一例犬右侧前后肢同时骨折内固定手术治疗

本文结合1例犬肱骨远端骨折、胫骨中端骨折内固定手术的过程,介绍了这个病例从术前、术中到术后的具体情况。结果表明,该犬采用塑形钢板加柯氏针对肱骨远端骨折进行固定和采用DCP接骨板对胫骨中端骨折内固定整复后效果良好,术后第4d该犬就能正常下地行走,2周后基本恢复正常。通过这个病例的研究,证明了采用内固定的手术疗法可使骨折很快愈合,治疗效果也能达到预期目的。     

一例犬桡骨骨折的诊治

自2010年到2020年,人们对犬猫的需求大大的增加,犬猫的繁殖数量同时也在增加。同时,受车祸、争斗等影响,犬猫骨折病例有增多趋势。犬的桡尺骨骨折是由于各种外力作用下导致其生物力学改变而发生的骨折,常见于小型犬。本文论述了一例小型犬遭遇车子碾压桡尺骨骨折的诊治过程,经过详细的问诊,触诊和临床检查,最终通过X光确诊该犬为桡尺骨骨折,通过手术进行治疗,最终康复。给临床接诊类似病例提供一定的依据。     

一例贵宾犬两前肢桡尺骨双骨折病例治疗与分析

犬桡尺骨干双骨折,又称前臂双骨折,是常见的犬前臂损伤病例,多见于体型较小的犬种。报道了一只8月龄贵宾犬两前肢桡尺骨双骨折病例的诊断,采用钢板内固定术治疗,预后良好。临床上犬前臂骨折大都是桡骨、尺骨同时骨折,根据患病动物的情况采用内固定或外固定术是可行的治疗方法。     

一例犬桡尺骨骨折的诊治

为了对一例小型博美犬撞伤进行诊断并治疗,试验采用临床检查及X射线检查进行确诊。结果表明:患犬为桡尺骨中部横断骨折,手术采用了桡尺骨横断骨折内固定术进行治疗,患犬恢复良好。说明小型犬适合桡尺骨骨折内固定手术治疗,治疗效果较好。     

犬股骨远端干骺骨折内固定25例

1 病例来源 2003年12月到2006年11月,本动物医院收治了犬股骨远端干骺骨折患犬25例,其中:雄犬15例.雌犬10例.1岁以内患犬18例,主要为北京犬、西施和博美等小型犬.只有1只犬手术时体重超过了10 kg.患犬中16例发生于右后肢,9例为左后肢.发病原因主要为从高处跳下、车祸或被踢等原因所致.     

一例犬下颌骨骨折的诊治体会

犬类下颌骨骨折是常见的一类手术难度偏高的骨科手术,其发生部位一般以正中矢面骨折或齿槽间隙一侧或两侧较多见,多因打斗、车祸而发生。笔者在宠物医院诊治了一例犬下颌骨骨折病例,通过呼吸麻醉,利用医用钢丝和加压钛骨板内固定,并注意调整咬合关系,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…     

一例犬股骨骨折内固定术失败病例

通过询问病史、体格检查、影像学检查以及血液检查等方法对一只5月龄中华田园犬的近端股骨骨折进行诊断，应用矫形钢板与螺钉内固定方法对该患犬进行手术治疗。患犬在术后7 d出现了钢板松脱，确认骨折内固定手术失败，后手术取出钢板，采用夹板绷带外固定法并进行药物治疗，2个月后患犬虽然有轻微跛行，但是基本恢复行走，不影响正常生活。详述了该病例的诊疗过程，剖析了内固定手术失败的原因，并结合该病例的治疗过程总结了防止内固定手术失败的方法以及手术失败后的补救方案。     

单纯用不锈钢丝固定治疗小型犬下颌骨折

临床上犬下颌骨骨折多因打斗时过于用力撕咬、车祸、人为打击等因素造成.犬下颌骨一旦发生骨折,特别是双侧性骨折,若不通过内固定手术治疗,骨折部很难自行愈合,严重导致犬无法进食,最终造成机体衰竭而死亡.     

高分子绷带结合铝板外固定治疗小型犬桡尺骨中段骨折

医用高分子矫形绷带加铝板外固定治疗幼龄小型犬桡尺骨中段骨折,与传统的夹板、石膏以及钢板、髓内针内固定等方法相比,更方便易行、固定效果比较确实[1-2]. 2010年3月以来,在本院就诊的5例幼龄小型犬,通过临床症状和X线检查,确定为桡尺骨中段闭合性骨折,3例为非粉碎性骨折,2例为粉碎性骨折,均采用医用高分子绷带加铝板外固定,术后功能恢复效果较好[3-4].治疗方法、结果及分析报告如下.     

Fractures of the humerus

Humeral fractures are the least common long bone fracture in small animals. The low incidence of these fractures combined with the unique anatomy of the humerus makes repair of humeral fractures challenging. This chapter provides a review of humeral fracture management.     

Radius/Ulna fracture repair

Fractures of the radius and ulna are commonly encountered in the small animal population. Diaphyseal fractures are the most common location and are often repaired with the use of external fixators or a bone plate. Select patients, such as young large breed dogs, may be managed with external coaptation. Extremely proximal and distal fractures require special consideration, especially if articular involvement is present.     

Tibial fractures

Tibial fractures are common in small animal practice. As with other appendicular fractures, the patient's age, fracture location, and fracture type must be considered thoroughly. While methods for tibial fracture repair are similar to those used for appendicular fractures elsewhere, there are some unique considerations, both anatomically and functionally, that must be contemplated before repair. The following article will review the incidence of tibial fractures, tibial fracture types, and options for tibial fracture management and treatment. The use of external fixators, orthopedic bone plates, open reduction with internal fixation (ORIF), and external coaptation will be discussed. An emphasis will be placed on the most common types of tibial fractures, as well as those best suited for repair by general practitioners of veterinary medicine. Three case based examples will follow the overview.     

Evaluation of surgical repair of humeral condylar fractures using self-compressing orthofix pins in 23 dogs

OBJECTIVE: To report short- and long-term clinical and radiographic outcomes in dogs with humeral condylar fractures repaired using self-compressing Orthofix pins. STUDY DESIGN: Retrospective evaluation with solicited long-term clinical and radiographic evaluations. ANIMALS: Twenty-three dogs with humeral condylar fractures. METHODS: Medical records and radiographs were reviewed. Owners were asked to return dogs for long-term clinical and radiographic evaluation. RESULTS: Dogs were aged 1.5-26 months (mean+/-SD, 5.8+/-5.0 months) with 20 dogs weighing <5 kg (mean, 3.6+/-2.8 kg). Of 21 dogs with immediate post-operative radiographs, 10 had anatomic reduction with the rest having either a step and/or gap at the articular surface. Kirschner wire migration and implant loosening were the most common post-operative complications. All fractures with adequate follow-up radiographic evaluations achieved union. Twelve of 13 dogs returned for long-term evaluation (mean, 19.0+/-18.5 months) were either sound (10 dogs) or had subtle, weight-bearing lameness (2). Fourteen dogs had radiographs >/=75 days after surgery (mean, 18.7+/-18.3 months), 8 dogs (57%) had no radiographic evidence of osteoarthritis (OA; mean OA score, 0.8; median 0), and all dogs had good or excellent limb function. CONCLUSIONS: Self-compressing Orthofix pins are suitable implants for the stabilization of humeral condylar fractures in small breed dogs. Implants were convenient and simple to use and complications were easily resolved. Dogs consistently had good long-term clinical and radiographic outcomes with no or minimal lameness and OA. CLINICAL RELEVANCE: Self-compressing Orthofix pins should be considered for the repair of humeral condylar fractures in small breed dogs.     

DOES CHANGING THE ORIENTATION OF A THORACIC RADIOGRAPH AID DIAGNOSIS OF RIB FRACTURES?

To test the hypothesis that changing the orientation of a thoracic radiograph aids diagnosis of rib fractures, a case–control study was carried out using 120 radiographs of small animal patients with recent thoracic trauma. Six independent observers representing three levels of experience viewed the radiographs in randomized order in conventional and unconventional orientations at 15‐s intervals in a PowerPoint^® presentation. Sensitivity for rib fractures was 53–69% and specificity was 74–97%, depending on the observer. Radiologists had higher specificity than less experienced observers (P=0.0001), but comparable sensitivity for rib fractures. Radiologists had significantly higher accuracy than residents (P=0.03), and residents had higher accuracy than interns (P=0.02). Accuracy of diagnosis was reduced significantly when based on lateral radiographs compared with dorsoventral (DV)/ventrodorsal (VD) views (P=0.02) mainly because of low sensitivity of lateral radiographs of dogs with rib fractures. Rotating radiographs 90° clockwise was associated with increased specificity of one intern (from 74 to 90%, P=0.03), but had no effect on accuracy of diagnosis by other observers (P>0.16). Turning DV/VD views upside down had no effect on accuracy of diagnosis of any observers (P>0.40). Changing the orientation of a thoracic radiograph may make it easier for some novices to examine the ribs; hence it could be considered a training aid rather than a technique that will benefit an experienced radiologist.     

Pedal bone fractures

Fractures of the pedal bone are usually the result of direct trauma, and are relatively commonly encountered in equine practice. Either front or hind feet may be affected. Seven distinct fracture types are recognised. Type I fractures involve the palmar/plantar process and do not enter the distal interphalangeal (DIP) joint. Type II fractures are oblique or parasagittal fractures that are articular but are not on the midline. Type III fractures are midline articular fractures that bisect the pedal bone into 2 equal halves. Type IV fractures involve the extensor (pyramidal) process of the pedal bone. Type V fractures are comminuted and split the pedal bone into multiple fragments. Type VI fractures are solar margin fractures. Type VII fractures are exclusive to foals and are also fractures of the solar margin. In most cases the onset of clinical signs is acute. The diagnosis is usually achieved by radiography, although computed tomography or magnetic resonance imaging can be helpful in some cases. Treatment options include surgical and nonsurgical therapies. The prognosis for articular fractures (Types II and III) is worse than for nonarticular fractures (Types I, IV, VI and VII) because of the likelihood of osteoarthritis within the DIP joint. Nonarticular fractures carry a good prognosis if a long enough convalescence is undertaken. Comminuted fractures (Type V) carry a poor, but not hopeless, prognosis.     

Rehabilitation of fractures in small animals: maximize outcomes, minimize complications

Successful fracture management accomplishes 2 major objectives: bony union and return to functional activities. For many years, Physical Therapy has routinely helped human patients recovering from fractures reach their functional goals by helping them regain movement, flexibility, strength, coordination, and balance. Rehabilitation is now commonly provided to small animals recovering from fractures to accomplish similar goals. Knowledge of tissue healing is critical when determining the appropriate stresses to apply throughout the healing timeline. The detrimental effects of immobilization, including the potential for development of fracture disease, must be considered when formulating a Rehabilitation plan of care. Many Rehabilitation interventions are readily amenable to application by both Veterinary professionals and owners of patients. Superficial thermal modalities, passive range of motion and stretching, soft tissue massage, therapeutic ultrasound, electrical stimulation, and therapeutic exercise can ensure a more complete patient recovery. Providing owners with education regarding appropriate patient handling and home modifications allows a safer return to the home environment. Detailed written instructions for rehabilitation at home promotes owner compliance and accurate completion.     

COMPUTED TOMOGRAPHIC EVALUATION OF COMMINUTED MIDDLE PHALANGEAL FRACTURES IN THE HORSE

Comminuted fractures of the middle phalanx have been well described in the horse. Choice of treatment, surgical planning and prognosis have traditionally been based upon evaluation of radiographs. However, the complex nature of comminuted fractures makes radiographic interpretation difficult. Computed tomography (CT) allows the production of cross-sectional images with spatial separation of structures which are superimposed on survey radiographs. This allows accurate assessment of the number and direction of fracture lines within the bone. In this paper we report the use of CT in the evaluation of 6 comminuted middle phalangeal fractures. Computed tomography is potentially useful in deciding the type of treatment, surgical planning and determining the prognosis.     

INCOMPLETE OSSIFICATION OF THE HUMERAL CONDYLE IN VIETNAMESE POT-BELLIED PIGS

The purpose of this study was to evaluate the occurrence of humeral condylar fractures in Vietnamese pot-bellied pigs and to postulate a possible predisposing cause for these fractures. Thirteen Vietnamese pot-bellied pigs (Group A) were evaluated over an eight year period (1990-1998), each with a history of either a unilateral or bilateral forelimb lameness. The cause of lameness was localized to the elbow region. Of the thirteen pigs, twenty-one elbows were evaluated radiographically. Pigs ranged in age from six months to four years old. All pigs over the age of seven months showed radiographic evidence of elbow degenerative joint disease. Fractures involving the medial aspect of the humeral condyle were identified in 8/21 studies (38%). A well-defined linear intracondylar articular lucency was identified in 7/21 studies (33%) on the craniocaudal projection. The site of this lucency corresponded to the location of the articular component of the fractures seen involving the humeral condyle. The elbows of five pot-bellied pigs with no known history of forelimb lameness or trauma (Group B) were evaluated radiographically following euthanasia. All five pigs were of unknown age and gender. An intracondylar vertical linear lucency was identified bilaterally in three pigs (60%). Concurrent degenerative joint disease was present in all instances. The remaining two pigs were radiographically normal. Computed tomography of the elbows was performed in one affected pig from Group B. The radiographic findings in this pig were verified. Histopathology of the right elbow of this affected pig was diagnostic for incomplete endochondral ossification of the humeral condyle. A similar condition involving the humeral condyle has been previously described in Cocker and Brittany Spaniels. These canine breeds also have a high incidence of humeral condylar fractures. It is postulated that Vietnamese pot-bellied pigs are similarly prone to humeral condylar fractures, even in the absence of known trauma, due to incomplete ossification of the humeral condyle.     

昆明犬胫腓骨骨折的诊治

本研究通过回顾分析临床上使用外固定支架治疗11例昆明犬胫腓骨骨折病例,探讨使用外固定支架治疗昆明犬胫腓骨骨折的临床效果。手术后100 d回访,骨折全部愈合,骨折愈合最短时间为30 d,最长为90 d,除少数有针孔感染和固定针松动外,无其他重大并发症。结果表明,外固定支架是治疗昆明犬胫腓骨骨折的理想方法。