of medial patellar luxation were I (1 stifle), II (11 stifles), III (9 stifles), and IV (1 stifle). Preoperative function was good (1 dog), fair (9 dogs), and poor (6 dogs). Surgical correction was performed in dogs with grades II, III, and IV luxations (21 stifles). Complications included one wound dehiscence and trochlear wedge migration, one pin loosening, and one persistent lameness caused by lymphoplasmacytic synovitis. Long-term follow-up was available in 13 dogs (18 stifles). Function was judged by owners to be excellent in seven dogs, good in five dogs, and poor in one dog. Surgical treatment of grades II and III luxations yielded good (8 stifles) and excellent (9 stifles) results, while one grade IV luxation had a poor long-term outcome.  相似文献   

4.
OBJECTIVE: To determine the practicality and clinical outcome of miniature total hip replacement (THR) in dogs. STUDY DESIGN: Retrospective study. Sample Population- Seventeen client-owned dogs that had miniature THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, implant size, surgical technique, and intraoperative and postoperative complications. Radiographic evaluation included angle of lateral opening of the acetabular component, implant positioning, cement mantle quality, and femoral displacement measurement and ratio. Client questionnaire and orthopedic examination were used to obtain long-term follow-up information. RESULTS: Miniature THR was performed to address hip dysplasia and secondary osteoarthritis. In 1 dog, a staged bilateral procedure was performed. Mean body weight was 19 kg (range, 12 to 25 kg). Penetration or fissure of the femoral cortex was the most common intraoperative complication and occurred in 3 dogs. In 3 dogs, there was excessive coxofemoral laxity after reduction of the prosthesis. This instability was addressed specifically in 2 dogs by capsulorrhaphy or capsular prosthesis. Postoperative convalescent complications (craniodorsal luxation, 2 dogs; acetabular cup displacement, 1 dog) were related to surgical errors. Aseptic loosening of the femoral implant was diagnosed in 1 dog at 18 months. Mean follow-up time was 17 months (range, 4 to 42 months). Fifteen of 18 (83%) miniature THRs had good or excellent outcomes. CONCLUSIONS: Miniature THR should be considered a satisfactory alternative to femoral head and neck ostectomy in medium-size dogs affected by hip dysplasia and secondary osteoarthritis. The population of medium-size dogs that might derive more benefit from THR than FHO has yet to be defined. CLINICAL RELEVANCE: Miniature THR is a viable treatment option in medium-size dogs with hip dysplasia.  相似文献   

5.
Three different pin types (Ellis, enhanced threaded, and nonthreaded) were used in type 1 external skeletal fixation after transverse osteotomy of the radius and ulna in 12 skeletally mature dogs. Dogs were placed into three groups of four dogs based on the pin type used. Axial extraction forces were determined for each of the pin types after 8 weeks of weight bearing (chronic study). Nine contralateral radii were used to determine axial extraction forces for nine of each pin type not subjected to weight bearing forces (acute study). The force required for extraction of the enhanced threaded and Ellis pins in the chronic and acute studies was not significantly different. The force required to extract the nonthreaded pins was significantly less than that required for the other two pin types. Ground reaction forces had returned to levels measured before surgery by 2 weeks after surgery in the enhanced threaded and Ellis pin groups, however, dogs in the nonthreaded pin group required 4 weeks until normal ground reaction forces were measured. Radiographic evaluations 1,2,4, 6, and 8 weeks after surgery showed no difference among groups in the number of pin tract radio-lucencies, however, the enhanced threaded pins had caused more trans-cortical chip fractures than the other two pin types. None of the pins broke during the eight-week chronic study.  相似文献   

6.
OBJECTIVE: To determine long-term outcome of distal femoral osteotomy as a component of treatment for distal femoral varus and medial patellar luxation in large-breed dogs. DESIGN:Retrospective case series. ANIMALS: 12 dogs (16 stifle joints). PROCEDURES: Medical records and radiographs were reviewed to identify large-breed dogs with medial patellar luxation (grade > or = 2) and femoral varus angle > or = 12 degrees treated with distal femoral osteotomy, with a minimum follow-up (by a veterinarian) of 18 months. Signalment, weight, medial patellar luxation and lameness grade, pre- and postoperative femoral varus angle, surgical technique, time to radiographic bone union, and complications were recorded. Follow-up with owners via questionnaire was performed > 18 months after surgery. RESULTS: 16 corrective distal femoral osteotomies were performed with ancillary medial patellar luxation procedures in 12 dogs; 4 dogs had staged bilateral procedures. Mean +/- SD preoperative and postoperative femoral varus angles were 16.3 +/- 4.3 degrees and 3.9 +/- 2.5 degrees , respectively. Mean +/- SD time to radiographic union of the distal femoral osteotomy was 52.6 +/- 13 days. One dog had Kirschner wire migration from the tibial tuberosity. Patellar luxation was not detected after surgery in any dog. Mean +/- SD follow-up by a veterinarian was 1,335 +/- 410 days and by use of an owner questionnaire was 1,497 +/- 464 days. All 10 variables of owner-observed patient comfort and function were significantly improved. CONCLUSIONS AND CLINICAL RELEVANCE: Distal femoral osteotomy in combination with traditional treatment provided predictable osteotomy healing, patellar stabilization, and long-term improvement in patient comfort and function when used to treat combined distal femoral varus and medial patellar luxation in large-breed dogs.  相似文献   

7.
A transarticular pinning technique is described for the treatment of coxo-femoral luxation in the dog. It provides an alternative technique in recurrent luxation cases and in cases complicated by other factors which render more conservative methods inapplicable.  相似文献   

8.
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   

9.
Objective— To report clinical features associated with iatrogenic peripheral nerve injury in dogs and cats admitted (1997–2006) to a referral teaching hospital.
Study Design— Retrospective study.
Animals— Dogs (n=18), 9 cats.
Methods— Patients had acute signs of monoparesis attributable to sciatic nerve dysfunction that developed after treatment. Neurologic examination and electrodiagnostic testing were performed. Surgical therapy was used for nerve entrapment and delayed reconstructive surgery used in other cases.
Results— Of 27 nerve injuries, 25 resulted from surgery (18 with treatment of pelvic injuries). Iliosacral luxation repair resulted in tibial (4 cats) and peroneal (3 dogs) nerve dysfunction. Other causes were intramedullary pinning of femoral fractures (3), other orthopedic surgery (cemented hip prosthesis [2] and tibial plateau-leveling osteotomy [1]), and perineal herniorrhaphy [1]. Nerve injury occurred after intramuscular injection (1 cat, 1 dog). Immediate surgical treatment was removal of intramedullary nails, extruded cement, or entrapping suture. Delayed nerve transplantation was performed in 2 dogs. Within 1 year, 13 patients recovered completely, clinical improvement occurred in 7, and there was no improvement in 7. Five of the 7 dogs that did not recover had acetabular or ilium fracture.
Conclusion— Iatrogenic sciatic nerve injury occurred most commonly during treatment of pelvic orthopedic diseases and had a poor prognosis. Clinical variation in sciatic nerve dysfunction in dogs and cats can be explained by species anatomic differences.
Clinical Relevance— Iatrogenic sciatic nerve injury leads to severely debilitating locomotor dysfunction with an uncertain prognosis for full-functional recovery.  相似文献   

10.
A modified segmental spinal stabilization technique was used in four dogs weighing 10 to 56 kg with thoracolumbar and lumbosacral spinal fractures/luxations. A Steinmann pin was bent to encircle the dorsal spinous processes and was wired together with longitudinal pins to the cranial articular facets and dorsal spinous processes in the thoracolumbar application. The central pin was omitted, and the longitudinal pins were bent at a right angle and passed through the ilial wings in the lumbosacral application. Fracture fixation and stabilization were excellent in all dogs. One broken pin was detected in one dog after 18 months. No other complications due to the spinal instrumentation were observed. Neurologic recovery was excellent in two dogs, good in one dog, and fair in one dog.  相似文献   

11.
OBJECTIVE: To review surgical techniques and postoperative complications associated with correction of patellar luxation in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n = 109) with patellar luxation (n = 131). METHODS: Medical records of dogs that had corrective surgery for patellar luxation were reviewed. Signalment, history, grade and direction of patellar luxation, operative technique and clinical outcomes were retrieved. RESULTS: Overall frequency of postoperative complications was 18%. Frequency of major (requiring revision surgery) complications was 13%. Frequency of patellar reluxation was 8%. Frequency of overall, major, and patellar reluxation complications was higher for dogs weighing > or =20 kg compared with those <20 kg. Frequency of overall and major complications was higher for dogs with higher grades of patellar luxation. Femoral trochlear sulcoplasty resulted in lower frequency of patellar reluxation. Tibial tuberosity transposition (TTT) resulted in lower frequency of major complications and patellar reluxation. Retinacular/capsular release resulted in higher frequency of major complications. Patient age, gender, medial versus lateral patellar luxation, left versus right hindlimb, capsular/retinacular imbrication, use of anti-rotational sutures, and whether stifle surgery had been performed previously did not significantly influence frequency of complications. CONCLUSION: TTT and femoral trochlear sulcoplasty minimize the risk of postoperative patellar reluxation and major complications. CLINICAL RELEVANCE: Information derived from this study can be used to estimate the likelihood of postoperative complications for canine patients undergoing corrective surgery for patellar luxation.  相似文献   

12.
OBJECTIVE: To report successful limb-sparing surgery in a dog with a proximal femoral osteosarcoma (OSA) using a composite allograft-prosthetic technique. STUDY DESIGN: Case report. ANIMAL: Client-owned dog. METHODS: A stage IIB OSA of the proximal aspect of the femur was resected in accordance with oncologic and limb-sparing principles. The osseous defect was reconstructed with a proximal femoral allograft and cemented, long-stemmed femoral prosthesis. Soft tissue reconstruction was achieved by suturing host tendons to their respective allogeneic tendons on the allograft. Coxofemoral joint function was preserved using standard total hip arthroplasty techniques. RESULTS: Limb-sparing surgery of the proximal aspect of the femur using a composite allograft-prosthetic technique resulted in excellent limb function. Postoperative complications included aseptic loosening of the femoral composite graft and allograft nonunion, which required revision, traumatic implant luxation, and local tumor recurrence. Limb function was excellent after surgical stabilization of the allograft nonunion but deteriorated after implant luxation 270 days postlimb-sparing surgery. Pulmonary and skeletal metastases were diagnosed and local tumor recurrence suspected 596 and 650 days postoperatively, respectively. The dog was euthanatized 688 days after limb-sparing surgery as a result of progressive local and metastatic disease. CONCLUSIONS AND CLINICAL RELEVANCE: Limb-sparing surgery for dogs with primary bone tumors of the proximal aspect of the femur is feasible with good functional results.  相似文献   

13.
Objective: To describe the surgical technique for the micro total hip replacement (Micro THR) system and report clinical outcomes. Study Design: Prospective study. Animals: Dogs (n=49) and cats (n=8) with coxofemoral arthropathy. Methods: Small breed dogs and cats with coxofemoral arthritis were enrolled for Micro THR. Patient data were recorded. Implant positioning and cement mantle quality were evaluated radiographically. Orthopedic examinations and client interviews were used to assess outcome. Results: Micro THR was performed unilaterally (40 dogs, 8 cats) and staged bilaterally (9 dogs) to resolve pain associated with osteoarthritis or trauma. Mean body weight was 7.2 kg. Postoperative complications included prosthesis luxation (9), cup aseptic loosening (1), and sciatic neurapraxia (1). Mean radiographic follow up was 96.1 weeks; 10 joints were followed for ≥3.0 years. Sixty of the 66 (91%) Micro THRs had excellent outcomes. Two dogs (<2.75 kg) were too small for the prosthesis and 4 dogs with unmanageable luxation had explantation. Conclusions: Micro THR is considered a satisfactory procedure for management of small breed dogs and cats with coxofemoral disease unresponsive to medical management. Clinical Relevance: Micro THR is a viable option to treat disabling disorders of the hip. More than 170 cat and small dog breeds, and many mixed breeds, could benefit from Micro THR surgery.  相似文献   

14.
OBJECTIVE: To identify risk factors for luxation after canine total hip replacement (THR). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: 256 client-owned dogs that underwent THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, prior hip surgery, implant size, intraoperative complications, and angle of lateral opening of the acetabular component. RESULTS: Postoperative complications were recorded in 20 cases (7.8%). The most common complication was dorsal luxation which occurred in 12 dogs (4.7%). The interval between joint replacement and luxation ranged from 1 to 116 days (mean, 44 days). In 1 case, luxation was attributable to failure of the repair of an intraoperative fracture of the greater trochanter. Excluding this case, the mean angle of lateral opening in those dogs that sustained luxation was 62 degrees (range, 46 degrees - 75 degrees). The mean angle of lateral opening overall was 48 degrees (range, 18 degrees - 76 degrees). The angle of lateral opening was the only factor that had a statistically significant effect on whether luxation occurred (P = .035). Acetabular revision, performed primarily to reduce the angle of lateral opening, was performed in 8 dogs and successfully prevented subsequent luxation. CONCLUSION: Luxation of the prosthesis is substantially under the control of the surgeon. It is recommended that the acetabular cup be inserted at an angle of lateral opening of 35 degrees to 45 degrees. In those cases of THR luxation in which an inappropriate angle of lateral opening is identified, acetabular revision arthroplasty generally results in a good clinical outcome.  相似文献   

15.
Patellar luxation in 70 large breed dogs   总被引：1，自引：0，他引：1  
O bjectives : To report the signalment, history, clinical features, and outcome in dogs weighing greater than 15 kg, treated surgically and non-surgically for patellar luxation. Risk factors for the development of patellar luxation, postoperative complications, and outcome were evaluated.
M ethods : Details regarding signalment, bodyweight, breed, aetiology, unilateral or bilateral luxation, duration of lameness, grade of luxation, direction of luxation, grade of lameness at presentation, concomitant cranial cruciate ligament rupture, method of treatment, surgical technique, surgeon, and complications were obtained from the medical records. Outcome was graded as excellent, good, fair, or poor, according to the degree of lameness.
R esults : Seventy dogs (45 males and 25 females) were included. Thirty-five had bilateral luxations (105 limbs). Mean age was two years, and mean weight was 30 kg. The relative risk for Labrador retrievers was 3·3 (P<0·001). All luxations were developmental. Luxations were medial in 102 stifles and lateral in three. Fourteen stifles had concomitant cranial cruciate ligament rupture. As the grade of patellar luxation increased, so did the grade of lameness (P<0·001). Surgery was performed in 70 stifles, and outcome was excellent/good in 94 per cent and fair/poor in 6 per cent of stifles. Complications occurred in 29 per cent of stifles, and increasing bodyweight was found to be a risk factor (P=0·03). Thirty-five stifles were managed non-surgically, and outcome was excellent/good in 86 per cent and fair/poor in 14 per cent of stifles.
C linical S ignificance : In view of the potential risk of postoperative complications, all surgically treated cases of patellar luxation in large breed dogs should be managed with a femoral trochleoplasty, a tibial tuberosity transposition (stabilised with K-wires and a tension band wire), and soft tissue releasing and tightening procedures.  相似文献   

16.
A surgical technique is described for transposition of the sacrotuberous ligament to replace the teres ligament in the treatment of coxofemoral luxation in dogs. Ten dogs with coxofemoral luxation were treated using this technique and all animals regained full limb function within two months of surgery. It is suggested that the technique could be employed in dogs suffering from all types of hip luxations.  相似文献   

17.
Congenital luxation of the ulnar and radius is a rare orthopaedic condition in the dog. This case report describes a novel surgical treatment for congenital elbow luxation in a medium-breed dog. A 6-week-old Kelpie presented for left forelimb lameness and deformity. Radiographs and computed tomography (CT) confirmed the diagnosis of unilateral ulnar and radius luxation. The surgical repair involved open reduction followed by fixation with an extraarticular pin and a transarticular external fixator. The outcome of surgery was improved leg function and weight-bearing, however, reluxation of the radial head was diagnosed 7 weeks following surgery. This technique may offer an alternative surgical option to improve clinical signs, as well as insight into improving the management of this condition.  相似文献   

18.
OBJECTIVE: To determine outcome of open toggle rod stabilization in dogs with luxation of the hip joint. Design-Retrospective case series. ANIMALS: 62 dogs. PROCEDURES: Information on signalment, surgical procedure, and postoperative care was obtained from the medical records. A questionnaire was sent to all owners to solicit follow-up information. RESULTS: The distribution for time between luxation and surgery was bimodal, with 24 (39%) dogs examined < or = 2 days after injury and 23 (37%) examined > 7 days after injury. Postoperative complications developed in 16 of the 62 (26%) dogs, with complications developing within 1 week after surgery in 10 of the 16. The most common complication was reluxation, which occurred in 7 dogs. Dogs in which surgery time was < 2 hours were significantly less likely to have a reluxation (2/40 [5%]) than were dogs in which surgery time was > or = 2 hours (5/22 [23%]). When asked to rate current limb function (0 = no lameness and 5 = non-weightbearing lame) a minimum of 6 months after surgery, 23 of 27 (85%) owners indicated a score of 0 or 1. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggest that toggle rod stabilization is an effective treatment for hip joint luxation in dogs. However, complications, particularly reluxation, were common.  相似文献   

19.
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   

20.
This retrospective study documents deep gluteal tenodesis (DGT) used to stabilize coxo- femoral luxation (CFL) in dogs and cats, and to report reluxation rate and clinical outcome after DGT. Medical records (1995-2008) of 65 dogs and cats with traumatic CFL treated by capsulorrhaphy and DGT were reviewed. Animals with radiographic evidence of pre-existing hip dysplasia or articular fractures had been excluded. Reluxation rate and outcome were assessed by clinical examination, performed two and ten weeks postoperatively. Surgical treatment was performed between one and 20 days after the initiating event. No perioperative complications occurred. All hip joints were correctly reduced and stabilized immediately after DGT completion. Except for five patients, placement of the screw was considered correct. In two of these patients, the screws were too long and were protruding into the pelvic canal. In two dogs, the screws were not tightened adequately, and in one dog the screw was too short. Twenty-six dogs and eight cats were re-examined between eight and 13 weeks postoperatively. Re- luxation did not occur in any of them. Outcomes were good in two cases and excellent in 32 cases; all but two had a normal range-of-motion of the reconstructed hip, and were free of lameness and did not show any signs of pain. Traumatic CFL can be stabilized safely and effectively by DGT in dogs and cats. This technique should be considered among other capsular reinforcement techniques in the presence of an intact deep gluteal muscle.  相似文献   

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