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1.
OBJECTIVE: To determine the effect of sliding and wedge osteotomies of the humerus on the joint surface contact areas in anatomically normal elbow joints of dogs. SAMPLE POPULATION: Left thoracic limbs from 5 skeletally mature mixed-breed canine cadavers. PROCEDURE: Joint casting was performed by placement of colored polymethylmethacrylate in the elbow joint cavity followed by loading in a materials testing system at physiologic angle and load. Joint casting was performed in unaltered specimens, after 10 degrees medial opening wedge osteotomy, and after lateral sliding osteotomy of the proximal portion of the humerus. Computer-aided analysis of photographs of proximal radial and ulnar articular surfaces after each casting procedure was performed. RESULTS: The lateral sliding humeral osteotomy and 10 degrees medial opening wedge osteotomy significantly altered joint surface contact regions of the canine elbow joint. Osteotomies resulted in a reduction in the size of the radial, ulnar, and combined radioulnar contact areas. Both osteotomies also resulted in craniolateral migration of the radial contact area and craniomedial recession of the ulnar contact area. Although the reduction in ulnar contact area with these treatments is consistent with our hypotheses, the reduction in radial contact area was not anticipated. CONCLUSIONS AND CLINICAL RELEVANCE: Humeral osteotomies alter joint surface contact areas of the canine elbow joint in vitro. Humeral osteotomies may decrease contact areas on the diseased region of the joint in dogs with elbow dysplasia; however, the overall decrease in joint surface contact area suggests that these procedures may induce focal increases in pressure that may cause iatrogenic cartilage damage when applied in vivo.  相似文献   

2.
OBJECTIVE: To evaluate areas of articular contact of the proximal portions of the radius and ulna in normal elbow joints of dogs and the effects of axial load on size and location of these areas. SAMPLE POPULATION: Forelimbs obtained from cadavers of 5 adult mixed-breed dogs. PROCEDURE: After forelimbs were removed, liquid-phase polymethyl methacrylate was applied to articular surfaces of the elbow joint, and limbs were axially loaded. Articular regions void of casting material were stained with water-soluble paint. Relative articular contact areas were determined by computer-assisted image analyses of stained specimens. Repeatability of the technique was evaluated by analyses of casts from bilateral forelimbs of 1 cadaver. Incremental axial loads were applied to left forelimbs from 4 cadavers to determine effects of load on articular contact. RESULTS: Specific areas of articular contact were identified on the radius, the craniolateral aspect of the anconeus, and the medial coronoid process. The medial coronoid and radial contact areas were continuous across the radioulnar articulation. There was no articular contact of the medial aspect of the anconeus with the central trochlear notch. Coefficients of variation of contact areas between repeated tests and between contralateral limbs was < 20%. Significant overall effects of axial load on contact area or location were not identified. CONCLUSIONS: Three distinct contact areas were evident in the elbow joint of dogs. Two ulnar contact areas were detected, suggesting there may be physiologic incongruity of the humeroulnar joint. There was no evidence of surface incongruity between the medial edge of the radial head and the lateral edge of the medial coronoid process.  相似文献   

3.
The efficacy of free autogenous fat grafts in inhibiting healing of partial ulnar ostectomies was investigated. Fat grafts did impede or prevent bone union in the treated ulnar ostectomies. Protection from forced weight bearing on the operated limb by splinting minimized varus deformity of the radius and ulna, and enhanced the survival of the fat graft and the formation of an ulnar nonunion. The procedure was then applied to treatment of radius curvus resulting from surgically induced premature distal ulnar physeal closure. Partial ulnar ostectomy with free autogenous fat grafting released the ulnar restraint on radial growth and allowed partial correction of the degree of radial curve associated with premature distal ulnar physeal closure.  相似文献   

4.
Necropsy dogs (n = 234) ranging in age between 2 days and 17 years were examined to characterize the cross-sectional shape of the humeroantebrachial contact area of the radius and ulna on radioulnar scans of giant, large, mid-sized, small, and chondrodystrophic breeds. During growth, the contact areas became more circular in shape in all breeds, those in small dogs remained most elliptic. Smallest normalized heights (distance between the tip of the anconeal process and the most proximal aspect of the cranial margin of the radial head = RUH, distance between the tip of the anconeal process and the cranial tip of the medial coronoid process = UH) and depths (distance determined in a right angle to RUH = RUD, distance determined in a right angle to UH = UD) were noted in large and giant breeds with no significant difference between these. In juveniles, a decrease in UD was correlated with a decrease in UH in all breeds as was a decrease in RUD correlated with a decrease in RUH, whereas in non-arthrotic adults this condition could only be proven for mid-sized dogs and small breeds but not for giant, large and chondrodystrophic dogs. The average radioulnar and ulnar heights and depths (as seen in non-arthrotic adults) were calculated to be obtained in mid-sized dogs at least 3-4 weeks earlier than in large dogs. Lipping of the cranial margin of the radial head was significantly (P < 0.001) associated with lesion(s) of the articular surface (i.e. erosion of the articular cartilage and subchondral bone and/or fragmentation of the medial coronoid process) and caused additional change in shape of this contact area, which was then even more circular. However, the variables evaluated (RUH, RUD, UH, UD) allowed only poor discrimination between constitution types and between non-arthrotic and arthrotic joints.  相似文献   

5.
OBJECTIVE: To determine the distribution of force between the articular surfaces of the humerus and radius and between the humerus and ulna in normal canine forelimbs. SAMPLE POPULATION: 12 cadaveric canine right forelimbs. PROCEDURE: Transarticular force maps were created by placing a tactile array pressure sensor into the elbow joint cavity and loading cadaveric forelimbs in a materials testing system. Mean joint forces were determined at loads of 50, 100, 150, and 200 N. RESULTS: All tests produced 2 distinct areas of high load that corresponded with the proximal articular surfaces of the radius and ulna. Mean forces for the radial proximal articular surface were slightly but significantly greater than for the ulna, averaging 51% to 52% of total force for all applied loads. CONCLUSIONS AND CLINICAL RELEVANCE: The proximal articular surface of the ulna contributes substantially to load transfer through the canine elbow joint. Abnormalities, which increase this load, might contribute to canine elbow joint dysplasia, specifically fragmentation of the medial coronoid process and osteochondritis dissecans of the medial aspect of the humeral condyle. In the treatment of these conditions, the normal force distribution within the canine elbow joint should be taken into consideration.  相似文献   

6.
Objective: To determine the effect of proximal ulnar osteotomy (PUO), distal ulnar osteotomy (DUO), and DUO with release of the interosseous ligament (DOLR) on displacement of the proximal ulna at the radioulnar joint. Study Design: Experimental mechanical study. Sample Population: Cadaveric, skeletally mature canine thoracic limb pairs (n=11). Methods: Thoracic limbs disarticulated at the elbow were randomly assigned to 1 of 2 groups: (A) limbs were tested with no treatment (NOTX), then with PUO; (B) limbs were tested with DUO followed by DOLR. A distraction force was applied to the proximal ulna with the distal limb secured in a frame, and displacement of the proximal ulnar segment at the radioulnar joint was recorded. Results: Mean displacement was 0.36 mm (95% confidence interval [CI]: 0?1.12 mm) in the NOTX group, 4.68 mm (95% CI: 3.82–5.55 mm) for PUO limbs, 0.95 mm (95% CI: 0.52–1.39 mm) for the DUO group, and 4.36 mm (95% CI: 3.71–5.02 mm) for the DOLR group. Mean ulnar displacement of the DOLR group was significantly different compared with the DUO group, but there was no significant difference between the PUO and DOLR groups. Conclusions: No significant difference was observed in displacement of the proximal ulnar segment after DOLR compared with PUO.  相似文献   

7.
Congenital elbow luxation was diagnosed in a 12-week-old, intact male, dachshund with a lateral elbow prominence and mild lameness of the right forelimb. Closed reduction of the radial head, ulnar ostectomy, and external stabilization of the joint were performed. Function was returned to the limb, but radial head and ulnar subluxation persisted.  相似文献   

8.
After 2,000 rads of x-radiation to the right distal radial physis of eight 70-day-old dogs, the longitudinal growth of the right radius was retarded 42.1% when compared with the growth of the nonirradiated left radius. Asynchronous growth of the right radius and ulna resulted. The gross and radiographic changes that occurred over the subsequent 75 days were described. Subluxation of the humeroradial and humeroulnar joints occurred and was first observed 31 days after irradiation. By 75 days after irradiation, the radius was puller 7.8 mm distally by the radioulnar ligament. However, subluxation of the humeroradial joint was minimized by accelerated growth from the proximal radial physis and articular cartilage. Acceleration of growth also occurred at the distal radial articular cartilage. Growth from the distal ulnar physis and styloid process was retarded. It was thus apparent that after retardation of growth from the distal radial physis, considerable adjustment occurred in the relationship between the radius and the ulna and also in growth from their other physes, which reduced the deleterious effects of the growth retardation.  相似文献   

9.
OBJECTIVE: To compare radioulnar incongruence (RUI) of normal canine elbows and elbows with arthroscopically confirmed medial compartment disease in vivo using systematic computed tomography (CT) measurements. STUDY DESIGN: Prospective comparison of RUI measurements in normal and dysplastic canine elbows. SAMPLE POPULATION: Right elbows of 25 medium-large breed, adult dogs with medial compartment disease and 9 medium-large breed, adult dogs with no elbow disease. METHODS: Transverse CT images of proximal radioulnar articulation were reformatted to dorsal and sagittal planes. RUI in 3 locations of the forelimb's medial coronoid was measured. Arthroscopy confirmed diagnosis of medial compartment disease in the diseased group. RUI measurements of the diseased and normal elbows were compared. RESULTS: Cumulative statistical analysis of RUI in all planes revealed no significant difference between the normal and abnormal elbows (P = .61). The abnormal elbows had negative mean RUI at the mid (P = .56) and cranial (P = .24) coronoid regions that were not significantly different from normal elbows and mean positive RUI at the base coronoid that was significantly greater than in normal elbows (P = .00082). CONCLUSION: Canine elbows with established medial compartment disease do not have significant RUI at the medial coronoid region at the time of diagnosis when compared with normal elbows. CLINICAL RELEVANCE: If RUI is a significant factor in the pathophysiology of medial compartment elbow disease in the dog, it does not appear to be present at the time of diagnosis of disease. Ulnar or radial osteotomies do not appear to be indicated for restoration of normal radioulnar articular surface alignment.  相似文献   

10.
An ununited medial coronoid process was found in the region of the medial ulnar articular rim of seven elbow joints in four Persian stray dogs in a survey of joint disease in dogs. The clinical, radiographical and pathological aspects of this condition are described and discussed.  相似文献   

11.
George G.  Keller  DVM.  MS  John M.  Kreeger  DVM.  PH.D  Fred A.  Mann  DVM.  MS  Jimmy C.  Lattimer  DVM.  MS 《Veterinary radiology & ultrasound》1997,38(4):272-276
Elbow dysplasia is osteoarthrosis/degenerative joint disease due to abnormal development of the elbow joint. The abnormaldevelopment is the result of specific inherited etiologies alone or in combination. This paper attempts to clarify the diagnosis of elbow dysplasia based on the presence of degenerative joint disease by correlating rediographic necropsy, necropsy, and histopathologic results using elbows from 8 German Shepherd dogs. All elbows had radiographic changes consistent with osteoarthrosis/degenerativejoint disease which were identified best on the flexedmedial-lateral projection. Radiographically, a specific diagnosis was made inseven elbows; ununited anconeal process(6) and osteochondrosis (1). At necropsy these lesions were confirmed plus 14 elbows were identified that had fragmented medial coronoid process (6), abnormally shaped medial coronoid processes of fissures in the articualr cartilage of the medial coronoid process (8). additionally, histopathologically there was proliferative synovitis at the radial notch of the ulna and degenerative changes on the proximal, nonarticualr surface of the anconeal process at the site of insertion of the olecranon ligament and joint capsule.Therefore, for screening the elbow joint to identify elbow dysplasia, the recognition of osteoarthrosis/degenerative joint disease on an extreme flexed mediolateral rediograph appears to be sufficient.  相似文献   

12.
This case report describes the results of bilateral elbow arthrotomy and a unilateral ulnar osteotomy in a 10-month-old dog with bilateral elbow dysplasia. Fragmented coronoid processes were removed from both joints via bilateral medial arthrotomies. On the right side an ulnar osteotomy was also performed using a caudolateral approach. Bilateral flexed lateral elbow radiographs taken before surgery and 5 months postoperatively were assessed for changes in osteophyte size on the anconeal process, caudal epicondylar ridge and radial head. Osteophytes on the anconeal process and caudal epicondylar ridge disappeared over the postoperative period in the joint that received an ulnar osteotomy. In the contralateral joint the size of the oesteophytes on the anconeal process and caudal epicondylar ridge increased in size during the same period.  相似文献   

13.
Four skeletally immature, small breed dogs (five elbows) with elbow incongruency were evaluated for forelimb lameness. Findings on clinical examination included pain, effusion and decreased range of motion of the affected elbow. Radiography, computed tomography and arthroscopy demonstrated elbow incongruency in all dogs. Fragmented medial coronoid process was diagnosed arthroscopically in three dogs (four elbows). Arthroscopic subtotal coronoidectomy was performed in all cases of fragmented medial coronoid process. Incongruency was corrected with acute ulnar lengthening under arthroscopic visualisation. The ulna was stabilised with a plate following correction. In two elbows an ostectomy of the anconeal process was performed to prevent impingement against the olecranon fossa. All dogs demonstrated improvement in lameness scores and client‐scored visual analogue scale scores. Postoperative computed tomography showed significant improvement in elbow incongruency in all dogs. Arthroscopic‐guided ulnar lengthening may be considered as a valid treatment in severe cases of elbow incongruency .  相似文献   

14.
The Effects of Fixation of the Ulna to the Radius in Young Foals   总被引：1，自引：0，他引：1  
The effects of radioulnar fixation were studied in 21 Quarter horse foals by applying a bone plate to the caudal aspect of the proximal part of the ulna, with screws engaging both the radius and the ulna. The plates were applied at 1 month of age in six foals (group I), 5 months of age in six foals (group II), and 7 months of age in three foals (group III). Six foals underwent sham operations at 1 month of age to serve as controls (group IV). Ulnar dysplasia and elbow subluxation developed in all treated foals. The magnitude of ulnar dysplasia was inversely related to the patient's age at fixation and was accompanied by degenerative joint disease and lameness in foals undergoing fixation at 1 and 5 months of age. Removal of the fixation appliances 16 weeks after implantation in three foals from each of groups I and II failed to reverse the degree of ulnar dysplasia. Although foals undergoing fixation at 7 months of age (group III) were not lame, radiographic evidence of subluxation and subtle degenerative changes in the articular cartilage of the treated elbow did develop. Recommendations for avoidance of radioulnar fixation were developed from these observations.  相似文献   

15.
Periarticular anatomy and techniques for arthroscopic access to the equine elbow were studied in six joints from cadavers. Caudomedial and craniolateral approaches were evaluated subsequently in 11 anesthetized horses. The caudomedial approach was made between the flexor carpi radialis and flexor carpi ulnaris muscle bellies. Most of the caudal articular surfaces of the humeral condyles, the caudal perimeter of the radius, and the trochlear notch and portions of the anconeal process of the ulna could be identified. The voluminous caudal joint capsule cul-de-sac proximal to the anconeal process was readily entered. A 70 degree arthroscope allowed examination of more of the joint recesses and articular surfaces of the olecranon fossa than a 25 degree arthroscope. A second portal for intraarticular instrument manipulation was made caudal and slightly proximal to the arthroscope entry. Entry more proximal than the level of the radiohumeral articulation carried significant risk of damage to the ulnar nerve and collateral ulnar artery and vein. For examination of the cranial regions of the elbow, a craniolateral portal was established cranial to the lateral collateral ligament. An instrument portal was made through the muscle bellies of the extensor carpi radialis or common digital extensor muscles. The cranial articular surfaces of the humeral condyles were readily exposed by extension of the elbow. The weight-bearing articular surface of the radius could not be seen. Eight horses were euthanatized without recovery from anesthesia and the elbows were dissected for examination. Three horses were allowed to recover from anesthesia and were euthanatized on days 3, 30, and 60.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

16.
Objective: To report use of an ulnar interlocking intramedullary nail for repair of an open highly comminuted fracture of the proximal third of the antebrachium in a dog, caused by gunshot. Study Design: Case report. Animals: 1.5‐year old, 60 kg, neutered male Mastiff. Methods: An ulnar interlocking intramedullary nail was used to stabilize an open comminuted proximal antebrachial fracture and a cast applied for 4 weeks. Results: Union by secondary bone healing occurred in 8 weeks. At 16 weeks, there was advanced remodeling of the radial and ulnar bony callus and fracture lines were no longer evident. Limb use was normal with normal pain free range of motion of the right elbow. Conclusion: Ulnar interlocking nail is a viable alternative treatment for highly comminuted fracture of the proximal third of the antebrachium in dogs.  相似文献   

17.
Objective— To determine the effect of humeral wedge and humeral slide osteotomies on force distribution between the articular surfaces of the humerus and the radius and ulna in normal canine thoracic limbs.
Study Design— In vitro mechanical testing.
Sample population— Cadaveric canine right thoracic limbs (n=12).
Methods— Transarticular elbow force maps were measured using a tactile array pressure sensor in elbow joints of axially aligned limbs under 200 N axial load before and after humeral wedge and humeral slide osteotomies.
Results— Loading induced 2 distinct areas of high forces that corresponded with the proximal articular surfaces of the radius and ulna. Mean force on the proximal articular surface of the ulna was reduced by 25% and 28% after 4 and 8 mm sliding osteotomies, respectively. Statistically significant differences were not observed for the wedge osteotomies.
Conclusion— Humeral slide osteotomy significantly decreases force on the proximal articular surface of the ulna.
Clinical Relevance— The proximal articular surface of the ulna contributes significantly to load transfer through the canine elbow joint. Abnormalities that significantly increase this force might contribute to canine elbow dysplasia, specifically fragmentation of the medial coronoid process and osteochondritis dissecans of the medial aspect of the humeral condyle. Under the conditions studied, the overall reduction in mean joint surface force across the proximal articular surface of the ulna after humeral slide osteotomy indicates that this technique merits further investigation for potential use in medial compartmental osteoarthritis of the canine elbow joint.  相似文献   

18.
Marked lameness and elbow incongruity occurred in seven 21-week-old dogs following experimental premature closure of the distal radial physis at 10 weeks of age. Midradial transverse osteotomies and bone plate stabilization performed on five dogs resulted in marked reduction of elbow incongruity and forelimb lameness. Two dogs had no surgery and served as controls for the surgical procedure. At 50 weeks of age the proximal radial articular surface was displaced 5.3 mm farther from the coronoid process in control dogs as compared to dogs having transverse radial osteotomy. Markedly worse clinical, radiographic, and pathologic changes in the control group demonstrated the importance of reestablishing and preserving elbow congruity when treating asynchronous growth of the canine forelimb caused by premature closure of the distal radial physis. The technique described is recommended as one method to treat premature distal radial physeal closure clinically.  相似文献   

19.
SUMMARY To test the hypothesis that joint incongruity contributes to the pathogenesis of elbow osteochondrosis, the left and right radius and ulna of 20 young large breed dogs were measured to determine any variation in length and to observe any incongruity of the elbow joint. Both lame and normal dogs were included in the study. Nine of the 20 dogs had marked disparity in radial and ulnar lengths yet only one had obvious elbow joint incongruity. The use of a sliding osteotomy for the treatment of fragmented coronoid process and a lengthening osteotomy for the treatment of an ununited anconeal process is also discussed. All four dogs treated with a sliding osteotomy showed a marked clinical improvement, and two of the three dogs treated with a lengthening osteotomy showed radiographic fusion of the anconeal process.  相似文献   

20.
OBJECTIVE: To determine if fatigue microdamage is associated with fragmented medial coronoid process (FMCP). STUDY DESIGN: Prospective study. ANIMALS: Thirty-eight dogs were admitted for subtotal coronoid ostectomy as treatment for FMCP. Surgical specimens of medial coronoid process (MCP) were retrieved from treated dogs. Normal MCP were collected from 5 age- and breed-matched dogs and 2 age-matched research beagles that were euthanatized for reasons other than elbow disease. METHODS: MCP specimens from affected elbows were classified into 4 groups based on disease severity. Specimens were bulk-stained for microdamage using 1% basic fuchsin, embedded in polymethylmethacrylate and sectioned at 130 microm. Specimens were evaluated using epifluorescent microscopy (425-440 excitation, 475 nm barrier filter) for diffuse damage (D.DX), osteocyte loss, and porosity. Cartilage thickness was evaluated using bright field microscopy. Qualitative observations were also made. RESULTS: MCP specimens from affected elbows had increased D.Dx, increased osteocyte loss, and greater porosity than normal groups. Specimens classified as severe FMCP (Classes 3, 4) had the most fatigue microdamage. Some Class 1 specimens, defined as having no visible fissuring of the articular cartilage (AC), had large microcracks in trabecular bone. CONCLUSIONS: Accumulation of subchondral fatigue microdamage, is associated with MCP fragmentation. Fissuring occurs in the subchondral bone before gross fibrillation of articular cartilage develops. CLINICAL RELEVANCE: Accumulation of fatigue microdamage in the MCP is important in the pathogenesis of FMCP. The underlying cause of this microdamage accumulation must be identified before treatment plans that will prevent further osteoarthritis of the elbow joint can be designed.  相似文献   

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