一例泰迪犬桡尺骨骨折的诊断与治疗

文章对曾经临床收治诊疗的一例泰迪犬桡尺骨骨折的病例进行总结分析.患犬就诊时精神尚可,经过触诊和DR检查见右前肢遭到破坏、发生断裂,因此采取骨板内固定对桡尺骨完全断裂的患犬进行整复,内固定后利用DR诊断技术对桡尺骨的愈合情况作一系列评估.经过治疗,患犬愈后良好.文章为临床上犬桡尺骨骨折相关的诊疗提供参考.     

Ulnar Subluxation Following Repair of a Fractured Radius in a Foal

Compression plating of a transverse mid-diaphyseal radial fracture in a 4-month-old Arabian filly resulted in subluxation of the ulna. Two screws transfixed the radius to the ulna and resulted in synostoses. This was followed by uncoordinated growth of the radius and ulna, and subluxation of the ulna. Progressive remodeling of the ulna subsequently reestablished articular congruity between the humerus and ulna.     

A complication arising after surgical correction of short radius syndrome

A nine-month-old, male whippet underwent corrective surgery for ‘short radius syndrome’ which had resulted in elbow subluxation. This consisted of a radial osteotomy and placement of K-wires, connected by elastic bands, in the ulna and radius. The implants were removed two weeks later as the elbow subluxation had reduced. However, the correct anatomy was not maintained and the radial head migrated distally. K-wires were reinserted and when the subluxation had reduced, a screw was placed through the ulna into the proximal radius. Recovery was uneventful and at follow-up limb function had improved.     

Ventral approach for stabilization of atlantoaxial subluxation secondary to odontoid fracture in a foal

Atlantoaxial subluxation secondary to odontoid fracture in a 30-day-old foal was corrected by alignment of the atlantoaxial joint and stabilization with 2 ventrally placed dynamic compression plates. At 90 days after surgery, healing of the fracture, with adequate alignment of the atlantoaxial joint, was confirmed radiographically. The foal was only slightly tetraparetic at that time. At 1 year after surgery, the gait was normal. It was concluded that the technique has advantages over the use of Steinmann's pins or external coaptation for stabilization. The ventral approach allows decompression, anatomic alignment, and immediate stabilization of the subluxation. Potential complications of the ventral approach include laryngeal paralysis.     

Treatment of Humeroulnar Subluxation with a Dynamic Proximal Ulnar Osteotomy A Review of 13 Cases

Humeroulnar subluxation was treated surgically in 13 dogs with 18 affected elbows using a proximal osteotomy of the ulna that allowed the ulna to elongate dynamically. Distal humeroulnar subluxation was secondary to premature closure of the distal ulnar physis in 16 elbows. One distal subluxation was secondary to a radioulnar synostosis, and one proximal subluxation developed after premature closure of the distal radial physis. The mean follow-up time was 22 months. Twenty-eight percent of the elbows were judged to have excellent results, 22% good results, 50% fair results, and none was judged to have a poor outcome. The presenting lameness grade and the severity of preoperative and postoperative humeroulnar subluxation had significant correlations with the prognosis. Associated orthopedic abnormalities and complications of concurrent surgical procedures affected the outcome in several dogs. Overall, the dynamic proximal ulnar osteotomy was a simple and effective technique for the treatment of uncomplicated humeroulnar subluxation.     

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.     

Multiple Intramedullary Wire Fixation of a Radial Fracture in a Dog

Multiple intramedullary wire fixation infrequently can be used as an alternative technique to plating, transfixation devices, single intramedullary pinning, or external coaptation for some radius and ulna fractures.
This report describes a comminuted fracture of the radius and ulna with fissures and comminution extending too far into the proximal radius for effective application of a bone plate or Kirschner-Ehmer apparatus. Resulting fracture instability and collapse prohibited effective use of external coaptation as a primary means of fixation. The radial fracture was repaired and stabilized with full cerclage wires and multiple intramedullary Kirschner wires. The dog was using the leg normally 12 months following surgery.     

Treatment of a Periarticular Tibial Fracture in a Foal with a Hybrid External Fixator

Objective— To report repair of a right proximal tibial Salter-Harris type II fracture in a foal with a hybrid external fixator (HEF).
Study Design— Case report.
Animals— A 5-month-old male foal.
Methods— After open surgical reduction, an HEF built with wires, 2 half-rings, 3 half-threaded connecting rods, and Schanz pins was used to stabilize the fracture.
Results— Immediately after surgery, the foal had relatively good weight bearing. The HEF was removed at 60 days after radiographic confirmation of healing.
Conclusions— HEF can be used to stabilize a proximal tibial Salter-Harris type II fracture in a 5-month-old foal.
Clinical Relevance— HEF should be considered as another option for repair of proximal tibial Salter-Harris type II fractures in foals.     

LOOSENING OF TRANSOSSEOUSLY PLACED ANTEBRACHIAL SCREWS IN TWO DOGS

Radius and ulna fractures in two dogs were repaired by application of a bone plate to the cranial surface of the radius. In both dogs, two screws were placed through the radius and into the ulna. Return of function and bone healing occurred as expected; however, return of lameness at 5 and 7 months postoperatively was attributed to loosening of the transosseous screws. The lameness resolved following implant removal. Loosening of only the transosseous screws could have resulted from the normal motion between the radius and ulna.     

Type IV Monteggia fracture in a cat

A one-year-old neutered male cat was referred for a grade IIIA open radius and ulna fracture. The mid-diaphyseal radial and ulnar fractures were associated with lateral radio-humeral and radio-ulnar dislocations. From these abnormalities, a diagnosis of type IV Monteggia fracture was made. The annular ligament was found to be intact on examination and the radial head was correctly positioned and stable after fracture reduction and plate fixation. Eighteen months postoperatively, the cat did not exhibit any signs of lameness or any signs of pain on palpation and mobilisation. Signs of mild osteoarthritis were present on radiographs. Type IV Monteggia fractures are very rare in animals. The combination of a radial head dislocation with an intact annular ligament is uncommon. This pattern allowed a single reconstruction with two plates without a radio-ulnar screw.     

Repair of fracture of the proximal portion of the radius and ulna in a llama

Repair of a comminuted fracture of the proximal portion of the radius and ulna in a 4-month-old llama was achieved by use of internal fixation. An 8-hole narrow dynamic compression plate was applied to the lateral aspect of the radius and a 7-hole narrow dynamic compression plate was applied to the cranial aspect of the radius. One year after surgery, the llama had a normal gait and the cosmetic appearance of the limb was excellent.     

Resuscitation attempts in a foal with sudden cardiac arrest in the early recovery period

A 3‐month‐old female Warmblood foal, weighing 150 kg, was presented to the Equine Clinic of the University of Hannover with a fracture of the ulna (type 5 fracture of the olecranon). Anaesthesia was induced with midazolam and ketamine after sedation with xylazine and maintained with isoflurane. Anaesthesia was uneventful until cardiac arrest occurred in the early recovery period. Cardiopulmonary resuscitation (CPR) was performed with chest compressions and electrical defibrillation. During resuscitation palpebral reflexes and spontaneous breathing returned but ventricular fibrillation could not be converted to sinus rhythm by transthoracic defibrillation of the heart by electrical shock.     

普通T形骨板治疗玩具犬桡尺骨远端骨折的手术效果

旨在评估普通T形骨板内固定治疗玩具犬桡尺骨远端骨折的临床效果及并发症。回顾了在中国农业大学动物医院采用开放式复位和普通T形骨板内固定治疗桡尺骨远端骨折的玩具犬的病历记录,并对这些病例进行回访。入选病例满足：体重不超过7 kg;骨折位置位于前臂远端(远端骨段与桡骨长度比值<0.25);回访时间>12个月;病例信息记录完整。结果表明：共纳入29只犬的29例桡尺骨远端骨折,26例(89.7%)术后无跛行,3例(10.3%)术后勉强可见跛行。未发生严重并发症,轻微并发症的发生率是20.7%(n=6)。普通T形骨板内固定能有效治疗玩具犬桡尺骨远端骨折,临床效果良好,无严重并发症。     

Birth of live triplets in a mare

An 11‐year‐old American Buckskin mare gave birth to live triplets unattended at approximately 300 days gestation. All foals were small and dysmature, requiring intensive care. The smallest foal died 4 days after admission, the second was subjected to euthanasia 24 days after admission due to poor healing of a third metatarsal fracture. The remaining foal survived to discharge and was considered small but otherwise normal at age one year.     

Bullous emphysema with haemorrhage in a premature foal

A Warmblood foal was admitted at one day of age because of prematurity and seizures. Clinical and clinical pathology abnormalities were consistent with prematurity and suspected hypoxic seizures that responded to anti‐convulsive therapy. The foal stabilised after several days of intensive care but then developed an airway infection. Thoracic radiographs showed multiple cavitary lesions and ultrasound examination suggested intra‐cavital haemorrhage. The foal went on to develop septicaemia and was subjected to euthanasia. Post mortem examination revealed multiple bullous emphysema with haemorrhage. This disorder should be considered in the differential diagnosis of foals having air‐fluid filled cavities on thoracic radiographs.     

Closed reduction and blind cross-pinning for repair of a proximal tibial fracture in a foal

A 4-day-old foal underwent repair of a proximal metaphyseal fracture of the tibia. After closed reduction, fixation was achieved by use of blind cross-pinning. Thirty-five days after surgery, radiography demonstrated complete healing. The foal was mildly lame 4 months after repair of the fracture. Blind cross-pinning may be considered as a method of repair for certain long bone fractures in small foals.     

Use of orthopedic markers for quantitative determination of proximal radial and ulnar growth in foals

Cortical bone screws were implanted into the proximal portion of the right and left radius and ulna of 6 newborn Quarter Horse foals as radiographic markers for measurement of growth. Distance between markers on a lateral radiographic view was measured. Radiographs were taken at 2-week intervals until the horses were 8 weeks old, at 4-week intervals until they were 48 weeks old, and at 12-week intervals until they were 72 weeks old. The proximal radius and ulna grew at similar rates during the 72-week period of evaluation, and growth continued throughout 72 weeks. The proximal radius grew 3.5 cm, and the ulna grew 3.4 cm. Although the rates of growth were similar, growth from the ulnar physis contributed only to the length of the olecranon; growth was not transmitted to the ulnar diaphysis distal to the cubital joint. The proximal radius slid distally in relation to the ulna as growth occurred at the proximal radial physis. These findings suggest that transfixing the ulna to the radius while growth is occurring at the proximal radial physis impedes the natural shifting process, and subluxation of the elbow can result. Severity of subluxation would be inversely related to the age of the horse at the time of transfixation.     

Management of antebrachial deformity and shortening secondary to a synostosis in a dog

A nine-week-old labrador was presented with a deformed left forelimb causing obvious lameness. Radiographs suggested that the dog had suffered a fracture involving the radius and ulna which had healed resulting in a synostosis. There was a concurrent radial physeal injury. The dog was treated initially by osteotomy of the radius and ulna stabilised using a static external skeletal fixator. At a subsequent surgery lengthening of the limb was achieved by using an Ilizarov apparatus. Worsening carpal hyperflexion was managed by bandaging in forced extension. A successful outcome was achieved with a final result of a 24 per cent discrepancy in length between the two radii at 17 months of age. An increase in length of the ipsilateral humerus was seen in association with the shortened forelimb.     

Fixation of a complete scapular neck fracture in a foal using two 3.5 mm locking compression plates

This report describes the successful surgical repair of a transverse, displaced scapula fracture in a foal. A 3.5 mm locking compression plate (LCP) was used on either side of the spine of the scapula. The suprascapular nerve was apparent upon dissection as it passed directly over the fracture line and care was taken to leave it intact, although the fracture line itself caused some irritation. The foal recovered without long‐term nerve damage and is sound at 1.5 years post surgery.     

Correction of angular deformities caused by premature closure of the distal ulnar epiphyseal plate in dogs

Surgical correction of angular deformities caused by premature closure of the distal ulnar growth plate in dogs. Correction of angular deformities in 14 cases of premature closure of the distal ulnar growth plate is described. Angular deformities were most frequently seen in large breeds during the most active phase of growth at 3-5 months of age. Preoperative axial deviations measured on radius were from 7 to 38 degrees in valgus and 0 to 35 degrees in antecurvation compared with the contralateral leg. According to the kind of treatment, the dogs were divided into two groups: In group I which consisted of cases with sufficient remaining growth potential of the radius, segmental ostectomy of ulna with insertion of an autologous fat graft in the ostectomy diastasis was performed to allow spontaneous correction by asymmetrical epiphyseal growth. In group II reconstructive osteotomy and stable, internal fixation with a plate was accomplished. The cosmetic result was judged as excellent in 10 cases, good in 3 and less favourable in 1. Postoperative follow up time was in average 33 months. On control 43% of the dogs showed no lameness, 57% were slightly lame after exercise or rest. None of the cases turned out to be permanently lame at the end of the follow up investigation.