Results of Screw/Wire/Polymethylmethacrylate Composite Fixation for Acetabular Fracture Repair in 14 Dogs

Objective- To assess the clinical results in dogs with acetabular fractures stabilized using a screw-wire-polymethylmethacrylate (SWP) composite fixation.
Study Design- A retrospective study of client-owned dogs with acetabular fractures.
Animals- Fourteen dogs ranging in age from 4 to 95 months (mean, 34 ±25 months; median, 25 months) and body weight from 8 to 39 kg (mean, 25 ±6 kg; median, 27 kg).
Methods- Medical records and radiographs were retrospectively evaluated to determine location of the fracture, presence of preexisting degenerative joint disease, accuracy of fracture reduction and complications associated with surgery. Long-term results were evaluated by subjective assessment of lameness, elicitation of pain and/or crepitus on manipulation of the coxofemoral joint, measurements of pelvic limb circumference, coxofemoral joint goniometric measurements, and radiographic evaluation.
Results- Fracture reduction was considered anatomic in 13 dogs. At the time of the last follow-up evaluation (mean, 347 ±261 days; median, 380 days) 10 dogs were sound on the affected limb, three dogs had a subtle weight-bearing lameness of the affected limb, and the remaining dog had a consistent non-weight-bearing lameness of the affected limb. Mild (n = 10) or moderate (n = 1) degenerative changes of the affected coxofemoral joint attributed to the acetabular fracture and its repair were noted on the follow-up radiographs in 11 dogs. Limb circumference of the affected limb ranged from -8.2% to +10.8% (mean, -0.8 ±4.2%; median, -0.7%) of the contralateral limb.
Conclusions- The SWP composite fixation consistently maintained anatomic reduction, was associated with few complications, and yielded satisfactory clinical results.
Clinical Relevance- The SWP composite fixation technique would seem to be an acceptable means of stabilizing acetabular fractures in dogs.     

Sacroiliac Fracture-Separation in the Dog: A Study of 92 Cases

The case records of 92 consecutive dogs that suffered sacroiliac fracture-separation were examined. Seventy-seven per cent (71 of 92) had unilateral sacroiliac injury and 23% (21 of 92) had bilateral sacroiliac injury. Of the unilateral cases, 93% (66 of 71) of the dogs had associated acetabular, ilial, femoral, or tibial fractures; coxofemoral luxations; or cruciate injuries. Eighty-five per cent (78 of 92) of the dogs had either bilateral sacroiliac injury or unilateral sacroiliac injury and other orthopedic injuries of the opposite limb, thus disabling both hind limbs.
Sixty-five per cent (60 of 92) of the dogs received lag screw fixation of the sacroiliac joint. Of 29 dogs that were re-radiographed on an average of 437 days following fixation, 38% (11 of 29) showed evidence of loosening of the lag screw fixation.a
Screws that were placed in the body of the sacrum in some dogs resulted in the fewest loosened fixations (12%, 2 of 17), compared to other locations of screw placement. The fixation had loosened in 7% (1 of 14) of dogs that had a cumulative screw depth/sacral width of 60% or more, compared with 48% of dogs (10 of 21) where cumulative screw depth was less than 60%. The number of screws per fixation and whether the separation was fully reduced or not did not affect whether the fixation loosened.     

Proximal interphalangeal joint instability in the dog

A prospective study into the use of transarticular external skeletal fixation in the treatment of proximal interphalangeal instability was undertaken. Only dogs with soft tissue injuries were included. All the dogs except one were greyhounds or related breeds. A hypothesis was proposed that if the articular surfaces were held in normal congruency for a period of time then the development of periarticular fibrosis would alone give sufficient joint support. Joint congruency was maintained by the application of a unilateral external skeletal fixator for approximately three weeks. Complications were common and were due to frame impingement on the neighbouring digit, pin tract infection and pin loosening, and all resolved following frame removal and antibiotic therapy. Careful pin placement and prophylactic antibiotic treatment prevented complications in subsequent cases. All dogs returned to normal function with no lameness, with the exception of one racing greyhound which had a recurrence of the instability.     

Caudal Cruciate Ligament Rupture A Retrospective Analysis of 14 Dogs

Fourteen dogs were presented with caudal cruciate ligament (CaCL) rupture without concurrent cranial cruciate ligament (CrCL) rupture. The history usually included moderate to severe trauma. Presenting signs included lameness, positive drawer sign, and additional orthopedic injuries. A final diagnosis of CaCL rupture was made during surgical exploration of the joint in 12 of the dogs. In nine of the dogs, this diagnosis was not included in the preoperative differential diagnoses, and seven of the dogs were misdiagnosed as sustaining CrCL rupture. Methods of treatment included intracapsular and extracapsular stabilization. Follow-up time ranged from 3 weeks to 7 years. Function of the limbs was good regardless of surgical procedure chosen and did not appear to depend upon stifle stability.     

普通骨板内固定治疗玩具犬桡尺骨骨折的回顾性分析

本试验旨在评估普通骨板内固定治疗玩具犬桡尺骨骨折的临床效果及并发症。回顾了中国农业大学动物医院使用普通骨板（圆洞骨板或兽医可剪裁骨板）开放式复位和内固定治疗桡尺骨骨折的玩具犬的病历记录，并对这些病例进行回访。入选病例满足以下条件：体重不超过7 kg；回访时间大于12个月；病例信息记录完整。结果显示：共纳入63只犬的64例桡尺骨骨折，49例（76.6%）术后无跛行，7例（10.9%）术后勉强可见到跛行，6例（9.3%）存在轻度跛行，2例（3.1%）存在中度跛行。严重并发症的发生率是6.3%，轻微并发症的发生率是27%。试验表明，普通骨板内固定能有效治疗玩具犬桡尺骨骨折，该方法临床效果良好，且严重并发症发生率低。     

Traumatic Coxofemoral Luxation In Dogs Results of Repair

The medical records of 171 dogs with traumatic hip luxations were examined. German shepherds, mixed breeds, and poodles were significantly overrepresented. The mean age of the patients at the time of diagnosis was 4.4 years (range 5 months to 14 years). Vehicular trauma caused 83% of the 133 luxations where the etiology was known; 53% had at least one other diagnosed traumatic injury. Long-term results were obtained from owner questionnaires (25 dogs) or clinical and radiographic examinations (11 hip joints). The short-term recurrence rate after closed reduction (47.3%) was higher than that after surgical reduction using any of the three surgical techniques most frequently used here (9.5, 12.5, and 14.3%), even when the operation was performed after failure of a closed reduction (11.8%). Excluding dogs that had a femoral head ostectomy, 68% (17 of 25) of the dogs had a normal gait, 16% had only a mild lameness, and 16% had more severe lameness when evaluated on an average of 31 months after repair. Of 11 hip joints radiographed on an average of 25 months following repair, five had no radio-graphic abnormalities related to the luxation and six showed one or more of the following: periosteal new bone formation, femoral head subluxation, partial resorption of the femoral head, periarticular osteophytes, and subchondral bone erosion. Closed reduction should be the initial treatment of choice in uncomplicated luxations even though the rate of reluxation is high, because it avoids the need for surgery in approximately one half of affected dogs and does not increase the recurrence rate following subsequent surgical reduction.     

Long-term outcome of juvenile pubic symphysiodesis and triple pelvic osteotomy in dogs with hip dysplasia

OBJECTIVE: To compare long-term outcomes of juvenile pubic symphysiodesis (JPS) and triple pelvic osteotomy (TPO) in dogs with hip dysplasia. DESIGN: Prospective clinical trial. ANIMALS: 18 dogs with hip dysplasia (ie, distraction index > or = 0.5 in at least 1 hip joint and no, mild, or moderate radiographic evidence of degenerative joint disease [DJD]). PROCEDURES: Dogs between 4 and 5.5 months old at enrollment were assigned to undergo JPS, and dogs between 5 and 12 months old were assigned to undergo TPO. All dogs were reexamined at 2 years of age. RESULTS: At 2 years of age, there were no significant differences between groups in regard to lameness scores, angle of extension of the hip joints, distraction index, peak vertical force, acetabular angle, radiographic DJD score, or owner-assigned scores of clinical function. Dorsal acetabular rim angle was significantly higher in dogs that underwent JPS than in dogs that underwent TPO. For dogs that underwent TPO, dorsal acetabular rim angle was significantly decreased and acetabular angle was significantly increased at 2 years of age, compared with values obtained prior to surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that JPS and TPO have similar effects on hip joint conformation in dogs with moderate to severe hip dysplasia but that neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of degenerative changes.     

Multiple ligamentous injuries of the canine stifle joint: a study of 12 cases

Multiple ligamentous injuries of the canine stifle are uncommon. In this study, they affected mainly adult, male, working or sporting dogs and occurred secondary to severe trauma, or where chronic joint infection had weakened the supporting structures. Rupture of the cranial cruciate, caudal cruciate and lateral collateral ligaments was the most common injury observed and this occurred after catching the limb in a fence or gate. Reconstruction of the collateral and cranial cruciate ligaments, and careful repair of damaged menisci and joint capsule, was an effective method of treatment for medium- and large-size dogs. Reconstruction of the caudal cruciate ligament and postoperative limb support was not found to be essential. All dogs with subluxated stifles had good to excellent limb function with minimal loss of mid-thigh circumference or stifle joint range of motion at follow-up. Less favourable results were achieved where there was stifle joint luxation with extensive disruption to secondary joint restraints.     

Treatment of canine appendicular osteosarcoma using cobalt 60 radiation and intraarterial cisplatin.

Twelve dogs with appendicular osteosarcoma were treated with 24-40 Gy of cobalt 60 radiation and two doses of intraarterial cisplatin. Improvement in limb function occurred in four dogs, and three dogs, which had only mild initial lameness, had no worsening of their lameness post-treatment. In nine dogs in which local control was evaluable, eight had local failure, with the median (95% CI) duration of local control being 5.9 (4.6, 6.7) months. Two dogs had metastatic disease before therapy, and an additional nine dogs had metastatic disease at a median time of 6.4 months. Pathologic fracture was present in four dogs; two fractures occurred before treatment and two were documented at the time of tumor recurrence. Median (95% CI) survival time for all 12 dogs was 4.9 (3.4, 6.8) months. Excluding the two dogs with preexisting metastatic disease, median survival time was 6.7 months. Three dogs survived longer than 1 year. This mode of therapy was well tolerated and may be considered an alternative to amputation or limb-sparing surgical procedures in selected dogs with appendicular osteosarcoma.     

Effects of treatment with polysulfated glycosaminoglycan on serum cartilage oligomeric matrix protein and C-reactive protein concentrations, serum matrix metalloproteinase-2 and -9 activities, and lameness in dogs with osteoarthritis

OBJECTIVE: To investigate the effects of polysulfated glycosaminoglycan (PSGAG) treatment on serum cartilage oligomeric matrix protein (COMP) concentration, matrix metal-loproteinase-2 (MMP-2) and -9 (MMP-9) activities, C-reactive protein (CRP) concentration, and lameness scores in dogs with osteoarthritis. ANIMALS: 16 dogs with osteoarthritis and 5 clinically normal dogs. PROCEDURES: Dogs with osteoarthritis had a history of chronic lameness, and osteophytes were observed on radiographic evaluation of the affected joint. Polysulfated glycosaminoglycan was administered IM twice a week for a total of 8 treatments to all dogs with osteoarthritis and to clinically normal control dogs. RESULTS: Lameness scores after PSGAG treatment in osteoarthritic dogs improved in 12 of the 16 dogs. Serum COMP concentrations in osteoarthritic dogs were significantly higher than in control dogs before treatment. Lameness scores in osteoarthritic dogs decreased significantly after treatment, compared with before treatment. Lameness scores of 9 dogs with hind limb lameness improved significantly after treatment; these dogs had corresponding decreases in serum COMP concentrations. After treatment, serum COMP concentrations and lameness scores of 7 dogs with forelimb lameness remained high and were significantly higher than those of dogs with hind limb lameness. Serum MMP-9 activities of dogs with forelimb lameness were significantly higher than in dogs with hind limb lameness after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: IM administration of PSGAG inhibited COMP degradation in dogs with osteoarthritis. Results indicate that decreases in serum COMP concentrations might be related to improvement in lameness after PSGAG treatment.     

Caudal proximal tibial deformity and cranial cruciate ligament rupture in small-breed dogs

Eight dogs presented with chronic hindlimb lameness associated with cranial cruciate ligament rupture. Seven were small terriers. A caudal deformity of the proximal tibial shaft, originating at the proximal tibial physis, and an excessive caudal slope of the tibial plateau were present bilaterally in all dogs. The deformity was thought to be responsible for the cranial cruciate ligament failure and poor response to conservative management. Tibial plateau angles were in excess of 26 degrees in all dogs. The lameness was bilateral in three dogs. There was complete cranial cruciate ligament rupture in seven stifles and partial rupture in four. There were no meniscal injuries. Surgical correction resulted in a significant improvement (P<0.0001) in all dogs, with a mean follow-up of 12 months (range three to 24 months). There were no complications.     

Treatment of Canine Appendicular Osteosarcoma Using Cobalt 60 Radiation and Intraarterial Cisplatin

Twelve dogs with appendicular osteosarcoma were treated with 24–40 Gy of cobalt 60 radiation and two doses of intraarterial cisplatin. Improvement in limb function occurred in four dogs, and three dogs, which had only mild initial lameness, had no worsening of their lameness post-treatment. In nine dogs in which local control was evaluable, eight had local failure, with the median (95% CI) duration of local control being 5.9 (4.6, 6.7) months. Two dogs had metastatic disease before therapy, and an additional nine dogs had metastatic disease at a median time of 6.4 months. Pathologic fracture was present in four dogs; two fractures occurred before treatment and two were documented at the time of tumor recurrence. Median (95% CI) survival time for all 12 dogs was 4.9 (3.4, 6.8) months. Excluding the two dogs with preexisting metastatic disease, median survival time was 6.7 months. Three dogs survived longer than 1 year. This mode of therapy was well tolerated and may be considered an alternative to amputation or limb-sparing surgical procedures in selected dogs with appendicular osteosarcoma.     

Iatrogenic sciatic nerve injury in eighteen dogs and nine cats (1997-2006)

Objective— To report clinical features associated with iatrogenic peripheral nerve injury in dogs and cats admitted (1997–2006) to a referral teaching hospital.
Study Design— Retrospective study.
Animals— Dogs (n=18), 9 cats.
Methods— Patients had acute signs of monoparesis attributable to sciatic nerve dysfunction that developed after treatment. Neurologic examination and electrodiagnostic testing were performed. Surgical therapy was used for nerve entrapment and delayed reconstructive surgery used in other cases.
Results— Of 27 nerve injuries, 25 resulted from surgery (18 with treatment of pelvic injuries). Iliosacral luxation repair resulted in tibial (4 cats) and peroneal (3 dogs) nerve dysfunction. Other causes were intramedullary pinning of femoral fractures (3), other orthopedic surgery (cemented hip prosthesis [2] and tibial plateau-leveling osteotomy [1]), and perineal herniorrhaphy [1]. Nerve injury occurred after intramuscular injection (1 cat, 1 dog). Immediate surgical treatment was removal of intramedullary nails, extruded cement, or entrapping suture. Delayed nerve transplantation was performed in 2 dogs. Within 1 year, 13 patients recovered completely, clinical improvement occurred in 7, and there was no improvement in 7. Five of the 7 dogs that did not recover had acetabular or ilium fracture.
Conclusion— Iatrogenic sciatic nerve injury occurred most commonly during treatment of pelvic orthopedic diseases and had a poor prognosis. Clinical variation in sciatic nerve dysfunction in dogs and cats can be explained by species anatomic differences.
Clinical Relevance— Iatrogenic sciatic nerve injury leads to severely debilitating locomotor dysfunction with an uncertain prognosis for full-functional recovery.     

Mineralization of the supraspinatus tendon in dogs: a long-term follow-up

Mineralization of the supraspinatus tendon was diagnosed in 24 large-breed dogs as a probable cause for a chronic unilateral forelimb lameness. Owners of 12 dogs responded to a questionnaire survey evaluating the treatment that their dog had received which consisted of either surgical removal of the mineralization after failure of conservative treatment (operated group; n=9) or rest and nonsteroidal anti-inflammatory drugs (NSAIDs) (nonoperated group; n=3). In eight out of the 12 dogs, the mineralization was also present in the asymptomatic forelimb. Based on owner evaluation, the degree of lameness had decreased distinctly in both groups. Six dogs (four operated and two nonoperated) were reevaluated at Michigan State University Veterinary Teaching Hospital (MSU-VTH) and were without lameness except for one dog in the operated group. The mineralizations had reformed in all dogs in the operated group after a mean follow-up time of 5.1 years.     

Haemophilia A in German shepherd dogs

Haemophilia A was diagnosed in 14 male German shepherd dogs. Factor VIII: coagulant (FVIII:C) activities ranged from 1.13% of a normal canine plasma pool. von Willebrand's factor antigen values were normal or increased in all 9 of these dogs which were tested. Twelve of these dogs had a common maternal grandsire. Five dogs had exhibited no tendency to bleed (when tested between 2 to 23 months of age). They were tested because of pedigree links with clinically affected animals. Common clinical signs in the latter dogs included: bleeding from the mouth, subcutaneous and intramuscular haematomas and lameness. Since these dogs usually had a mild to moderate deficiency of FVIII:C, they may survive to adulthood without exhibiting clinical signs severe enough to necessitate veterinary attention.     

In vivo comparison of two hinged transarticular external skeletal fixators for multiple ligamentous injuries of the canine stifle.

Controlled mobilization after the surgical repair of multiple disrupted ligaments is considered to be essential for return to normal function. This study compared the outcome after post-surgical mobilization without any protection to mobilization with two transarticular external skeletal fixator hinge prototypes after surgical repair of experimental injuries to multiple stifle ligaments in 15 hounds. The repair was left unprotected (NP: n=5), protected with a self-centering hinge (SH: n=5) and with a conventional hinge (CH: n=5) for four weeks after surgical repair. Outcome measurements included: orthopaedic examination, goniometric and thigh circumference (TC) measurements, total tibial translation (TT), radiographs, and kinetic gait analysis up to 120 days post-operatively. A significant effect of treatment controlling for time for medial collateral stability, TC, TT, osteophyte scores, peak vertical force (PVF) and vertical impulse (VI) was not found. There was a significant difference between time points for subjective lameness scores, TC, PVF, VI, TT and osteophyte scores within treatment. Stifle extension was significantly decreased in CH dogs compared to NP dogs on day 28. Stifle flexion was significantly decreased in CH and SH dogs on day 28 compared to NP dogs. Stifle flexion was normal in all dogs by day 42. Both hinges compromised stifle flexion initially after hinge removal, but range of motion normalized within two weeks. Hinges were not indicated for adjunct treatment after repair of multiple experimentally induced ligamentous stifle injuries.     

Effect of carprofen, etodolac, meloxicam, or butorphanol in dogs with induced acute synovitis

OBJECTIVE: To compare the analgesic and anti-inflammatory effect of single doses of carprofen, etodolac, meloxicam, and butorphanol in dogs with induced acute synovitis (acute pain model) via kinetic gait analysis and orthopedic evaluation and examine measurement of serum C-reactive protein (CRP) concentration as an indicator of treatment efficacy. ANIMALS: 12 Beagles and 6 additional Beagles that were used only in serum CRP analyses. PROCEDURE: Acute synovitis was induced in right stifle joints of dogs via intra-articular injection of monosodium urate solution. Treatments included butorphanol (0.2 mg/kg, i.v.), carprofen (4 mg/kg, PO), etodolac (17 mg/kg, PO), or meloxicam (0.2 mg/kg, PO); control dogs received no treatment. The procedure was repeated (3-week intervals) until all dogs received all treatments including control treatment. Lameness was assessed on a biomechanical force platform and via orthopedic evaluations of the stifle joints; blood was collected to monitor serum CRP concentration. RESULTS: Compared with control dogs, treated dogs had significantly different vertical ground reaction forces and weight-bearing scores. Greatest improvement in lameness was observed in carprofen-treated dogs. Etodolac had the fastest onset of action. Compared with butorphanol treatment, only carprofen and etodolac were associated with significantly lower pain scores. An increase in serum CRP concentration was detected after intra-articular injection in all dogs; this change was similar among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Carprofen, etodolac, and meloxicam had greater efficacy than butorphanol in relief of acute pain. Carprofen was most effective overall. In this acute pain model, serum CRP analysis was not useful to assess drug efficacy.     

Accuracy and optimization of force platform gait analysis in Labradors with cranial cruciate disease evaluated at a walking gait

OBJECTIVE: To determine the combination of ground reaction forces (GRFs) that best discriminates between lame and non-lame dogs. To compare the sensitivity of force platform gait analysis and visual observation at detecting gait abnormalities in Labradors after surgery for rupture of the cranial cruciate ligament (CCL). ANIMALS: All dogs were adult Labrador Retrievers: 17 free of orthopedic and neurologic abnormalities, 100 with unilateral CCL rupture, and 131 studied 6 months after surgery for unilateral CCL injury, 15 with observable lameness. PROCEDURE: Dogs were walked over a force platform with GRF recorded during the stance phase. Analytic properties of force platform gait analysis were calculated for several combinations of forces. The probability of visual observation detecting a gait abnormality was compared with that of force platform gait analysis. RESULTS: We determined that a combination of peak vertical force (PVF) and falling slope were optimal for discriminating sound and lame Labradors. After surgery, many dogs (75%) with no observable lameness failed to achieve GRFs consistent with sound Labradors. CONCLUSION: A force platform is an accurate method of assessing lameness in Labradors with CCL rupture and is more sensitive than visual observation. Assessing lameness with a combination of GRFs is better than using univariate GRFs. CLINICAL RELEVANCE: Therapies for stifle lameness can be accurately and objectively evaluated using 2 vertical ground reaction forces obtained from a force platform.     

A Biomechanical Comparison of Screw and Wire Fixation With and Without Polymethylmethacrylate Re-Enforcement for Acetabular Osteotomy Stabilization in Dogs

Objective— Compare the biomechanical characteristics of screw and wire fixation with and without polymethylmethacrylate (PMMA) re-enforcement for acetabular osteotomy stabilization in dogs. Animals— Pelves removed from 8 adult mixed breed dogs weighing between 25 and 30 kg. Procedure— The pubic symphysis of each pelvis was split and a central transverse acetabular osteotomy was performed. One hemipelvis from each dog was stabilized with the composite fixation (interfragmentary Kirschner wire, two screws and a figure-of-eight orthopedic wire with PMMA). The contralateral hemipelves was stabilized with an interfragmentary Kirschner wire, two screws, and a figure-of-eight orthopedic wire without PMMA. All hemipelves were tested in bending by using a materials testing machine at a cross head speed of 5 mm/min. An extensometer was placed on the dorsomedial surface of the hemipelves centered over acetabular osteotomy to record distraction of the osteotomy during loading. A load/deformation curve and a load/distraction curve was produced for each hemipelvis. The slope for the initial linear portion of the load/deformation curve and the load/distraction curve, yield load and maximum load sustained were compared between repair groups using a paired t-test with P < .05 considered significant. Results— The slope of the load/deformation curve was significantly greater (P= .001 ) for hemipelves stabilized with the composite fixation (mean ± SD: 69 ± 18 N/mm) compared with hemipelves stabilized without PMMA (mean ± SD: 39 ± 8 N/mm). There was no significant difference (P= .593 ) between repair groups in the slope of the load/distraction curves as measured on the extensometer. Yield load was significantly greater (P= .0002 ) for hemipelves stabilized with the composite fixation (mean ± SD: 184 ± 25 N) compared to hemipelves stabilized without PMMA (mean ± SD: 74 ± 12 N). Maximum load sustained was also significantly greater (P= .013 ) for hemipelves stabilized with the composite fixation (mean ± SD: 396 ± 71 N) compared to hemipelves stabilized without PMMA (mean ± SD: 265 ± 94 N). Failure of hemipelves stabilized with the composite fixation occurred primarily by ventrolateral bending of the cranial and caudal pelvic segments at the osteotomy site. Failure of hemipelves stabilized without PMMA occurred by ventrolateral bending of the cranial and caudal pelvic segments at the osteotomy site with pronounced concurrent ventrolateral rotation of the cranial pelvic segment. Conclusion— PMMA improves the mechanical characteristics of acetabular fracture fixation, at least in part by neutralization of rotational forces. The results of this study justify use of PMMA as a component of the composite fixation when repairing acetabular fractures.