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1.
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   

2.
While the use of external skeletal fixation was once associated with substantial postoperative morbidity, clinical and experimental studies have led to technological advances and modifications in application techniques that have greatly improved the results obtained with this treatment modality. The past decade saw numerous advances in external skeletal fixator implants, components and instrumentation, including improvements in fixation pin design, and the development of new linear external skeletal fixation systems and economical circular external skeletal fixation systems specifically engineered for use in dogs and cats. In addition, a greater understanding of fixator biomechanics and the pathobiology of the bone-fixation pin interface have improved fixator application practices. This article reviews many of the more significant recent advances in external skeletal fixation.  相似文献   

3.
A prospective study into the use of transarticular external skeletal fixation in the treatment of proximal interphalangeal instability was undertaken. Only dogs with soft tissue injuries were included. All the dogs except one were greyhounds or related breeds. A hypothesis was proposed that if the articular surfaces were held in normal congruency for a period of time then the development of periarticular fibrosis would alone give sufficient joint support. Joint congruency was maintained by the application of a unilateral external skeletal fixator for approximately three weeks. Complications were common and were due to frame impingement on the neighbouring digit, pin tract infection and pin loosening, and all resolved following frame removal and antibiotic therapy. Careful pin placement and prophylactic antibiotic treatment prevented complications in subsequent cases. All dogs returned to normal function with no lameness, with the exception of one racing greyhound which had a recurrence of the instability.  相似文献   

4.
Objectives— To describe the clinical outcome of a 4 pin lumbosacral fixation technique for lumbosacral fracture–luxations, and to refine placement technique for iliac pins based on canine cadaver studies.
Study Design— Retrospective and anatomic study.
Sample Population— Dogs (n=5) with lumbosacral fracture-luxations and 8 cadaveric canine pelvi.
Methods— Lumbosacral fracture–luxations were stabilized with a 4 pin (positive-profile threaded) and bone cement fixation. Caudal pins were inserted in the iliac body and cranial pins were inserted into the L7 or L6 pedicle and body. Follow-up examinations and radiographs were performed to assess patient outcome. Intramedullary pins were inserted into the iliac bodies of 8 cadaver pelvi. Radiographs were taken to measure pin insertion angles and define ideal insertion angles that would maximize pin purchase in the ilium.
Results— Follow-up neurologic examination was normal in 4 dogs. Radiographic healing of the fracture was evident in 5 dogs. One implant failure occurred but did not require re-operation. For cadaver iliac pins, mean craniocaudal insertion angle was 29° and mean lateromedial insertion angle was 20°.
Conclusions— Four pin and bone cement fixation effectively stabilizes lumbosacral fracture luxations. The iliac body provides ample bone stock, which can be maximized using an average craniocaudal pin trajectory of 29° and an average lateromedial pin trajectory of 20°.
Clinical Relevance— Lumbosacral fracture–luxations can be stabilized with 4 pin and bone cement fixation in the lumbar vertebrae and iliac body, using 29 and 20° as guidelines for the craniocaudal and lateromedial pin insertion angles in the ilium.  相似文献   

5.
Radiologic and gross anatomic evaluation of bone healing in the dog.   总被引：1，自引：0，他引：1  
Bone healing associated with 3 techniques of midshaft femoral fracture fixation in 36 young adult Beagle-type dogs was evaluated in radiographic and gross pathoanatomic studies. A serrated transverse fracture was surgically and aseptically created on the midshaft of either the left or the right femur of each dog. The fixation devices used were intramedullary (IM) pin, IM pin and 1/2 Kirschner device, and tension bone plates. The radiographic evaluation was done in series. The first radiographs were taken during surgery. Radiographs were then taken immediately after surgery, to record the status of reduction, alignment, and fixation. Radiographs were taken at the 4th and 10th postoperative weeks, to monitor healing. All dogs were euthanatized at the 10th week. Both the normal femur and the healing femur were removed from all dogs, all soft tissue was removed from the bone, and each femur was examined grossly. Each type of fixation was associated with a distinct mode of osteogenesis. Bony union and clinical union (that stage in the healing process when fixation can be removed) were defined as a successful conclusion to each case. Malunion and nonunion were defined as unsuccessful conclusions. Delayed union was defined as neither successful nor unsuccessful. The IM pin cases had a 64.2% success rate and a 14.2% failure rate. The IM pin and 1/2 Kirschner cases had a 100% success rate. The bone plate cases were 91% successful, with 0% failure. A problem identified with IM pinning was axial rotation (6 of 14 or 42% of the cases). It was concluded that IM pins should not be used alone for the fixation of femoral fractures in adult dogs.  相似文献   

6.
A modified intramedullary pin technique for surgical repair of distal femoral physeal fractures in dogs and cats provided stability at the fracture site and allowed early range of motion. The fixation and stability of this technique was compared with that achieved with a multiple pin technique. Fixation failure did not occur in 11 animals treated by the modified intramedullary pin technique, whereas there were 2 failures in 13 patients treated by a multiple pin technique.  相似文献   

7.
Fracture stabilization using circular external skeletal fixation was evaluated in 14 dogs with antebrachial fractures and 11 dogs with crural fractures. Most dogs were consistently weight bearing on the stabilized limb by 3 days following surgery. Although all dogs developed minor wire/pin tract inflammation and eight dogs developed major wire/pin tract inflammation, postoperative lameness was not consistently associated with wire/pin tract complications. Fractures in 23 dogs achieved radiographic union (mean +/- standard deviation [SD], 61 +/- 21 days; median, 57 days) without additional surgery; two dogs required restabilization of their fractures with linear fixators. Twenty of the 21 owners that could be contacted felt their dog had no (n=15) or only a mild (n=5) intermittent lameness at the time of final, long-term (mean +/- SD, 37 +/- 17 months; median, 42 months) assessment.  相似文献   

8.
External skeletal fixation is a very useful technique for managing many orthopedic problems in veterinary practice. The Kirschner apparatus has been the most widely used fixator for many years in veterinary orthopedics because of its versatility, simplicity, and economy in use. The medium-sized device has the widest indications and is easiest to begin with. The small size can be acquired later for use on cats and small dogs. The new "raised thread" fixation pin designs improve bone-pin integrity and can be used in combination with nonthreaded pins to decrease the incidence of postoperative complications and for economy. Acrylic-pin external fixators are particularly useful for treatment of mandibular fractures and transarticular application since they allow nonlinear placement of fixation pins in highly contoured bones. A commercial system, currently being developed, will have all the equipment and materials necessary for their application in a convenient kit. Circular fixators (Ilizarov design) use thin K wires placed under tension to replace rigid fixation pins. Their unique adjustability characteristics make them useful in the treatment of limb deformity and shortening. Many other human fixators can be used for veterinary application if the basic principles of fixators are followed. Instrumentation required for external fixator application include a pin driver, pin cutter, and wrenches. Although surgical versions of these materials are available, less expensive alternatives are available using gas sterilization instead of autoclaving. The use of selected orthopedic instrumentation such as a periosteal elevator, bone clamps, and curets will facilitate fracture management.  相似文献   

9.
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   

10.
A technique using a modification of the transilial pin technique for stabilization of fracture/ luxations of the lumbosacral joint was performed in six dogs. This technique used an internal skeletal fixator composed of two transilial pins secured with two double fixator clamps. Collapse (shortening) of the seventh lumbar vertebra (L7) was observed in five dogs without compromise of the vertebral canal. Kirschner wires placed across the articular facets as supplemental fixation devices migrated to the subcutaneous tissues in two dogs and were easily removed. Migration of the internal fixators was not observed during healing; vertebral canal dimensions were maintained in all cases, and the internal fixators were not removed after resolution of fracture healing. All fractures were healed within 6 to 12 weeks of surgery without evidence of pain, neurologic impairment, or long-term complications.  相似文献   

11.
OBJECTIVE: To compare anatomic reduction and the biomechanical properties of a circular external skeletal fixator (CESF) construct to pin and tension band wire (PTBW) fixation for the stabilization of olecranon osteotomies in dogs. STUDY DESIGN: Cadaveric study. ANIMALS: Forelimbs from 12 skeletally mature mixed-breed dogs, weighing 23 to 28 kg. METHODS: An olecranon osteotomy was stabilized with either a CESF construct or PTBW fixation. A single distractive load to failure was applied to each specimen through the triceps tendon. Osteotomy reduction and biomechanical properties were compared between fixation groups. RESULTS: Reduction was not significantly different (gap: P =.171; malalignment: P =.558) between fixation groups. Osteotomies stabilized with the CESF had greater stiffness (P <.0001) and maximum load sustained (P <.0001) compared to PTBW fixation. There was no significant difference for yield load (P =.318) or for load at 1 mm of axial displacement (P =.997) between fixation groups. Failure of fixation occurred by bending of the intramedullary Steinmann pin and the fixation wires in the CESF specimens and by untwisting of the tension band wire knot with pullout and bending of the Kirschner wires in the PTBW specimens. CONCLUSIONS: Specimens stabilized with the CESF construct had similar reduction and yield load, greater stiffness and maximum load sustained, and less elastic deformation than specimens stabilized with PTBW fixation. CLINICAL RELEVANCE: The CESF construct may provide a biomechanically favorable alternative to PTBW fixation for stabilization of olecranon osteotomies in dogs, and its application warrants clinical investigation.  相似文献   

12.
Highly comminuted supracondylar humeral fractures were stabilised in six large-breed dogs with a modified type I external fixator using a craniomedial acrylic connecting column and an Intramedullary pin which was incorporated into the connecting frame. This construct provided sufficient stability to allow satisfactory bone healing in five of the six dogs, while premature removal of the intramedullary pin and external fixator resulted in subsequent refracture of the humerus in the remaining dog. Limb function at the time of final assessment was considered excellent in two dogs, good in three dogs and poor in one dog. The craniomedial acrylic connecting column simplified application of this modified type 1(a) configuration to the humerus by reducing the number of clamps required; the acrylic column also facilitated contouring of the cranlomedial connecting column to the brachium and was readily extended proxlmally to engage the intramedullary pin. In addition, the acrylic connecting column allowed placement of intramedullary pins of varying diameter.  相似文献   

13.
Severely comminuted diaphyseal fractures in 11 dogs were repaired with standard bone plates that spanned a fracture gap filled with autogenous cancellous bone graft. Five dogs had closed injuries, 4 dogs had open fractures, and 2 dogs had infected nonunion fractures for which previous attempts at internal pin fixation had failed. A second autogenous cancellous bone graft was performed in 3 of the dogs during the healing period. The technique was successful in all dogs. The technique was considered a versatile and relatively simple alternative, compared with meticulous small fragment reconstruction and cortical bone allografts.  相似文献   

14.
OBJECTIVE: To describe for the first time a modification of the De Vita pinning technique to manage hip luxation in the dog and to assess its use in a preliminary study. DESIGN: A prospective, clinical study using five client-owned dogs with naturally occurring injuries. PROCEDURE: A modified De Vita pinning technique was employed, using a nonthreaded Steinmann pin to reduce the risk of trauma to the sciatic nerve during pin insertion. The pin was anchored by implanted Kirschner-Ehmer clamps in an attempt to lower the risk of postoperative pin migration. RESULTS: Surgical outcome was very favourable with respect to pain on manipulation, restriction of range of movement and lameness in all dogs as assessed by veterinary examination. In four of five dogs, owners also reported normal movement at rest, walk and trot. The fifth dog was lost to follow-up. CONCLUSION: This preliminary study found that a modified De Vita pinning technique was useful in dogs with uni and bilateral hip luxation and hip luxation in the presence of other limb injuries. The modified technique may provide a sound surgical alternative to existing procedures. The described modification allows the use of a nonthreaded pin and also substantially reduces the risk of postoperative pin migration.  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.
Steinmann pins and methylmethacrylate were used to stabilize 17 vertebral fractures or luxations and one unstable congenital spinal deformity in 18 dogs of a wide range of ages and body weights. Of 12 dogs available for follow-up examination (4–43 months), 10 were normal or only mildly ataxic, and two were ambulatory but severely ataxic. Five dogs died or were euthanized in the early postoperative period, but none of the deaths could be attributed to the technique. Uncommon complications associated with this fixation technique were pin migration and wound infection.  相似文献   

17.
Objective— To compare the biomechanical properties of cervical arthroplasty to a ventral slot procedure and pin‐polymethylmethacrylate (pin‐PMMA) fixation. Sample Population— Fresh cadaveric cervical (C2–T1) spines from 6 large dogs. Methods— Four spinal conditions were studied in each spinal specimen: intact, disk arthroplasty, ventral slot, and fixation with smooth pin‐PMMA at C5–C6 intervertebral space. Axial compression, torsion, flexion–extension, and lateral bending moments were sequentially tested on each specimen for the 4 spinal conditions. Data from the C3–C4, C4–C5, C5–C6, and C6–C7 vertebral motion units (VMUs) were compared among treatments. Results— In axial compression and torsion, the ventral slot procedure allowed significantly less motion than intact, pin‐PMMA, and arthroplasty groups at C5–C6. In lateral bending and flexion–extension, pin‐PMMA had the least motion of C5–C6, followed by the arthroplasty group, intact spine, and ventral slot, all of which were significantly different from each other. Overall, the artificial disk was better able to mimic the behavior of the intact specimens compared with the ventral slot and pin‐PMMA, producing similar displacements in axial compression and rotation in torsion, but more limited motion than intact in flexion–extension and in lateral bending. Conclusion— Cervical spine specimens with an implanted prosthesis have biomechanical behaviors more similar to an intact spine compared with spinal specimens with ventral slot and pin‐PMMA procedures. Cervical arthroplasty may then preserve some of the motion in the affected area after neural decompression while providing distraction. Clinical Relevance— Cervical arthroplasty should be further investigated in vivo to determine if it is a viable alternative to the ventral slot or pin‐PMMA procedures for surgical treatment of cervical diseases in dogs and in particular for treatment of disk‐associated caudal cervical spondylomyelopathy.  相似文献   

18.
Toggle pin stabilization is an accepted technique for the management of coxofemoral (CF) luxation in dogs. The purpose of this study was to determine, in vitro, the respective contributions of several aspects of toggle pin repair to the overall stability of fixation. Factors evaluated were the manner and frequency with which toggle pins oriented on insertion, effect of orientation on toggle pin strength, effect of suture type on ligament prosthesis strength and load sustained by the fixation, and comparison of repair using a modified toggle design to that of capsulorrhaphy. When placed in cadavers using standard technique, conventional toggle pins were found to orient significantly more frequently in one of two possible positions. Mechanical testing of fixations performed in experimentally luxated cadaver hips demonstrated a high (12/20) incidence of toggle pin failure using the conventional implant in the most common orientation. When tested alone, toggle pins were weakest mechanically in this orientation. Rotating the implant 180° increased mean load to failure by 249%. There was no significant difference in load sustained by conventional toggle fixations using No. 2 braided polyester versus 50 lb test monofilament nylon as the suture ligament prosthesis. However, the higher stiffness of the polyester suture may be more favorable for use in this application. Fixation using a toggle rod designed to allow evaluation of construct stability when failure of the toggle is eliminated resulted in an increase in maximum load sustained before luxation (47% of the intact control hips). This load was not significantly different than the resistance to luxation afforded by capsulorrhaphy. This study suggests that when implanting conventional toggle pins, consideration should be given to ensuring placement in the strongest orientation.  相似文献   

19.
Objective: To report use of semicircular external skeletal fixators (ESF) for management of femoral fractures in dogs. Study Design: Prospective clinical study. Animals: Dogs (n=16) with femoral fractures (n=18). Methods: A semicircular ESF system composed of 6‐hole 45° or 5‐hole 40° carbon‐fiber arches, 6 mm threaded rods, half pin fixation bolts, 6 mm nuts, and negative profile end‐threaded half pins were used for open repair of femoral fractures. ESF configuration, complications, limb use, fixator removal time, and functional outcomes were evaluated. Outcome was graded as excellent, good, fair, or poor. Results: Seventeen fractures with sufficient follow‐up healed. Eight dogs started using the limb immediately after waking up from anesthesia whereas initial limb use was 1–4 days after repair in the other dogs. Time to fixator removal ranged from 28 to 63 days (mean, 38 days). Functional outcome was excellent in 13 cases, good in 4, and poor in 1 nonunion. Conclusion: Semicircular ESF combined with open surgical reduction can be used to successfully repair metaphyseal and diaphyseal femoral fractures in young growing dogs.  相似文献   

20.
OBJECTIVE: To compare the mechanical properties of two types of external skeletal fixation of the lumbar spine with polymethylmethacrylate (PMMA)/Steinmann pin fixation in a canine unstable spine model. STUDY DESIGN: Cadaver study. SAMPLE POPULATION: Lumbar spines of 17 mature large-breed dogs. METHODS: Spine stiffness (N-m/deg) in flexion, extension, and rotation under physiological loading conditions and spine strength (N-m) in flexion were determined. Spines were destabilized at L3-L4, instrumented and retested. Fixation techniques included four-pin PMMA (PMMA4), eight-pin PMMA (PMMA8), eight-pin biplanar type I external skeletal fixator (ESF) (SK), and eight-pin spinal arch ESF (ARCHES). RESULTS: All fixation groups were as stiff as intact spines in extension and rotation and were significantly stiffer in flexion. In flexion, both PMMA8 and ARCHES were significantly stiffer than SK, and PMMA8 was significantly stiffer than PMMA4. In rotation, PMMA8 and ARCHES were significantly stiffer than SK, and in flexion to failure, PMMA8 and ARCHES were significantly stiffer than PMMA4. CONCLUSIONS: External skeletal spinal fixation (ESSF) has mechanical properties comparable to more commonly used PMMA/pin internal fixation techniques. CLINICAL RELEVANCE: External fixation of the canine spine has several potential advantages over internal fixation including minimal dissection for pin placement, the ability to span affected vertebrae with placement of implants distant from the site of injury, postoperative adjustability, and complete removal of implants after healing. This study supports the biomechanical stability ESSF of the canine lumbar spine. Further studies are indicated to evaluate zones of consistently safe and secure placement of pins and clinical efficacy.  相似文献   

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