Repair of transverse process fractures of multiple lumbar vertebrae in an adult dairy cow

Objective: To report lumbar vertebrae transverse process fracture repair using a narrow 3.5 mm limited contact dynamic compression plate (LC‐DCP) in an adult dairy cow. Study Design: Case report. Animals: A 3‐year‐old Holstein cow. Methods: Under general anesthesia, fractured left transverse processes of lumbar vertebrae 2–4 were repaired using internal fixation. A narrow 3.5 mm LC‐DCP was contoured and secured to the spinous process and the transverse process of each fractured vertebra. Results: Fractured transverse processes of the lumbar vertebrae were successfully repaired and the cow discharged 10 days after surgery. At 10 months after surgery, the cow was declared reserved champion at a regional show. Conclusion: A paramedian approach and muscle splitting can be used to repair multiple lumbar transverse process fractures using internal fixation with an excellent cosmetic outcome.     

An In Vitro Biomechanical Comparison of a 5.5 mm Locking Compression Plate Fixation with a 4.5 mm Locking Compression Plate Fixation of Osteotomized Equine Third Metacarpal Bones

Objectives: To compare the monotonic biomechanical properties and fatigue life of a 5.5‐mm‐broad locking compression plate (5.5 LCP) fixation with a 4.5‐mm‐broad locking compression plate (4.5 LCP) fixation to repair osteotomized equine 3rd metacarpal (MC3) bones. Study Design: In vitro biomechanical testing of paired cadaveric equine MC3 with a middiaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. Animal Population: Fifteen pairs of adult equine cadaveric MC3 bones. Methods: Fifteen pairs of equine MC3 were divided into 3 test groups (5 pairs each) for (1) 4‐point bending single cycle to failure testing, (2) 4‐point bending cyclic fatigue testing, and (3) torsional single cycle to failure testing. An 8‐hole, 5.5 LCP was applied to the dorsal surface of 1 randomly selected bone from each pair and an 8‐hole, 4.5 LCP was applied dorsally to the contralateral bone from each pair using a combination of cortical and locking screws. All plates and screws were applied using standard ASIF techniques. All MC3 bones had middiaphyseal osteotomies. Mean test variable values for each method were compared using a paired t‐test within each group with significance set at P<.05. Results: Mean yield load, yield bending moment, composite rigidity, failure load, and failure bending moment, under 4‐point bending, single cycle to failure, of the 5.5 LCP fixation were significantly greater than those of the 4.5 LCP fixation. Mean cycles to failure in 4‐point bending of the 5.5 LCP fixation (170,535±19,166) was significantly greater than that of the 4.5 LCP fixation (129,629±14,054). Mean yield load, mean composite rigidity, and mean failure load under torsional testing, single cycle to failure was significantly greater for the broad 5.5 LCP fixation compared with the 4.5 LCP fixation. In single cycle to failure under torsion, the mean±SD values for the 5.5 LCP and the 4.5 LCP fixation techniques, respectively, were: yield load, 151.4±19.6 and 97.6±12.1 N m; composite rigidity, 790.3±58.1 and 412.3±28.1 N m/rad; and failure load: 162.1±20.2 and 117.9±14.6 N m. Conclusion: The 5.5 LCP was superior to the 4.5 LCP in resisting static overload forces (palmarodorsal 4‐point bending and torsional) and in resisting cyclic fatigue under palmarodorsal 4‐point bending. Clinical Relevance: These in vitro study results may provide information to aid in selection of an LCP for repair of equine long bone fractures.     

Long-term results of bovine mandibular fractures involving the molar teeth

OBJECTIVE: To evaluate postoperative complications and long-term outcome of simple mandibular fractures involving the molar teeth in cattle. ANIMAL POPULATION: Seventeen cattle with mandibular fractures involving the molar teeth with disruption of the occlusal surface. METHODS: Treatment consisted of application of AO/ASIF-Pinless External Fixators (Synthes, Paoli, PA) in 14 cows, interdental wire stabilization in 1 cow, and conservative treatment in 2 cows. Long-term outcome was determined by telephone contact with the owners, and whenever possible, cows were reevaluated by physical, intraoral, and radiographic examination of the fracture site. RESULTS: Loosening of the fixation device (4 cattle) and bone sequestration (11 cattle) were the most commonly encountered complications. Oral incontinence during rumination was a minor complication in 1 cow. The mean (+/- SD) time the cattle were in production was 26 (+/- 14) months, with 10 cows still alive at follow-up examination; 9 cows were reevaluated. On intraoral examination there was a step in the occlusal surface at the level of the healed fracture site in 3 cows, wave and shear mouth formation in 3 cows, and enamel point formation in 1 cow. Radiographically, all the reevaluated fractures had healed, and there were no signs of tooth root infection. CONCLUSIONS: Complications during healing were bone sequestration and loosening of the fixator. None of the cows was removed from production because of fracture-associated complications, but decreased milk yield occurred in 2 cows. Tooth abnormalities developed in 6 cows, but function of the mandible was not altered. CLINICAL RELEVANCE: Mandible fractures involving the molar teeth carry a good prognosis for return to normal function. Radiographic follow-up is necessary to detect bone sequestration.     

Assessment of stiffness and strength of 4 different implants available for equine fracture treatment: a study on a 20 degrees oblique long-bone fracture model using a bone substitute

OBJECTIVE: To compare the mechanical properties of 4 stabilization methods for equine long-bone fractures: dynamic compression plate (DCP), limited contact-DCPlate (LC-DCP), locking compression plate (LCP), and the clamp-rod internal fixator (CRIF--formerly VetFix). STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Bone substitute material (24 tubes) was cut at 20 degrees to the long axis of the tube to simulate an oblique mid-shaft fracture. METHODS: Tubes were divided into 4 groups (n=6) and double plated in an orthogonal configuration, with 1 screw of 1 implant being inserted in lag fashion through the "fracture". Thus, the groups were: (1) 2 DCP implants (4.5, broad, 10 holes); (2) 2 LC-DCP implants (5.5, broad, 10 holes); (3) 2 LCP implants (4.5/5.0, broad, 10 holes) and 4 head locking screws/plate; and (4) 2 CRIF (4.5/5.0) and 10 clamps in alternating position left and right of the rod. All constructs were tested in 4-point bending with a quasi-static load until failure. The implant with the interfragmentary screw was always positioned on the tension side of the construct. Force, displacement, and angular displacement at the "fracture" line were determined. Construct stiffness under low and high loads, yield strength, ultimate strength, and maximum angular displacement were determined. RESULTS: None of the implants failed; the strength of the bone substitute was the limiting factor. At low loads, no differences in stiffness were found among groups, but LCP constructs were stiffer than other constructs under high loads (P=.004). Ultimate strength was lowest in the LCP group (P=.01), whereas yield strength was highest for LCP constructs (409 N m, P=.004). CRIF had the lowest yield strength (117 N m, P=.004); no differences in yield strength (250 N m) were found between DCP and LC-DCP constructs. Differences were found for maximum angular displacement at the "fracture" line, between groups: LPC相似文献   

In Vitro Biomechanical Comparison of a Modified 5.5 mm Locking Compression Plate Fixation with a 5.5 mm Locking Compression Plate Fixation of Osteotomized Equine Third Metacarpal Bones

Objectives: To compare number of cycles to failure for palmarodorsal 4‐point bending of a modified 5.5 mm broad locking compression plate (M5.5‐LCP) fixation with a 5.5 mm broad LCP (5.5‐LCP) fixation used to repair osteotomized equine third metacarpal (MC3) bones. Study Design: In vitro biomechanical testing. Animal Population: Adult equine cadaveric MC3 bones (n=6 pairs). Methods: An 8‐hole, M5.5‐LCP, obtained by having a 1.0 mm thickness removed from the bone contact portion of the 5.5‐LCP, was applied to the dorsal surface of 1 randomly selected MC3 from each pair, and an 8‐hole, 5.5‐LCP was applied dorsally to the contralateral bone from each pair using a combination of cortical and locking screws. Plates and screws were applied using standard ASIF techniques to MC3 bones with a mid‐diaphyseal osteotomy. MC3 constructs had palmarodorsal 4‐point bending cyclic fatigue testing. Mean cycles to failure for each method were compared using a paired t‐test within each group. Significance was set at P<.05. Results: Mean±SD cycles to failure of the M5.5‐LCP fixation (188,641±17,971) was significantly greater than that of the 5.5‐LCP fixation (166,497±15,539). Conclusion: M5.5‐LCP fixation was superior to 5.5‐LCP fixation of osteotomized equine MC3 bones in resisting cyclic fatigue under palmarodorsal 4‐point bending. Clinical Relevance: This suggests that biological plate fixation is not the ideal choice for osteotomized equine MC3 bones.     

In vitro biomechanical comparison of locking compression plate fixation and limited-contact dynamic compression plate fixation of osteotomized equine third metacarpal bones

Objective— To compare monotonic biomechanical properties and fatigue life of a broad locking compression plate (LCP) fixation with a broad limited contact dynamic compression plate (LC‐DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. Study Design— In vitro biomechanical testing of paired cadaveric equine MC3 with a mid‐diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. Animal Population— Cadaveric adult equine MC3 bones (n=12 pairs). Methods— MC3 were divided into 3 groups (4 pairs each) for: (1) 4‐point bending single cycle to failure testing; (2) 4‐point bending cyclic fatigue testing; and (3) torsional single cycle to failure testing. The 8‐hole, 4.5 mm LCP was applied to the dorsal surface of 1 randomly selected bone from each pair. One 8‐hole, 4.5 mm LC‐DCP) was applied dorsally to the contralateral bone from each pair. All plates and screws were applied using standard ASIF techniques. All MC3 bones had mid‐diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t‐test within each group. Significance was set at P<.05. Results— Mean yield load, yield bending moment, composite rigidity, failure load and failure bending moment, under 4‐point bending, single cycle to failure, of the LCP fixation were significantly greater than those of the LC‐DCP fixation. Mean cycles to failure for 4‐point bending was significantly greater for the LCP fixation compared with LC‐DCP fixation. Mean yield load, mean composite rigidity, and mean failure load under torsional testing, single cycle to failure was significantly greater for the broad LCP fixation compared with the LC‐DCP fixation. Conclusion— The 4.5 mm LCP was superior to the 4.5 mm LC‐DCP in resisting the static overload forces (palmarodorsal 4‐point bending and torsional) and in resisting cyclic fatigue under palmarodorsal 4‐point bending. Clinical Relevance— The results of this in vitro study may provide information to aid in the selection of a biological plate for the repair of equine long bone fractures.     

Distal Humeral Salter Harris (Type II) Fracture Repair by an Ulnar Osteotomy Approach in a Horse

Objectives: To report repair of a comminuted distal humeral type II Salter–Harris fracture using an ulnar osteotomy approach and locking compression plates (LCP). Study Design: Case report. Animal: A 3‐month‐old Standardbred filly with a type II Salter–Harris fracture of the distal humerus. Methods: Radiographic and computed tomography examinations were performed to assist surgical planning. The distal humeral fracture was approached by an ulnar osteotomy and repaired using a 7‐hole broad LCP and screws inserted in lag fashion. The osteotomy was subsequently repaired using a 7‐hole narrow LCP. Results: The distal humeral fracture was successfully approached and stabilized by an ulnar osteotomy approach. At 6‐month follow‐up, the filly was ambulating comfortably with a normal cosmetic appearance. Conclusions: An ulnar osteotomy approach was readily performed and allowed for repair of a type II Salter–Harris fracture of the distal humerus. Clinical Relevance: The equine distal humerus can be accessed readily using an ulnar osteotomy approach. LCPs allow for repair of complicated fractures that have previously been associated with a grave prognosis.     

Fractures and luxations of the vertebral column.

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.     

Maxillomandibular Circular External Skeletal Fixation for Repair of Bilateral Fractures of the Caudal Aspect of the Mandible in a Dog

Objective: To describe the novel use of circular external skeletal fixation (CESF) for repair of bilateral fractures of the caudal aspect of the mandibles. Study Design: Clinical report. Animals: A 5‐month‐old female Newfoundland. Methods: A 2‐ring CESF was used to immobilize the mandible relative to the maxillae. Results: Anatomic dental occlusion and reduction of the right hemimandible were achieved with mild malalignment of the left hemimandible. Fracture healing occurred within 20 days. Transient epistaxis and reduced temporomandibular joint range of motion occurred at the time of fixator removal but normal use of the mandible was reported 6 months postoperatively. Conclusions: CESF effectively immobilized the mandible permitting rapid fracture healing with minimal morbidity. Clinical Relevance: Maxillomandibular CESF may represent a simple, effective option for the management of challenging fractures involving the caudal aspect of the mandible.     

Minimally‐invasive plate osteosynthesis of a Salter‐Harris type 2 fracture of the proximal phalanx in a filly

A 7‐month‐old Warmblood filly was referred to the equine hospital because of a Salter‐Harris type 2 fracture of the proximal physis of the right hind P1. On admission, the filly had acute grade 3/5 lameness at the walk and diffuse swelling in the area of the right hind proximal phalanx. Radiographs were taken to assess the fracture and plan treatment. Surgical treatment using two 4.5 mm narrow locking compression plates (PIP‐LCPs) resulted in fracture stabilisation and rapid healing. This case report suggests that internal fixation using PIP‐LCPs is useful for the treatment of Salter‐Harris type 2 fractures of the proximal physis of P1 in large foals.     

Kinetics of solutes and particles of different size in the digestive tract of cattle of 0.5–10 years of age,and relationships with methane production

The digestive physiology of cattle is characterised by comparatively long digesta mean retention times (MRTs), a particle sorting mechanism (difference in MRTs of large vs. small particles) and a distinct digesta washing (difference in MRTs between particles and fluids) in the reticulorumen (RR). How these processes mature during ontogeny, and how they link to other digestion characteristics and methane production, is largely unknown. We used a set of passage markers (Co‐EDTA for fluids and hay particles of 2, 5 and 8 mm length mordanted with Cr, La and Ce, respectively) to measure MRTs in 12 heifers (0.5–2.1 years; hay only) and two groups of 15 lactating cows (2.4–10.0 years; forage‐only vs. forage‐concentrate diet). The MRTs differed between markers (Co < Cr < La < Ce) and were longer in heifers than cows, consistent with the lower feed intake in heifers. MRTs were mostly similar between cow groups and increased with age. Digesta washing was not affected by group, age, feed intake and number of chews per unit of feed. The degree of digesta washing was not related to CH₄ measures. Particle sorting was more prominent in cows than heifers but did not differ between cow groups or change with age in cows. This could be the consequence of the abrupt increase in intake from heifers to cows at a time when gut capacity is not yet fully developed; particle sorting might then clear smaller particles from the RR sooner allowing a higher intake. Surprisingly, CH₄ yield per ingested feed did not correlate with MRTs, and CH₄ yield per unit of digested fibre decreased with increasing MRTs and with increasing fibre digestibility. As this pattern occurred in heifers and both cow groups, it appeared independent of age, indicating a mechanism that has not been described in the literature so far and requires further investigation.     

Open reduction of sacral fractures using transarticular implants at the articular facets of L7-S1: 8 consecutive canine patients (1995-1999)

OBJECTIVE: To describe and evaluate facet stabilization as an aid for open reduction and fixation of sacral fractures. STUDY DESIGN: A clinical case series. STUDY POPULATION: Eight consecutive client-owned dogs with sacral fractures. METHODS: A combination of a standard lateral approach to the ilium and a dorsal approach to the articular facets of L7-S1 was performed. The articular facets were reduced and stabilized with a Kirschner wire or a combination of a Kirschner wire and a cortical screw. Primary stabilization of the sacrum was then accomplished using a cortical screw inserted from the lateral aspect of the ilium, through the sacral fracture into the body of the sacrum. Accuracy of reduction, position of the implants, percent screw depth/sacral width, pelvic canal diameter ratio, and complications were assessed using radiographs and physical examination. RESULTS: Mean sacral fracture reduction was 91% immediately after surgery, and was 87% when measured at follow-up examinations. Mean screw depth/sacral width was 66%. Mean pelvic canal diameter ratio was 1.12 postoperatively and 1.03 at the 4- to 6-week reevaluation. Six of the 8 dogs were using the leg well 10 to 12 days after surgery; none had clinically detectable neurologic deficits. The long-term (mean, 2.7 years) outcome for these dogs was good (normal to grade I lameness). CONCLUSION: Fixation of the L7-S1 facet joints facilitates repair of sacral fractures.     

Open reduction and internal fixation with a locking plate for the treatment of a femoral fracture in a ferret (Mustela putorius furo)

Long bone fractures in ferrets (Mustela putorius furo) are usually traumatic in etiology, and the femur is commonly affected [1]. A 4-year-old, castrated male ferret was examined for acute, non-weight-bearing lameness of the left pelvic limb after presumably falling from its elevated enclosure. Clinical and radiographic evaluation showed a complete, comminuted fracture of the proximal diaphyseal third of the left femur. Open reduction and internal fixation (ORIF) of the left femoral fracture was performed with cerclage wires and a 1.5 mm locking compression plate with associated locking screws. Anatomic reconstruction was achieved, and postoperative radiographs confirmed appropriate fracture fragment apposition, limb alignment, and implant placement. At 9 weeks postoperatively, the ferret was ambulatory with no evidence of lameness, and complete radiographic union was noted. This is the first published report of the use of a bone plate for femoral fracture stabilization in a ferret. Bone plates, including locking plates, could be considered for long bone fracture stabilization in ferrets as an alternative to other methods.     

Treatment of a femoral fracture with a titanium locking compression plate distal femur (LCP‐DF) in a young donkey

A closed complete mid‐diaphyseal spiral fracture of the left femur in a one‐year‐old donkey was treated with a 4.5 mm titanium locking compression plate distal femur (LCP‐DF)¹. This plate was originally manufactured for human orthopaedics, primarily for femoral osteosynthesis. The LCP‐DF¹ has a distal head plate that was advantageous in this case because the distal fragment was smaller. Post operative radiographs showed optimal femoral reconstruction and a callus was present 3 weeks after surgery. The donkey was sound at the walk and trot 2 months after surgery. Radiographs taken 5 months after surgery showed stable implants and complete healing without complications.     

Evaluation of Closed Reduction and Screw Fixation in Lag Fashion of Sacroiliac Fracture‐Luxations

Objective— To evaluate outcome by radiographic assessment after closed reduction and percutaneous screw fixation in lag fashion of sacroiliac fracture‐luxations in dogs. Study Design— Retrospective study. Animals— Dogs (n=24) with sacroiliac fracture‐luxations. Methods— Medical records (1999–2006) and radiographs of 24 dogs (29 fracture‐luxations) that had stabilization of sacroiliac fracture‐luxation by fluoroscopic‐guided closed reduction and percutaneous screw fixation in lag fashion were reviewed. Signalment, body weight, number, and location of all concurrent injuries and implants used for repair were recorded. Radiographs were used to evaluate the accuracy of screw placement in the sacral body, screw depth/sacral width ratio, reduction of the sacroiliac joint, pelvic canal diameter, and hemipelvic canal width. Radiographic re‐examination (range, 4 to >8 weeks postoperatively) was available for evaluation. Results— Mean screw depth/sacral width ratio on immediate postoperative and re‐examination radiographs was 64% and 61%, respectively. Mean percentage reduction of the sacroiliac joint on immediate postoperative and re‐examination radiographs were 91% and 87%, respectively. Pelvic canal diameter ratio demonstrated successful restoration of the pelvic canal. Hemipelvic canal width ratio documented successful closed reduction repair independent of concurrent pelvic injuries. Conclusion— Successful repair of sacroiliac fracture‐luxations, determined by radiographic assessment, can be achieved by fluoroscopic‐guided closed reduction and percutaneous screw fixation in lag fashion. Clinical Relevance— Fluoroscopic‐guided closed reduction and percutaneous screw fixation in lag fashion of sacroiliac fracture‐luxations is a minimally invasive technique that restores and maintains pelvic canal dimensions and should be considered as an alternative to open reduction or nonsurgical management of sacroiliac fracture‐luxations.     

An in vitro biomechanical comparison of a locking compression plate fixation and kerf cut cylinder fixation for ventral arthrodesis of the fourth and the fifth equine cervical vertebrae

Objectives: To (1) define mechanical properties in flexion, extension, and left lateral bending of cadaveric equine 4th and 5th cervical (C4–C5) articulations, (2) compare biomechanical properties of C4–C5 when stabilized with a kerf cut cylinder (KCC) compared with a ventrally placed 4.5 mm locking compression plate (LCP). Study Design: In vitro biomechanical investigation. Sample Population: Cadaveric adult equine cervical vertebral columns (n=54). Methods: Cervical vertebrae aged by horse dentition and size measured from radiographs were divided into 3 age groups then randomly allocated to 3 groups. The C4–C5 articulation was treated differently in each of the groups: KCC group; KCC‐implanted LCP group; 8‐hole 4.5 mm LCP implanted and intact group; no implant. Specimens were randomly subdivided into 1 of 3 loading conditions, before testing to failure under 4‐point bending. Stiffness, yield bending moment, failure bending moment, and failure mode were recorded. General linear models were performed to analyze associations between biomechanical properties and test variables. Results: All specimens failed at the C4–C5 intervertebral articulation. The cervical vertebrae with the LCP construct had significantly higher stiffness, yield bending moment, and failure bending moment than the KCC‐implanted cervical vertebrae. Failure modes differed between groups and varied with loading direction: KCC group, fractures of C5 associated with the KCC were common; LCP group, screw pull out or fractures (of C4 and C5 bodies, during extension and the caudal aspect of C4 during left lateral bending) were common; and intact group, subluxations were most common. Conclusions: In this model, LCP constructs had superior biomechanical properties compared with KCC constructs. Further research investigating the effect of repetitive loading is indicated.     

Orthopedic Infections in Equine Long Bone Fractures and Arthrodeses Treated by Internal Fixation: 192 Cases (1990–2006)

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.     

Management of Tibial Fractures Using a Circular External Fixator in Two Calves

Objectives: To report the repair of tibial diaphyseal fractures in 2 calves using a circular external skeletal fixator (CEF). Study Design: Clinical report. Animals: Crossbred calves (n=2; age: 6 months; weight: 55 and 60 kg). Methods: Mid‐diaphyseal tibial fractures were repaired by the use of a 4‐ring CEF (made of aluminum rings with 2 mm K‐wires) alone in 1 calf and in combination with hemicerclage wiring in 1 calf. Results: Both calves had good weight bearing with moderate lameness postoperatively. Fracture healing occurred by day 60 in 1 calf and by day 30 in calf 2. The CEF was well maintained and tolerated by both calves through fracture healing. Joint mobility and limb usage improved gradually after CEF removal. Conclusions: CEF provided a stable fixation of tibial fractures and healing within 60 days and functional recovery within 90 days. Clinical Relevance: CEF can be safely and successfully used for the management of selected tibial fractures in calves.     

A mechanical comparison of equine proximal interphalangeal joint arthrodesis techniques: an axial locking compression plate and two abaxial transarticular cortical screws versus an axial dynamic compression plate and two abaxial transarticular cortical screws

Objectives: To compare in vitro monotonic biomechanical properties of an axial 3‐hole, 4.5 mm narrow locking compression plate (ELCP) using 5.0 mm locking screws and 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (ELCP–TLS) with an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP–TLS) for equine proximal interphalangeal (PIP) joint arthrodesis. Design: Experimental. Animal Population: Cadaveric adult equine forelimbs (n=18 pairs). Methods: For each forelimb pair, 1 PIP joint was stabilized with an axial ELCP using 5.0 mm locking screws and 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion and 1 PIP joint with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion. Six matching pairs of constructs were tested in single cycle to failure under axial compression, 6 construct pairs were tested for cyclic fatigue under axial compression, and 6 construct pairs were tested in single cycle to failure under torsional loading. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results: Mean yield load, yield stiffness, and failure load under axial compression, single cycle to failure, of the DCP–TLS fixation were significantly greater than those of the LCP–TLS fixation. There was no significant difference between the mean number of cycles to failure in axial compression of the LCP–TLS and the DCP–TLS fixations. Mean yield load, yield stiffness, and failure load under torsion, single cycle to failure, of the LCP–TLS fixation were significantly greater than those of the DCP–TLS fixation. Conclusion: The DCP–TLS construct provided significantly greater stability under axial compression in single cycle to failure than the ELCP–TLS construct, the ELCP–TLS construct provided significantly greater stability under torsional loading in single cycle to failure than the DCP–TLS construct, and there was no significant difference in stability between the 2 constructs for cyclic loading under axial compression.     

Femur fractures associated with canine total hip replacement

OBJECTIVE: To report femur fracture as a complication of canine total hip replacement (THR) and to report the incidence, predisposing factors, treatment options, and outcome. STUDY DESIGN: Prospective clinical study. ANIMALS: Twenty-two client-owned dogs with 24 femoral fractures occurring during or after THR. METHODS: Cemented THR (BioMedtrix, Boonton, NJ) was performed. Medical records and radiographs were used to identify dogs that had femur fracture and to identify risk factors. Follow-up was obtained until dog death or study end. RESULTS: The overall incidence of femur fracture after THR was 2.9%. Femoral fractures occurred intraoperatively, immediately postoperatively, and up to 2196 days after THR. In 17 dogs, fractures resulted from a traumatic event. Osteopathy was present at THR in 5 dogs; all developed femoral fissures during reaming. Three dogs had fractures associated with cortical thinning secondary to aseptic loosening. Fracture treatment included euthanasia (1 dog), strict confinement (3 dogs), full cerclage wires on long oblique fractures (3 dogs), or plate and screw fixation (10 with, and 7 without, cerclage wires). All fractures extended near the distal tip of the femoral stem and all aggressively treated fractures healed. CONCLUSIONS: Predisposing risk factors for femur fracture after THR include osteopathy and iatrogenic fissures created during reaming. Trauma, excessive load concentration, and increased torque can lead to mid-diaphyseal fracture near the end of the femoral stem. Fracture did not disrupt THR implants. Cement fracture exposing the tip of the femoral stem did not affect fracture healing or rehabilitation. Immediate plate and screw fixation resulted in the most favorable outcome; healing occurred in 6-10 weeks. CLINICAL RELEVANCE: Femur fractures that occur after THR should be repaired using plate and screw fixation augmented with cerclage wire when needed. Forces on fissures should be neutralized to prevent propagation and fracture. Owners of high-risk patients (old dogs with osteopathies or previous hip surgery) should be counseled before THR. The prognosis is excellent when fractures are treated correctly.