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

2.
Arthroscopic examination of structures within the plantar pouch of the tarsocrural joint was accomplished via portals in both the plantaromedial and plantarolateral aspects of the joint. Flexion and extension of the tarsus while examining the joint through either portal allowed observation of the proximal and plantar aspects of the lateral and medial trochlear ridges, the trochlear groove, the caudal aspect of the distal tibia, and the deep digital flexor tendon (DDFT) in its sheath. From a plantarolateral portal, the plantar talocalcaneal ligament and the plantar aspect of the lateral malleolus could be observed. The caudal aspect of the medial malleolus could not be observed with flexion or extension of the joint from a plantaromedial portal, but in some horses, the caudal aspect of the lateral malleolus could be observed. The dorsolateral and dorsomedial aspects of the plantar pouch were best examined from a portal on the ipsilateral side of the joint. An instrument portal opposite either arthroscope portal allowed access to most regions of the joint except the abaxial surface of the trochlear ridge opposite the instrument.  相似文献   

3.
以铸型方法观察了家禽肝门静脉的分支。其中，鸡有左、右肝门静脉各１支，左叶有左外叶颅侧支、左外叶尾侧支和左内叶支，右叶有右叶颅侧支及右叶尾侧支；鹅、鸭则有左肝门静脉２支，右肝门静脉１支。左叶有左外叶颅侧支和左外叶尾侧支，右叶有右叶颅侧支和尾侧支。左、右肝门静脉于横部汇集，并向颅侧及尾侧发出许多分支。此外，还强调和讨论了家禽肝门静脉系统在分布上的一些特点  相似文献   

4.
A novel surgical approach, using portal venotomy during total hepatic vascular occlusion, was used to locate and attenuate congenital intrahepatic portosystemic shunts in nine dogs. Shunt location was consistent with a persistent ductus venosus in only two dogs. In the remaining seven dogs the shunts were window-like orifices arising from either the left (two dogs) or right portal vein branch (five dogs) and communicating with the ipsilateral hepatic vein or caudal vena cava. The transportal approach using total hepatic vascular occlusion consistently provided good access to the portosystemic shunts, including those with window-like communications. A 7 to 16 minute period of total vascular occlusion was well-tolerated hemodynamically, with few intraoperative complications. Intrahepatic shunts were successfully attenuated in eight dogs, while one dog with portal atresia was euthanatized. The postoperative course was complicated by high protein pulmonary edema (one dog), an encapsulated biliary pseudocyst (one dog) and uncontrollable hemorrhage caused by an uncharacterized coagulopathy (one dog). Three dogs required a second operation to further attenuate their shunts. The clinical condition of all seven surviving dogs was improved after surgery.  相似文献   

5.
An arthroscopic technique for examination and surgical treatment of conditions of the shoulder joint was evaluated in eight normal horses and two horses with osteochondrosis lesions. A single arthroscope entry point caudal to the infraspinatus tendon allowed inspection of the cranial, lateral, and caudal surfaces of the shoulder joint. With the humeral head and glenoid cavity distracted by a curved forceps, the entire cartilage surface of the shoulder could be examined. The caudomedial portion of the humeral head was seen better with a 70 degree angled arthroscope. Instruments for intra-articular manipulation were introduced through a separate skin incision 2 to 4 cm caudal to the arthroscope entry point. Two horses with osteochondrosis lesions of the shoulder were examined arthroscopically and debrided with instrument triangulation. Five normal horses and both horses with osteochondrosis lesions were euthanized immediately after the procedure and a necropsy was performed. Minor iatrogenic damage to the cartilage surfaces and joint capsule resulted from the technique. Three horses recovered from anesthesia and were killed 3, 30, or 60 days after surgery. Subcutaneous fluid that accumulated during surgery had resorbed by 3 days and lameness was evident for 12 to 24 hours. Gross examination and histopathologic findings of specimens collected at 30 and 60 days showed several small nonhealing partial-thickness cartilage defects attributed to instrument insertion. Arthroscopy is a satisfactory method to examine the joint surfaces and to evaluate and treat osteochondrosis lesions of the shoulder joint in horses.  相似文献   

6.
Arthroscopic examination of the hip joint was performed in mature and juvenile horses, using a lateral approach and standard or long instruments depending on body weight. Nine hip joints were examined in three cadavers and four anesthetized horses. The lateral, cranial, and caudal regions of the femoral head and acetabulum were accessible, and, after distraction of the limb, the ligament of the head of the femur and the acetabular notch were also visible. In small horses, the medial regions of the hip joint were visible but were inaccessible in larger horses. Iatrogenic injury to the sciatic nerve or periarticular vasculature was not evident at necropsy examination. Six horses with lameness localized to the hip joint were examined arthroscopically. At surgery, two horses had tearing of the ligament of the head of the femur, two horses had osteochondrosis of the femoral head or acetabulum, and two horses had degenerative joint disease, one associated with a rim fracture of the caudal aspect of the acetabulum and the other of indeterminant origin. Improvement after debridement occurred in one of the horses with partial disruption of the ligament of the head of the femur and in both horses with osteochondrosis. Diagnostic and surgical arthroscopy of the hip can be accomplished in foals and weanlings using standard equipment, but, in adults weighing more than 300 kg, longer instruments are required and the ease of access and the visible extent of the hip joint is considerably reduced.  相似文献   

7.
An osteochondral fragment was removed from the caudal pouch of the lateral femorotibial joint in a 2-year-old Trakehner colt by use of arthroscopic surgery and a lateral approach. The approach to this aspect of the femorotibial joints was developed in another horse. The fragment was not attached and resembled an osteochondritis dissecans lesion. The intermittent lameness associated with the fragment resolved after surgical removal. A positive response to diagnostic anesthesia of the femorotibial joint in the absence of a confirmed diagnosis (following radiographic and arthroscopic evaluations of the other aspects of the stifle joint) is an indication for arthroscopic exploration of the caudal pouches of the femorotibial joints of stifles in horses.  相似文献   

8.
Congenital extrahepatic portosystemic shunts are anomalous vessels joining portal and systemic venous circulation. These shunts are often diagnosed sonographically, but computed tomography (CT) angiography produces high‐resolution images that give a more comprehensive overview of the abnormal portal anatomy. CT angiography was performed on 25 dogs subsequently proven to have an extrahepatic portosystemic shunt. The anatomy of each shunt and portal tributary vessels was assessed. Three‐dimensional images of each shunt type were created to aid understanding of shunt morphology. Maximal diameter of the extrahepatic portosystemic shunt and portal vein cranial and caudal to shunt origin was measured. Six general shunt types were identified: splenocaval, splenoazygos, splenophrenic, right gastric‐caval, right gastric‐caval with a caudal shunt loop, and right gastric‐azygos with a caudal shunt loop. Slight variations of tributary vessels were seen within some shunt classes, but were likely clinically insignificant. Two shunt types had large anastomosing loops whose identification would be important if surgical correction were attempted. A portal vein could not be identified cranial to the shunt origin in two dogs. In conclusion, CT angiography provides an excellent overview of extrahepatic portosystemic shunt anatomy, including small tributary vessels and loops. With minor variations, most canine extrahepatic portosystemic shunts will likely be one of six general morphologies.  相似文献   

9.
Multiple ligament injuries of the canine and feline stifle joint which result in luxation are uncommon. Two cats and one dog, that had sustained such a joint injury were surgically treated. A rupture of the cranial and caudal cruciate ligaments, and at least one collateral ligament was observed in all of the three animals. Prosthetic reconstruction was used, as previously described, in combination with a novel technique of intraoperative placement of a temporary trans-articular pin (TTP) to maintain intra-operative anatomical reduction. TTP placement facilitated maintenance of joint alignment during surgical reconstruction and aided appropriate tensioning of the prosthetic sutures, preventing collapse of femorotibial joint compartments. The TTP was removed prior to closure of the joint allowing immediate post-operative joint mobilisation. Based on assessment by their owners, all the animals made a complete recovery. TTP was considered a relatively simple and effective adjunctive aid for surgical treatment of traumatic luxation of the stifle joint.  相似文献   

10.
A technique for satisfactory arthroscopic examination of the lateral and medial femorotibial joints of the horse is described. The entry portal is made between the middle and medial patellar ligaments with the horse on its back and the stifle flexed. This position allows easy access to view the intercondylar eminence of the tibia. From this reference point, examination of all but the most caudal and medial structures of the joints are possible by manipulating the sleeve and telescope and maintaining joint distention. In a series of 20 examinations, iatrogenic trauma was recognized only once.  相似文献   

11.
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   

12.
OBJECTIVE: To (1) describe a caudal approach to equine medial and lateral femorotibial (FT) joints and (2) illustrate the complex anatomic detail of the caudal compartments of the lateral FT joint. STUDY DESIGN: Prospective experimental study. ANIMALS: Cadaveric equine hindlimbs (n = 36; 26 horses) and 6 horses (11 hind limbs). METHODS: Stifles (n = 8) were dissected and 10 FT joints were injected with silicone. Arthroscopic exploration (n = 29) was performed, followed by dissection to determine sites and structures penetrated during entry. RESULTS: A more caudal approach to the caudal pouch of the medial FT improved anatomic observation. A more caudal approach to the caudal pouch of the lateral FT joint occasionally caused damage to the common peroneal nerve; however, after reverting to the previously described approach, damage was avoided. CONCLUSION: Arthroscopy of the caudal pouch of the medial FT joint was facilitated using a more caudomedial approach, which improved observation of intrasynovial structures, most importantly, the caudal cruciate ligament and caudal horn of the medial meniscus. A more caudal approach to the caudal pouch of the lateral FT joint cannot be safely performed without risk to the common peroneal nerve and therefore the standard caudal approach is described in detail. CLINICAL RELEVANCE: A caudomedial arthroscopic approach allows improved surgical assessment of meniscal or caudal cruciate ligament injury. Care should be exercised when exploring the caudal pouch of the lateral FT joint because the common peroneal nerve is variably located and could easily be damaged during arthroscope or instrument insertion, especially if the limb is minimally flexed.  相似文献   

13.
Arthroscopic approaches to the scapulohumeral joint were developed in four clinically normal, live horses (5 limbs) to determine their usefulness for evaluation and potential surgical treatment of intraarticular lesions. The articular surface of the entire glenoid, cranial humeral head (medial and lateral) and caudolateral humeral head, as well as the synovial membrane, could be closely examined from an arthroscopic portal cranial to the infraspinatus tendon. The caudomedial humeral head could be examined partially. Cranial and caudal instrument portals allowed good surgical access to the entire glenoid and the majority of the humeral head (except caudomedial in adult, heavily muscled horses). The described arthroscopic and instrument portals allowed access to the areas frequently affected with osteochondritis dissecans (OCD). Potential difficulties with this technique include problems establishing triangulation, extravasation of fluids, and inability to reach potential lesions on the caudomedial humeral head with conventional equipment in heavily muscled horses.  相似文献   

14.
This article describes the treatment of single congenital portosystemic shunts (CPSs) (intrahepatic and extrahepatic) using an interventional radiology technique involving embolisation of anomalous vessels with percutaneous coils. Briefly, a multipurpose catheter was introduced into the caudal vena cava and then into the portosystemic shunt. An autoexpandable stent was placed in the caudal vena cava, next to the shunt, in order to avoid coil migrations, and a cobra-like vascular catheter was used to pass through the stent and to place the coils in the shunt. This technique was used for treatment of CPS in six dogs. The results indicate that percutaneous embolisation of a CPS using coils, a less invasive technique than the traditional surgical technique, may result in complete closure of the anomalous vessel without development of portal hypertension.  相似文献   

15.
Objective —To describe six dogs with congenital abnormalities involving the portal vein, caudal vena cava, or both.
Animals —Six client-owned dogs with congenital interruption of the portal vein or the caudal vena cava, or both.
Methods —Portal vein and caudal vena cava anatomy was evaluated by contrast radiography and visualization at surgery. Vascular casts or plastinated specimens were obtained in three animals.
Results —Portal blood shunted into the caudal vena cava in four dogs and the left hepatic vein in one. Two of these five dogs also had interruption of the caudal vena cava with continuation as azygous vein, as did an additional dog, in which the portal vein was normally formed. Portal vein interruption was present in 5 of 74 (6.8%) dogs with congenital portosystemic shunts evaluated at the Veterinary Teaching Hospital during the study period.
Conclusions —Serious malformations of the abdominal veins were present in more than 1 in 20 dogs with single congenital portosystemic shunts.
Clinical Relevance —Veterinarians involved in diagnosis and surgery for portosystemic shunts should be aware of these potential malformations, and portal vein continuity should be evaluated in all dogs before attempting shunt attenuation.  相似文献   

16.
Folding of the caudal horn of the medial meniscus after surgical severence of the cranial cruciate ligament was investigated. When the stifle was flexed and the tibia was placed in a cranial position, the caudal horn of the medial meniscus could move forward without damaging the meniscus or the caudal joint capsule. Forward movement of the tibia with the stifle extended could damage the meniscus and/or the joint capsule. Abnormal position of the meniscus did not necessarily indicate meniscal damage.  相似文献   

17.
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18.
The anatomical variations of the portal vein and the hepatic artery ramifications were analysed on liver corrosion casts in 20 dogs as a possible aid in the surgical management of the organ. The portal vein ramified similarly in all dogs. It divided into the smaller right portal branch from which vessels for the caudate process and both right lobes arose and the substantial left portal branch, which supplied the remaining liver portions and in 12 cases also the dorsal part of the right lateral lobe. Right lateral, right medial and left branches are the major arteries originating from the hepatic artery; however, their origin and course varied among individual animals. In 10 livers, the right lateral and the left branches originated from the hepatic artery, while the right medial branch arose from the left branch and usually supplied the right medial lobe solely. In nine livers, the right medial branch arose directly from the hepatic artery and supplied quadrate lobe and gallbladder as well, while in one liver the common artery, which subsequently divided into lobar branches, branched away from the hepatic artery. An additional branch for the caudate process, originating directly from the hepatic artery, was observed in 10 livers. Certain liver portions received the arterial blood from two major branches, which was particularly characteristic for the right medial lobe (six livers) and caudate process (10 livers). The course of the major arterial branches was also variable, although they proceeded in close anatomical relationship with the portal vein branches. The left arterial branch accompanied the left portal branch on its dorsal aspect (15 cases) or crossed it from the caudal aspect (five cases). The right lateral branch crossed the initial parts of the left and right portal branches either from cranial (12 cases) or caudal aspects (eight cases), while the right medial branch always crossed the left portal branch from its caudal aspect.  相似文献   

19.
Reasons for performing study: Idiopathic headshaking is often a facial pain syndrome, but a diagnostic protocol has not been described. In a previous study, caudal compression of the infraorbital nerve for treatment offered a fair success rate, but low case numbers and short follow‐up time were limitations. Objectives: To describe a diagnostic protocol for headshaking, examining the role of bilateral local analgesia of the posterior ethmoidal nerve (PET block). To report longer‐term follow‐up after surgery of the original cases and further cases and to determine whether changes to the technique influence success rates and complications. Methods: Records of horses that had undergone PET block and caudal compression surgery at 3 hospitals were reviewed. Modifications to the surgical technique included placing additional coils into the infraorbital canal and/or performing concurrent laser cautery of the nerve. Follow‐up information was obtained by telephone contact with owners. Results: The PET block was performed in 27 horses, with a positive result in 23 of 27 (85%). Surgery was performed in 58 horses. A successful outcome was initially achieved in 35 of 57 (63%) horses, but recurrence occurred between 9 and 30 months later in 9 (26%). Surgery was repeated in 10 of 31 (32%) horses. Final success rate, considering only response to the last performed surgery, was 28 of 57 (49%) horses with median follow‐up time of 18 months (range 2–66 months). Nose‐rubbing was reported post operatively in 30 of 48 (63%) horses. This resolved in all but 4 horses, which were subjected to euthanasia. Response to PET block or change in surgical technique did not appear to influence outcome or complications. Conclusions and potential relevance: The diagnostic protocol described is recommended for the investigation of headshakers. Caudal compression offers the best prognosis for a successful outcome compared with other treatments, for horses in which the only alternative is euthanasia. Surgical treatment of the disorder requires refinement, and the pathogenesis of the disorder requires investigation.  相似文献   

20.
Forty limbs with femoropatellar osteochondritis dissecans in 24 horses were treated with arthroscopic surgery. Lesions were bilateral in 16 horses and unilateral in eight horses. Diagnostic examination and surgical treatment were performed through a single arthroscopic portal; five different instrument portal locations and six instrument approaches were used. Lesions were localized to the lateral trochlear ridge of the femur in 31 affected joints, medial trochlear ridge in two joints, lateral and medial trochlear ridges together in two joints, lateral trochlear ridge plus patella in four joints, and patella alone in one joint. The lesions consisted of subchondral defects containing chondral or osteochondral flaps or fragments, or were seen as dimpling, cracking, fibrillation, or erosion of articular cartilage, or intact cartilage over a subchondral defect. Loose bodies were found in three joints. There was a poor correlation between radiologic and arthroscopic findings. Surgical manipulations included removal of flaps, fragments, and undermined articular cartilage, and debridement of the subchondral defect. Three horses were euthanized: one electively to assess the joint grossly, one because of complications following surgery and salmonellosis, and one because of unrelated forelimb abnormalities. Immediate clinical improvement after surgery was seen in the 22 horses permitted to survive. Long-term follow-up on seven of 10 racehorses revealed that two have raced successfully, two are "ready to race," three are training sound, two are sound at pasture (still in convalescence), and one has been reoperated. Of six horses used for show or pleasure, three are being shown sound, one is sound for pleasure, and two are training sound. The remaining horses are convalescing.  相似文献   

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