一例猫股骨粉碎性骨折外固定支架手术治疗

外固定支架手术技术是近几年在宠物临床上逐渐应用的一种治疗犬猫骨折修复的新技术,主要应用在治疗胫腓骨骨折、桡尺骨骨折等。针对一例猫股骨粉碎性骨折进行了外固定支架手术治疗,并取得了满意的治疗效果。     

开槽法髓内针内固定术治疗犬猫桡骨胫骨骨折4例

犬、猫桡尺骨、胫腓骨骨折约占骨折发病率的30%左右,绝大多数病例为桡尺骨或胫腓骨完全错位性骨折,且多发生在中段或远端1/3处。远端完全错位性骨折采用夹板外固定、钢板内固定效果不太理想,笔者采用开槽法髓内针内固定术治疗犬、猫桡骨、胫骨骨折4例,报道如下。1病例概况见表1。表1病例情况编号品种年龄(岁)性别体重(kg)骨折部位内固定针外固定犬1博美犬2母3右胫腓骨远端斯氏2.5托马支架犬2博美犬3公2右桡尺骨远端斯氏2.0托马支架犬3小鹿犬1母2.2左胫腓骨远端斯氏2.5夹板猫杂交猫4母2右桡尺斯氏2.0夹板2准备与手术2.1术部备皮消毒,常规骨科…     

1例犬胫腓骨骨折的内固定治疗

<正>犬胫腓骨骨折在兽医临床上是一种较常见的骨折,多由于机械性撞击等因素导致骨折,对于胫腓骨折的治疗多采用外固定的治疗方式,在治疗小型犬的胫腓骨折时若外固定确切,也可达到较好的治疗目的,但在治疗大型犬的胫腓骨折时,由于无法限制犬的运动和小腿部上粗下细的解剖特点,在实施外固定后很容易使外固定物滑脱,从而导致治疗失败,因此,内固定成为治疗该类骨折的最佳选择。笔者对一     

一例犬胫腓骨骨折的内固定治疗

小动物胫腓骨骨折在临床上较为多见,包括单纯胫骨骨折、腓骨骨折和胫腓骨完全骨折等,骨折发生后多采用外固定进行治疗,效果比较理想,但如果骨折部位比较靠近关节,此时尽量采用内固定治疗,不至于引起关节僵硬的后遗症。作者通过结合发病情况、临床表现及X光和B超检查确诊一萨摩耶犬胫腓骨远端完全螺旋型骨折病例,使用接骨板和钢丝进行内固定,并结合一定的术后护理措施,恢复良好。     

股骨骨折的固定方法探究

总结以往的临床经验,改进传统的骨折固定方法,提高骨折固定手术的成功率。以新疆农业大学动物中心医院接诊的骨折病例为实验动物,挑选出5例典型股骨骨折病例,其中1例实施外固定法,4例实施内固定配合外固定手术方法。4例内固定的患犬中,2例患犬又使用了外固定更替疗法。实施外固定法的1个病例出现畸形愈合,4例内固定手术均愈合良好,其中使用外固定更替法的2例患犬,骨折愈合非常理想。在股骨骨折治疗中,内固定的效果比外固定的效果好。内固定术后,相对于单一的托马斯架外固定,更替法会取得更好的疗效。     

阿富汗犬桡尺骨折修复手术

犬的桡骨尺骨、胫骨腓骨都较细,桡尺骨、胫腓骨远端完全错位性骨折采用外固定效果较差。为此,笔者介绍了一例阿富汗猎犬骨折的病例,通过内接骨板与螺针固定结合的治疗方案,取得了良好治疗效果,患犬最终康复,期望能为探讨临床上阿富汗猎犬骨折及治疗方法提供参考。     

克氏针在犬骨折外固定支架术中的应用效果

选择4只3～5月龄、3～7 kg杂交犬,随机分为A、B两组,对A、B两组犬分别制作前肢桡骨和后肢胫骨骨折模型,再用克氏针组合成外固定支架进行固定,以期了解外固定支架运用于犬骨折手术的操作技巧、术后护理要点及骨折愈合时间,同时探索克氏针在骨折外固定支架术中的应用效果。试验结果显示,术部炎症常见,针道感染普遍,针道感染易造成克氏针松脱,以A组的克氏针较B组容易脱出。在针道口涂抹红霉素软膏或太白老翁散可有效抑菌和制止渗出,术肢于术后3 d即点地行走,7～8周骨折线模糊。因此,骨折外固定支架术操作简单,骨折愈合时间短,易出现术部和针道感染,克氏针在外固定支架术中的应用效果一般,后肢应用效果较前肢稳定。     

骨外固定支架在小动物临床上的应用

骨外固定支架是国外治疗小动物骨折的重要方法之一。目前,国内小动物临床的骨折治疗主要采用内固定、夹板或石膏外固定等方法,而骨外固定支架则少用。其主要原因是人们对骨外固定支架相关知识缺乏足够的认识。因此,本文就骨外固定支架适应症、优点、构成、分类、使用原则,以及应用后的术后护理、并发症处理等作一介绍,以拓宽临床兽医对小动物骨折的治疗思路,提高骨折治疗水平。     

应用外固定支架治疗犬骨不连2例

骨不连是宠物临床上骨折手术治疗后一种常见后遗症,可造成犬疼痛、跛行等,采用传统的内固定方法进行二次治疗有许多困难。本文采用骨外固定支架方法治疗2例犬骨不连病例,一例为接骨固定失败,一例为髓内针固定失败,经过3个月的治疗,取得了满意的治疗效果。     

内固定治疗犬股骨骨折11例疗效分析

为探讨内固定治疗犬股骨骨折的治疗方法及疗效,总结骨折愈合缓慢或预后不良的可能原因,对本院采用内固定治疗股骨骨折11例患犬的临床资料进行回顾性分析.结果显示:除1例患犬因钢针刺出膝关节,手术处理愈合后跑动时出现跛行外,其余康复的病犬临床表现正常,患部无压痛感,能自行起卧,运步正常,成功率90.9％.结论:内固定治疗犬股骨骨折手术操作简单、安全性高,值得临床推广.     

Using the Unger system to classify 386 long bone fractures in dogs

A system already described by Unger and others was used to classify long bone fractures in dogs. The present paper reports experiences using the fracture classification system regarding its ease of use and the ability to analyse the data generated. Three hundred and eighty-six canine long bone fractures were classified from radiographs. Results were assessed by reviewing the medical records or by sending questionnaires to referring veterinarians. There were a few inconsistencies, particularly in classifying proximal ulnar fractures, but the system was easy to use and data retrieval was readily accomplished. Data from the system were used to compare the results of repairs of diaphyseal fractures of the radius/ulna, femur and tibia/fibula. A chi square analysis was used to determine significant differences between the outcome scores of the three fracture types. Fractures of the femoral diaphysis had a statistically poorer outcome than did diaphyseal fractures of the radius/ulna or tibia/fibula.     

一例猫胫腓骨骨折的诊治

猫胫腓骨骨折发生后,由于猫胫腓骨很细,且近心端附着丰富的肌肉,而远心端很少,如果单纯采用外固定或内固定的治疗方法,效果往往不理想。文章就一例猫胫腓骨骨折采用髓内针和金属丝进行内固定后,又在外面用夹板进行外固定,术后恢复良好的病例来进行研究,希望能对猫胫腓骨骨折的治疗提供参考。     

Radial and Tibial Fracture Repair with External Skeletal Fixation: Effects of Fracture Type, Reduction, and Complications on Healing

Twenty-eight consecutive fractures of the canine radius and tibia were treated with external skeletal fixation as the primary method of stabilization. The time of fixation removal (T1) and the time to unsupported weight-bearing (T2) were correlated with: (1) bone involved; (2) communication of the fracture with the external environment; (3) severity of the fracture; (4) proximity of the fracture to the nutrient artery; (5) method of reduction; (6) diaphyseal displacement after reduction; and (7) gap between cortical fragments after reduction. The Kruskal-Wallis one-way analysis of variance was used to test the correlation with p less than .05 set as the criterion for significance. The median T1 was 10 weeks and the median T2 was 11 weeks. None of the variables correlated significantly with either of the healing times; however, there was a strong trend toward longer healing times associated with open fractures and shorter healing times associated with closed reduction. Periosteal and endosteal callus uniting the fragments were observed radiographically in comminuted fractures, with primary bone union observed in six fractures in which anatomic reduction was achieved. Complications observed in the treatment of these fractures included: bone lysis around pins (27 fractures), pin track drainage (27 fractures), pin track hemorrhage (1 fracture), periosteal reaction around pins (27 fractures), radiographic signs consistent with osteomyelitis (12 fractures), degenerative joint disease (2 dogs), and nonunion (1 fracture). Valgus or rotational malalignment resulted in 16 malunions of fractures. One external fixation device was replaced and four loose pins were removed before the fractures healed. One dog was treated with antibiotics during the postoperative period because clinical signs of osteomyelitis appeared.(ABSTRACT TRUNCATED AT 250 WORDS)     

Unilateral Uniplanar External Skeletal Fixation for Isolated Diaphyseal Tibial Fractures in Skeletally Immature Dogs

Objective: To report and evaluate use of external skeletal fixation (ESF) for repair of isolated (fibula intact) diaphyseal tibia fractures in skeletally immature dogs.
Study Design: Case series.
Animals: Skeletally immature (mean age, 17 weeks; range, 12–23 weeks) dogs (n=5) with isolated diaphyseal tibial fractures.
Methods: Medical records (2006–2007) of 5 dogs with isolated diaphyseal tibial fractures treated with Type 1a ESF were reviewed and outcome assessed by clinical examination and telephone interviews.
Results: Dogs were evaluated ∼2 and 4 weeks after surgery. Limb function, muscle mass, and comfort level remained very good to excellent throughout healing. Bony union was confirmed radiographically and the ESF removed ∼4 weeks after surgery (mean, 31.4 days; range, 28–37 days). Owner satisfaction was high when contacted a minimum of 4 weeks after ESF removal.
Conclusions: Use of Type Ia ESF with positive profile threaded pins is a practical and biologic method for treatment of isolated tibial fractures in skeletally immature dogs
Clinical Relevance: ESF is an effective alternative treatment to external coaptation and internal fixation for isolated diaphyseal tibial fractures in skeletally immature dogs.     

Treatment of distal diaphyseal fractures using hybrid external skeletal fixation in three dogs

Stabilisation of distal diaphyseal/metaphyseal fractures or osteotomies of the tibia and the radius is challenging due to the small fragment size, with innovative implants and external skeletal fixation systems described for their management. Hybrid external skeletal fixation is a novel external fixation system for use in small animals. This case series describes the management of distal diaphyseal fractures with IMEX-SK hybrid external skeletal fixation in three canine patients. Fracture healing was achieved in all cases, with frame removal after 5 to 10 weeks. Minimal complications were encountered in two cases. IMEX-SK hybrid external skeletal fixation constructs provide the veterinary surgeon with another option in the management of distal diaphyseal/metaphyseal fractures.     

Treatment of radius-ulna and tibia fractures with circular external skeletal fixator in 19 dogs

This study was carried out on 19 dogs of different breed, age and sex. 10 different types of radius-ulna and 9 tibia fractures were treated by circular external skeletal fixator. The cases were followed by clinical and radiological controls in the postoperative period. It was observed that the cases tolerated the apparatus well. There was no looseness of fixator stability and configuration during the 15-day interval examination. Complications like pin track, serous drainage and pin loosening were observed postoperatively. It was concluded that radiographic, clinical and anatomical data together with good preoperative planning, the Ilizarov Method and circular external skeletal fixator was successful for the treatment of open or closed fragmented radius-ulna and tibia fractures in dogs.     

Incidence of and predisposing factors for nonunion of fractures involving the appendicular skeleton in cats: 18 cases (1998-2002)

OBJECTIVE: To identify the most common sites of and possible predisposing factors for nonunions in cats with fractures of the appendicular skeleton. DESIGN: Retrospective study. ANIMALS: 344 cats treated for fractures between 1998 and 2002, 18 of which developed nonunions. PROCEDURES: Information collected from the medical records included signalment; type of trauma; fracture location, orientation, and type; degrees of displacement and comminution; treatment; and outcome. RESULTS: The tibia and proximal portion of the ulna were identified as the most common sites for nonunions. Factors significantly associated with development of a nonunion included age, body weight, affected bone, fracture type, degree of comminution, and fixation type, with older cats, heavier cats, cats with fractures of the tibia or proximal portion of the ulna, cats with open fractures, cats with comminuted fractures, and cats with fractures stabilized with a type II external skeletal fixator being significantly more likely to develop a nonunion. Eleven of the 18 cats with nonunions had a successful outcome following treatment of the nonunion. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in cats, fractures involving the tibia and proximal portion of the ulna are more likely to develop nonunions than are fractures involving other sites but that many factors may increase the risk of nonunion. Use of excessively large and rigid type II external skeletal fixators may be associated with development of nonunions; however, type II external skeletal fixators were commonly used to stabilize fractures in sites predisposed to nonunion.     

Management of 49 antebrachial and crural fractures in dogs using circular external fixators

Objectives : To evaluate frame constructs, postoperative fracture reduction, postoperative care, complications, treatment duration and outcome of circular external fixation for management of 49 antebrachial and crural fractures in dogs. Methods : Medical records of dogs that underwent surgery with circular external fixation were examined for fracture location, frame configuration, postoperative fracture reduction, treatment duration, complications and outcome. Results : Forty‐nine fractures in 48 dogs were stabilised using circular external fixation. Frame removal occurred on average 61 days after surgery (median±sd, 52±30 days). Minor complications were observed in 35 cases (71 per cent) and major complications in seven (14 per cent). Radiographic outcome at frame removal was judged as excellent in 18 cases (37 per cent), as good in 26 (53 per cent), as fair in four (8 per cent) and poor in one (2 per cent). After frame removal, one fracture was stabilised with a plate, and eight patients were lost to follow‐up. Functional and cosmetic outcome at follow‐up was judged as excellent in 32 cases (80 per cent), good in seven (18 per cent) and fair in one (2 per cent). Clinical Significance : Circular external fixation can effectively treat antebrachial and crural fractures in dogs, even geometrically complex fractures. Minor complications are frequent but easily managed in most instances. Healing time is comparable to that of other external fixation methods.     

A survey of bone fractures in the dog and cat

A survey was made of 284 canine and 298 feline fractures admitted to a metropolitan small animal hospital over a 2-year period. Approximately 80% of fractures occurred in animals less than 3-years old. Males were more commonly involved than females in both species. Road accidents were the main cause of fracture but falls and crush injuries were more common in dogs than cats. Bones most commonly affected in the cat were femur (28·2%), pelvis (24·8%) and mandible (11·4%), and in the dog radius and ulna (17·3%), pelvis (15·8%), femur (14·8), and tibia (14·8%). Forty percent of fractures were treated conservatively or by external fixation, 46·8% by internal fixation, and 13-1% were not treated. Results were satisfactory in 96·7% of treated cases.     

Configuration of pathologic fractures in dogs with osteosarcoma following stereotactic body radiation therapy: A retrospective analysis

For some cases of canine appendicular osteosarcoma (OSA), limb-sparing treatment options are often desired, one of which is stereotactic body radiation therapy (SBRT). A major complication of SBRT is fracture of the irradiated bone at the site of treatment. The present study evaluated 127 appendicular OSA sites in 122 dogs treated with SBRT to identify the most common pathologic fracture locations and configurations. A total of 50 tumours experienced a pathologic fracture, and 38 had imaging sufficient to identify fracture configuration. The distal tibia was more likely to develop a fracture than other sites. Multiple types of fracture configuration (transverse, oblique, spiral and comminuted) were observed. The distal radius was significantly more likely to develop a transverse fracture than other sites. Documentation of fracture location and configuration leads to the identification of the forces contributing to fracture occurrence, since each configuration is a result of different forces acting on each affected bone. Such knowledge is imperative for the development of new approaches to diminish the occurrence of pathologic fractures.