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1.
The purpose of this retrospective study was to review the clinical use along with the short- and long-term outcome in patients treated with Lubra plates to stabilize spinal fracture and dislocations that were considered unstable at time of surgery according to the 'three compartment theory'. The data that were collected included breed, age, gender, body weight of the patients, cause of injury, neurological grade (pre- and postoperative), radiographic findings, surgical treatment, and clinical and radiological outcome. Thirteen dogs and two cats were included with thoracic (1 case), thoracolumbar (3 cases), midlumbar (5 cases) and caudal lumbar (6 cases) vertebral fractures. For stabilization, the small-sized (3 cases), medium-sized (6 cases), and large-sized (6 cases) Lubra plates were used. The clinical outcome was excellent in 10/15 patients, functional in 2/15 and poor in 3/15 with a median follow-up period of nine years (range 2 months to 12 years). The fractures eventually stabilized by ventral spondylosis. No implant failure was seen, however demineralization of the spinous processes necessitated implant removal in one case. Our results suggest that Lubra plating is an appropriate technique for thoracolumbar and lumbar vertebral fractures as well as luxations in dogs and cats. The prognosis for neurological recovery was excellent when the animal had a neurological grade of 3 and was not paralyzed.  相似文献   

2.
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   

3.
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   

4.
Objective— To evaluate outcome after closed fluoroscopic-assisted application of spinal arch external skeletal fixators in dogs with vertebral column injuries.
Study Design— Retrospective case series.
Animals— Dogs with traumatic vertebral column injuries (n=5).
Methods— Medical records of dogs with vertebral column fractures and/or luxations stabilized with spinal arch external skeletal fixator frames applied using a closed fluoroscopic-assisted technique were reviewed. Owners were contacted to obtain long-term clinical outcomes.
Results— Five dogs (age range, 6–72 months; weight, 10–54 kg) had traumatic vertebral column injuries stabilized with spinal arch external skeletal fixators applied in closed fashion. Injuries involved vertebral segments of the thoracolumbar junction, lumbar spine, and lumbosacral junction. Immediately postoperatively, 4 dogs had anatomic alignment of their vertebral fracture/luxation; 1 dog had 1 mm of vertebral canal height compromise. Time to fixator removal ranged from 65 to 282 days (141±87 days). All dogs had regained satisfactory neurologic function by 3 months. At long-term follow-up (range, 282–780 days; mean 445±190 days) all dogs were judged to have good to excellent return of function by their owners.
Conclusion— Successful closed fluoroscopic-assisted application of external skeletal fixators using spinal arches provided satisfactory reduction with few complications in 5 dogs. Return to function was judged to be good to excellent in all dogs at long-term evaluation.
Clinical Relevance— Closed fluoroscopic-assisted application of ESF using spinal arches provided satisfactory reduction and effective stabilization of spinal fractures with few complications and should be considered as a treatment approach.  相似文献   

5.
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   

6.
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   

7.
External fixation of the vertebral column is indicated to treat fractures of the caudal lumbar spine, open fractures where vertebral osteomyelitis is present or likely to occur, and vertebral fractures not easily stabilized by internal fixation alone (e.g., compression fractures, fractures including spinous processes, and articular facets). Advantages of external fixation of caudal lumbar fractures, especially in combination with dorsal fixation devices, include the following: Fracture fixation does not preclude dorsal decompression; fixation devices need not be applied directly to the fractured vertebrae; and the combined technique provides dorsal and ventral vertebral fixation, which is more stable than dorsal fixation alone. Although external fixation is not applicable to all vertebral fracture/luxations in small animals, it provides additional points of fixation for rigid stability. Animals with vertebral fracture/luxations treated with an external fixation device have tolerated the external portion well. Development of additional applications for this method of vertebral fracture repair seems warranted.  相似文献   

8.
Two useful techniques for the repair of caudal sacral fractures and sacrococcygeal fractures/luxations are described. Pre- and postoperative clinical, neurological and radiological findings in 16 operated animals (13 cats and 3 dogs) were compared with findings in 17 (13 cats and 4 dogs) conservatively treated animals. In the surgically treated patients follow up findings were characterized by absence of hyperesthesia and a higher number of animals with recovered tail function. The authors suggest the use of these techniques in cases of caudal sacral fractures or sacrococcygeal fractures/luxations.  相似文献   

9.
Maxillofacial miniplates and screws were used for skeletal fixation in 15 dogs and 3 cats that sustained a variety of mandibular and maxillary fractures. These implants were used as neutralization or buttress fixation in 11 caudal (junction of the ramus with the mandibular body) and 2 rostral mandibular fractures, 4 maxillary fractures, and 2 zygomatic arch fractures. All but one of the fractures healed with appropriate occlusion and excellent function. In one case of a rostral mandibular fracture, soft tissue dehiscence occurred accompanied by a loss of the fixation and subsequent distraction of the bone fragments; reasonable function was obtained by performing a rostral mandibulectomy. Plate contouring and application of the miniplates along the appropriate biomechanical lines of stress was easily performed and permitted the biomechanical principles of tension band fixation to be applied in most cases. Miniplate fixation, either used alone or in combination with other fracture fixation techniques, achieved sufficiently rigid skeletal fixation to provide uncomplicated healing and good to excellent functional and cosmetic results in 14 dogs and 3 cats.  相似文献   

10.
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   

11.
This report describes 14 dogs (mean age six years, mean bodyweight 25 kg) and three cats (mean age 9-3 years, mean bodyweight 6–7 kg) with coxofemoral luxations of one to 91 days duration (median four days). In 47 per cent of the cases concomitant fractures or luxations (including three bilateral luxations) were present. Closed reduction was immediately unsuccessful in five cases and eventually unsuccessful in seven cases, whereas in five cases the nature of the additional trauma required surgical intervention. Via a craniolateral approach to the hip joint, combined with trochanter osteotomy in 24 per cent of the cases, the luxation was reduced and remnants of the capsule were sutured in 82 per cent of the cases. In all cases an extra-articular iliofemoral suture band was applied to limit the range of motion of the femoral head. The technique is described and illustrated in detail. The success rate proved to be strongly related to the suture material and varied from excellent to poor. This extra-articular stabilisation technique had excellent results in acute and chronic coxofemoral luxations in dogs when multifilamentous non-absorbable material was used, even when no additional non-weightbearing sling was used.  相似文献   

12.
Open surgical fixation was performed on four hip joints in three dogs who were suffering from caudoventral hip luxations for which closed reduction had previously failed. Stabilization of the joint was achieved with a ventral coxofemoral approach, which augmented the function of the transverse acetabular ligament using a sling implant through a bone tunnel (n = 1), a sling implant around two pelvic screws (n = 1), or an internal fixator plate (n = 2). Transverse acetabular ligament augmentation resulted in successful joint stabilization in all cases, and should be considered for the surgical reduction of caudoventral hip luxations in dogs. The use of an internal fixator plate, while preserving soft-tissue blood supply and resulting in minimal to no long-term arthritic changes, may provide an optimal outcome.  相似文献   

13.
OBJECTIVE: To describe a modified ventral stabilization technique for surgical management of atlantoaxial subluxation in dogs and to evaluate the outcome. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Nineteen client-owned dogs. METHODS: Medical records of 19 dogs with a radiographic diagnosis of atlantoaxial subluxation surgically managed by a modified ventral fixation technique (cortical screws, Kirschner wires, polymethylmethacrylate) were reviewed. Data on pre- and post-operative neurologic status, surgical technique, and complications were retrieved. Follow-up evaluation was performed at approximately 1 month. Telephone interview of the owner was used for long-term assessment (median follow-up for 17 surviving dogs was 10.5 months). RESULTS: Adequate reduction and stabilization was achieved in all dogs based on radiographic assessment immediately after surgery. Improved neurologic outcome occurred in 16 dogs at 1 month and in 15 dogs at follow-up; 2 dogs died of post-operative complications within 24 hours of surgery. One dog was euthanatized at the owners' request because of recurrent neck pain associated with implant failure after 1 month. Two dogs required surgery to remove broken and migrated implants, but further stabilization was not necessary. CONCLUSIONS: Adequate stabilization and improved neurologic outcome was achieved in most dogs. However, on account of the small size of the study and the variable neurologic signs of the dogs on admission, the surgical technique described could not be compared to those previously reported. CLINICAL RELEVANCE: The surgical technique described is an effective means of surgical treatment for atlantoaxial subluxation.  相似文献   

14.
The strength and rigidity of a new surgical technique for the stabilization of caudal lumbar fractures in dogs, using a Kirschner-Ehmer apparatus and a dorsal spinal plate (KE/DSP), were compared with 2 other methods of internal spinal fixation and with intact (control) spines, using a spinal test system that subjected the spines to 4-point bending. The fixation devices were applied to isolated canine lumbosacral spines (L1 to S3) from cadavers. A complete spinal separation was made in the spine implant specimens at L5-L6 by sharp dissection of all ligamentous structures connecting the two vertebrae. Bending moment vs L5-L6 angular deformation curves, and rigidity and load sustained at 10 degrees angular deformation (failure) were recorded for each fixation method and for the control spines. Values were compared by statistical analysis. The combined KE/DSP fixation and a combined vertebral body plate/dorsal spinal plate (VBP/DSP) fixation were stronger and more rigid than were the control spines and those fixed with a modified segmental-fixation method (P less than 0.05). There were no statistical differences in strength and rigidity between the 2 combined-fixation techniques. Although the VBP/DSP technique is not applicable to clinical caudal lumbar (L5-L6) fractures, it was compared in this study to the KE/DSP technique because a similar VBP/DSP technique was reported strongest in a similar study of L3-L4 simulated fractures, compared with 3 other spinal-fixation techniques that have been used in repair of caudal lumbar fractures. The technique has been used successfully in 6 dogs with caudal lumbar fractures.  相似文献   

15.
OBJECTIVE: To report the results of acetabular fracture fixation in 25 dogs in which a specialized forceps (ASIF mandibular reduction forceps, Synthes USA, Paoli, PA) was used to obtain fracture reduction and stabilization. STUDY DESIGN: A retrospective clinical study. ANIMAL POPULATION: Twenty-five client-owned dogs with traumatic acetabular fractures. METHODS: The mandibular reduction forceps (MRF) use a screw on each side of the fracture to attach the clamp directly to the bone and permit direct manipulation of the fragments. Medical records from 25 dogs with acetabular fractures were reviewed to determine the effectiveness of this technique in obtaining, and then maintaining, fracture reduction while a plate was being applied. RESULTS: Clinical results were considered successful in 24 of 25 dogs; the small size of 1 dog prevented application of the MRF. The final reduction and fixation of the fractures was evaluated as anatomic in 17 dogs, near-anatomic in 6 dogs, and nonanatomic in 1 dog. CONCLUSIONS AND CLINICAL RELEVANCE: Application of the MRF is an effective technique for aiding the reduction of acetabular fractures in dogs. It maintains reduction while simultaneously permitting unimpeded access to the dorsal acetabular rim, thus facilitating accurate contouring of a plate. Accurate reduction and rigid fixation of articular fractures is essential to prevent secondary osteoarthritis.  相似文献   

16.
A combined tension band and lag screw technique for fixation of olecranon osteotomies was used in six canine clinical patients weighing 4.5 to 19 kg. After the proximal part of the ulnar shaft was exposed, a screw hole was drilled and tapped just cranial to the caudal cortex of the olecranon. An osteotomy was performed and the hole in the olecranon fragment was overdrilled to form a gliding hole. For reconstruction, the olecranon was reduced anatomically and compressed with a screw placed in lag fashion. With the trochlear notch exposed, a Kirschner wire was inserted cranial to the screw, using care not to enter the elbow joint. A double-twist figure-eight tension band wire was placed around the Kirschner wire in five dogs and around the screw in one dog. In this dog, a spiked washer was used with the screw because a small olecranon fragment had been produced by incorrect osteotomy position. A painful soft tissue swelling over the prominent washer, which resolved after implant removal, was the only complication attributed to the technique. The combined tension band wire and lag screw technique was a rapid and reliable method for fixation of olecranon osteotomies.  相似文献   

17.
Spinal trauma can originate from internal or external sources. Injuries to the spinal cord can be classified as either concussive or compressive and concussive. The pathophysiologic events surrounding spinal cord injury include the primary injury (compression, concussion) and numerous secondary injury mechanisms (vascular, biochemical, electrolyte), which are mediated by excessive oxygen free radicles, neurotransmitter and electrolyte alterations in cell membrane permeability, excitotoxic amino acids, and various other biochemical factors that collectively result in reduced SCBF, ischemia, and eventual necrosis of the gray and white matter. Management of acute spinal cord injuries includes the use of a high-dose corticosteroid regimen within the initial 8 hours after trauma. Sodium prednisolone and methylprednisolone, at recommended doses, act as oxygen radical scavengers and are anti-inflammatory. Additional considerations are the stability of the vertebral column, other conditions associated with trauma (i.e., pneumothorax), and the presence or absence of spinal cord compression, which may warrant surgical therapy. Vertebral fractures or luxations can occur in any area of the spine but most commonly occur at the junction of mobile and immobile segments. Dorsal and dorsolateral surgical approaches are applicable to the lumbosacral and thoracolumbar spine and dorsal and ventral approaches to the cervical spine. Indications for surgical intervention include spinal cord compression and vertebral instability. Instability can be determined from the type of fracture, how many of the three compartments of the vertebrae are disrupted, and on occasion, by carefully positioned stress studies of fluoroscopy. Decompression (dorsal laminectomy, hemilaminectomy, or ventral cervical slot) is employed when compression of the spinal cord exists. The hemilaminectomy (unilateral or bilateral) causes less instability than dorsal laminectomy and therefore should be used when practical. The preferred approach for atlantoaxial subluxation is ventral, and the cross pinning, vertebral fusion technique is used for stabilization. Fracture luxations of C-2 are repaired with small plates on the ventral vertebral body. The thoracic and upper lumbar spine is stabilized with dorsal fixation techniques or combined dorsal spinal plate/vertebral body plate fixation. Several methods of fixation can be used with lower lumbar or lumbosacral fractures, including the modified segmental technique and the combined dorsal spinal plate/Kirschner-Ehmer technique.  相似文献   

18.
Four horses, 2 to 17 years old, were treated for unilateral avulsion fractures of the tibial tuberosity. Two horses were treated successfully with tension band wiring or plating in combination with lag screw fixation. One horse was euthanatized because of implant failure during recovery and one was euthanatized on day 11 because a longitudinal fracture of the tibial tuberosity occurred through the plane of the screws used for stabilization.  相似文献   

19.
A total of 43 fractures of the distal tibia in dogs and cats were evaluated for fracture patterns, methods of stabilization, and time to bone union. Fractures of the metaphysis (9.3%), physis (30.9%), epiphysis (2.3%), and malleoli (58.2%) were classified. Open reduction and internal fixation, with combinations of Kirschner wire, orthopedic wire, and bone screws, were the methods of fixation used in the majority of fractures. These relatively simple methods of fixation were applied to all sizes of dogs and cats and resulted in an average bone healing time of 6 weeks.  相似文献   

20.
OBJECTIVE: To report clinical outcome after use of an interlocking nail (veterinary interlocking nail [VIN]) for stabilization of diaphyseal fractures in dogs and cats. STUDY DESIGN: Retrospective study. Animals: Seventy-eight dogs and 43 cats with diaphyseal fractures of the femur (n = 96), tibia (n = 14), or humerus (n = 11). METHODS: Interlocking nails (4 mm diameter [n = 72], 6 mm [n = 25] or 8 mm [n = 24]), were used in static (n = 106) or dynamic (n = 15) fixation mode. Cerclage wires also were used in 63 (52%) cases. Data about the patient (species, breed, weight, age), characteristics of the fracture, and details of the surgery and perioperative complications were recorded. The surgeon evaluated functional outcome, and fracture healing was quantified 6 weeks (W6) and 3 months (M3) after surgery with a radiographic index. RESULTS: Twelve cases had been unsuccessfully treated by another technique. Of 106 comminuted fractures, 60 were classified as unstable. Only 112 animals were evaluated at W6; 86 (77%) healed without complication and had a functional outcome considered excellent (n = 80, 93%), good (n = 5, 4%), or fair (n = 1). Twenty-six complications were noted: 16 (14%) patients did not require additional surgery and had a good or excellent outcome, whereas 10 (8%) patients needed surgical intervention to CONCLUSIONS: VINs can be used to repair diaphyseal fractures of the femur, tibia, and humerus in dogs and cats provided the implants are appropriately sized for the fractured bone. The high healing rate (even with unstable fractures), associated with a functional outcome, and low complication rate support the use of VINs for these fracture types. However, a period of training and the application of basic principles are necessary to ensure successful results. CLINICAL RELEVANCE: VINs should be considered as alternative technique for management of selected diaphyseal fractures of the femur, tibia, and humerus in dogs and cats.  相似文献   

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