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Objective: To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Study Design: Case series. Animals: Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Methods: Medical records (1990–2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. Results: Of 192 horses (171 [89%] closed, 21 [11%] open fractures), 157 (82%) were discharged from the hospital. Infection occurred in 53 (28% horses), of which 31 (59%) were discharged. Repairs without POI were 7.25 times more likely to be discharged from the hospital. Closed fractures were 4.23 times more likely to remain uninfected and 4.59 times more likely to be discharged from the hospital compared with open fractures. Closed reduction and internal fixation was associated with a 2.5‐fold reduction in rate of POI and a 5.9 times greater chance for discharge from the hospital compared with open reduction and internal fixation. Females had a strong trend for increased POI when compared with colts and stallion but not geldings. Conclusions: Overall rate of POI was 28%. Fracture classification, method of repair, gender, and surgical duration were significant risk factors.  相似文献   
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REASONS FOR PERFORMING STUDY: Fractures of the tibial tuberosity (FTT) are caused by direct trauma, and are the second most commonly reported injury in event horses with stifle trauma. Conservative management of horses with FTT has been advocated, but results and prognosis for this method of therapy are unknown. OBJECTIVES: To report and review the findings of a retrospective study of 17 horses admitted to a veterinary teaching hospital from 1986-2001 with nonarticular FTT that received conservative management. METHODS: Subject details, aetiology of the accident, limb affected, degree of lameness at time of admission, size and degree of displacement of the fracture fragment, complications such as comminution of the fracture fragment or damage to soft tissue structures within the affected stifle, and treatment recommendations were obtained from medical records. Owners and trainers were contacted regarding the horse's return to athletic use. The follow-up period consisted of 11-154 months. RESULTS: Two horses were reportedly sound, but unable to return to competition for unrelated reasons. Of the horses that completed the rehabilitation period, 12/15 (80%) returned to athletic use at the same level as before the injury. Three horses were diagnosed with damage to soft tissue supporting structures of the affected stifle and could not return to their former level of competition. CONCLUSIONS: Concurrent soft tissue damage, diagnosed at the time of the initial injury, was statistically significant in precluding horses from returning to athletic careers. All other variables were found to have no effect upon outcome. POTENTIAL CLINICAL RELEVANCE: This retrospective study suggests that the conservative management of nonarticular FTT is a viable treatment modality in managing athletic equine patients presenting with these fractures.  相似文献   
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Modified choledochoduodenostomy and gastrojejunostomy were used successfully to treat extensive duodenal ulceration and perforation in a dog. Concomitant pyometra, simultaneously managed by ovariohysterectomy, may have predisposed the dog to stress ulceration. Choledochoduodenostomy was performed by transplantation of the entire common bile duct and associated major duodenal papilla to a more distal duodenal location. An indwelling choledochostomy tube was used to stent the anastomotic site, externally divert bile flow, and allow postoperative cholangiography. Early postoperative complications included presumed metronidazole-induced neurotoxicosis, choledochostomy tube obstruction, and pancreatitis, all of which resolved within 2 weeks. The dog was clinically normal and medication (ranitidine and sucralfate) was discontinued 35 months later.  相似文献   
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Rupture of the gastrocnemius muscle and subsequent disruption of the reciprocal mechanism of the hind limb was diagnosed in 6 foals examined at 7 hours to 3 weeks of age. In 2 foals, the musculoskeletal injury was detected as an ancillary finding to clinical signs of neurologic dysfunction ascribed to hypoxic ischemic insult during delivery, whereas in the other 4 foals, musculoskeletal injury, manifested as inability to rise or stand unsupported, was the chief complaint at admission. Five foals had a history of dystocia and assisted delivery. Common clinical signs were inability to rise, disruption of the reciprocal mechanism, swelling in the caudal aspect of the thigh, instability of the stifle joint, and stifle joint effusion. For mild gastrocnemius injury, exercise restriction via forced recumbency, with minimal or no bandaging, may be sufficient treatment. For more severe disruption of the muscle, limb stabilization via splinting and intensive nursing and monitoring are necessary. Four foals had important concurrent problems, including musculoskeletal deformations (joint contractures), hypoxic ischemic disease, and failure of passive transfer and associated problems (ie, sepsis, polyarthritis, and pneumonia). Moderate to severe gastrocnemius muscle injury is difficult to treat successfully, and the long-term prognosis for athletic function should be regarded as guarded.  相似文献   
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