Fractures of the radius and ulna.

Fractures of the radius and ulna are common in the dog and cat. If treated inappropriately, complications may result. These include delayed union, nonunion, malunion, and growth deformities. ESF is a versatile method of fixation for fractures of the radius and ulna. Types that are applicable range from the simple type I to the complex type III fixator. In general, the more unstable the fracture, the more rigid the assembly must be to counteract fracture forces. There are three basic phases to consider when using ESF: (1) preoperative planning, (2) application of the ESF, and (3) long-term management. A deficiency in any one of these phases can lead to complications and an unsatisfactory clinical outcome. Although ESF can be used on many types of fractures, the technique is especially well suited for open or highly comminuted fractures when internal fixation is not applicable. In these cases, close attention must be paid to the integrity of the soft tissues. In addition, cancellous bone grafts should be placed either at the time of initial repair or in a delayed fashion after adequate vascularity has been established. Staged or complete removal of the ESF should be individualized to each fracture case. In general, staged disassembly or "dynamization" can begin when the bone and fixator begin to function as a composite as determined by radiographs. Complete fixator removal should be considered when the fracture exhibits clinical and radiographic evidences of union.     

Tibial segmental bone defect treated with bone plate and cage filled with either xenogeneic composite or autologous cortical bone graft. An experimental study in sheep.

Tibia segmental defect healing in sheep were clinically, radiographically and histologically evaluated. Twelve young sheep aged four to five months were divided into two groups, G1 and G2. A 3.5 cm long segmental defect was created in the right tibial diaphysis with maintenance of the periosteum. The bone defects in both groups were stabilized with a bone plate combined with a titanium cage. In G1 the cage was filled with pieces of autologous cortical bone graft. In G2 it was filled with a composite biomaterial which consisted of inorganic bovine bone, demineralized bovine bone, a pool of bovine bone morphogenetic proteins bound to absorbable ultra-thin powdered hydroxyapatiteand bone-derived denaturized collagen. Except for one G1 animal, all of them showed normal limb function 60 days after surgery. Radiographic examination showed initial formation of periosteal callus in both groups at osteo-tomy sites, over the plate or cage 15 days postoperatively. At 60 and 90 days callus remodeling occurred. Histological and morphometric analysis at 90 days after surgery showed that the quantity of implanted materials in G1 and G2 were similar, and the quantity of new bone formation was less (p = 0.0048) and more immature in G1 than G2, occupying 51 +/- 3.46% and 62 +/- 6.26% of the cage space, respectively. These results suggest that the composite biomaterial tested was a good alternative to autologous cortical bone graft in this experimental ovine tibial defect. However, additional evaluation is warranted prior to its clinical usage.     

Osteolysis of the radius and ulna induced by a circumferential foreign body in a cat

CASE DESCRIPTION: A 1-year-old neutered male cat was examined because of a 6-month history of recurrent swelling and draining wounds affecting the craniomedial aspect of the distal portion of the left forelimb. CLINICAL FINDINGS: No lameness or neurologic deficits were evident. Examination of craniocaudal and lateromedial radiographic views revealed nonprogressive circumferential osteolysis and a mildly radiopaque, ring-shaped foreign body surrounding the radius and ulna. TREATMENT AND OUTCOME: During surgery, a tight elastic band surrounded by a thick fibrous tissue capsule was found encircling the limb. Microbial culture yielded a Staphylococcus sp that was susceptible to clindamycin. Follow-up monitoring via telephone communication with the owners 1.5 years after removal of the foreign body indicated that the cat had healed with no recurrence of drainage. CLINICAL RELEVANCE: Pressure osteolysis of the bones of the forelimb can be caused by a circumferential foreign body without associated neurologic abnormalities or lameness.     

Angiographic examination of the forelimb in dogs with abnormal growth of the distal radius and ulna

Brachial angiograms were performed on 13 forelimbs from 12 dogs with growth-plate disorders of the distal radius and ulna. Eight angiograms were considered normal and five showed failure of individual arteries to fill, in two cases associated with hypertrophy of other vessels. Angiography was too insensitive to identify the small vessels which supplied the growth plates.     

Asynchronous growth of the canine radius and ulna: effects of retardation of longitudinal growth of the radius.

After 2,000 rads of x-radiation to the right distal radial physis of eight 70-day-old dogs, the longitudinal growth of the right radius was retarded 42.1% when compared with the growth of the nonirradiated left radius. Asynchronous growth of the right radius and ulna resulted. The gross and radiographic changes that occurred over the subsequent 75 days were described. Subluxation of the humeroradial and humeroulnar joints occurred and was first observed 31 days after irradiation. By 75 days after irradiation, the radius was puller 7.8 mm distally by the radioulnar ligament. However, subluxation of the humeroradial joint was minimized by accelerated growth from the proximal radial physis and articular cartilage. Acceleration of growth also occurred at the distal radial articular cartilage. Growth from the distal ulnar physis and styloid process was retarded. It was thus apparent that after retardation of growth from the distal radial physis, considerable adjustment occurred in the relationship between the radius and the ulna and also in growth from their other physes, which reduced the deleterious effects of the growth retardation.     

Postnatal modelling of the humeroantebrachial contact areas of radius and ulna in dogs

Necropsy dogs (n = 234) ranging in age between 2 days and 17 years were examined to characterize the cross-sectional shape of the humeroantebrachial contact area of the radius and ulna on radioulnar scans of giant, large, mid-sized, small, and chondrodystrophic breeds. During growth, the contact areas became more circular in shape in all breeds, those in small dogs remained most elliptic. Smallest normalized heights (distance between the tip of the anconeal process and the most proximal aspect of the cranial margin of the radial head = RUH, distance between the tip of the anconeal process and the cranial tip of the medial coronoid process = UH) and depths (distance determined in a right angle to RUH = RUD, distance determined in a right angle to UH = UD) were noted in large and giant breeds with no significant difference between these. In juveniles, a decrease in UD was correlated with a decrease in UH in all breeds as was a decrease in RUD correlated with a decrease in RUH, whereas in non-arthrotic adults this condition could only be proven for mid-sized dogs and small breeds but not for giant, large and chondrodystrophic dogs. The average radioulnar and ulnar heights and depths (as seen in non-arthrotic adults) were calculated to be obtained in mid-sized dogs at least 3-4 weeks earlier than in large dogs. Lipping of the cranial margin of the radial head was significantly (P < 0.001) associated with lesion(s) of the articular surface (i.e. erosion of the articular cartilage and subchondral bone and/or fragmentation of the medial coronoid process) and caused additional change in shape of this contact area, which was then even more circular. However, the variables evaluated (RUH, RUD, UH, UD) allowed only poor discrimination between constitution types and between non-arthrotic and arthrotic joints.     

Surgical correction of angular deformities of the radius and ulna following malunion fractures

Correction of angular deformities in 14 cases of malunion fractures in the canine radius and ulna is described. Angular deformities were most frequently seen in small breeds of dogs following transverse diaphyseal fractures. The most common disorders were valgus and recurvation. Following preoperative planning and measurement of the components of the deformity, reconstructive osteotomy and stable, internal plate fixation was performed. Postoperative follow up time was approximately 32.9 months. On control, 8 dogs showed no lameness, 4 were slightly lame after exercise and 2 dogs turned out to be permanently lame at the end of the follow up investigation.     

Risk factors affecting metaphyseal irregularities in the radius and ulna of growing Newfoundland dogs

The main objective of this study was to study risk factors affecting metaphyseal irregularities (MI) in the distal radius and ulna of growing Newfoundland dogs. Risk factors studied included the genetic effects, effects of litters, BW, circumferences of the distal radius and ulna (CDRU), and total serum alkaline phosphatase (ALP) concentrations. The study included 118 Newfoundland dogs (60 females, 58 males), derived from 32 litters. Body weight, separated on sex and MI, was fitted to the Gompertz function. Occurrence of MI differed significantly between sexes, with 55% of males and 35% of females affected (P = 0.03). Growth curves for the 2 groups of dogs, with and without MI, diverged after 60 to 70 d, and dogs with irregularities were heavier at maturity than dogs of the same sex without irregularities. In univariate analysis, the litter effect was a significant predictor of MI, explaining 32% of total variability of the MI incidence, but the genetic effects were not significant. However, the latter were significant in bivariate analysis of MI and BW. In the bivariate analysis, the effects of litter on MI and BW were significantly correlated at all observational points except at birth, 180 d, and 536 d. Total ALP concentrations decreased with increasing age, and differences between groups diminished with increasing age, indicating a negative effect of total ALP on MI. Correlation between MI and total ALP concentrations of litters was estimated in a bivariate analysis. This correlation was significant and ranged between -0.34 and -0.62. Similarly, the genetic relationship between total ALP and MI from 120 d of age onward varied between -0.31 to -0.60. However, correlations were only significant at 356 d of age (genetic correlation = 0.60; P = 0.01). The mean CDRU increased from 90 d of age toward a peak at 180 d. Thereafter, CDRU declined and stabilized at about 1 yr of age. The mean CDRU between the groups of dogs with and without MI diverged most at 90 d of age, then was nearly stable until 180 d and gradually declined until 356 d, when the CDRU began to equalize. Metaphyseal irregularities and CDRU levels of litter were significantly correlated. Litter effect was a significant predictor of MI. The effects of litters and the genetic effects on BW and MI were correlated at most phases of the growth of the dog. Similar, but lower, correlations were found for CDRU and MI, and total ALP and MI.     

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.     

Anthropometric measurements of the scapula, humerus, radius and ulna in Labrador dogs with and without elbow dysplasia

Objective To determine if anthropometric measurements of the Labrador scapula, humerus, ulna and radius, or their ratios, are related to the presence of elbow dysplasia (ED). Methods Digital calliper measurements of the lengths of the left scapula, humerus, radius and ulna, and their ratios, were analysed by gender in 103 volunteer Labradors (41 dogs, 62 bitches) against the ED radiological scores derived by the International Elbow Working Group (IEWG). The IEWG score is an umbrella score used to classify for ED and includes fragmented coronoid process, osteochondritis dessicans, incongruity and ununited anconeal process, the last of which occurs rarely in Labradors. Results Of the 103 Labradors studied, 31 were diagnosed radiographically with ED (20 bitches (32%), 11 (27%) dogs). Scapula length was significantly shorter for bitches with ED (P = 0.02), but not for dogs with ED. However, dogs showed a trend for a difference in the ulna:radius ratio (P = 0.06), which bitches did not. Although a greater percentage of bitches than dogs had ED in this study, the difference was not statistically significant. Conclusions Labrador bitches diagnosed with ED have a shorter scapula, which is a new finding associated with this condition. The difference in presentation associated with gender is unexpected and further research is recommended.     

Use of the Ilizarov method to manage a septic tibial fracture nonunion with a large cortical defect

The use of a 'hybridised' Ilizarov ring fixator is described in the salvage of a septic nonunion of a comminuted tibial fracture with a large diaphyseal cortical sequestrum in an 11-month-old German shepherd dog. A ring fixator assembly incorporating half pin application was chosen to provide flexibility of fixation placement options in limited bonestock which had previously been subject to conventional Kirschner-Ehmer external fixation. Diaphyseal regeneration was achieved by stimulating bone trophism through the axial loading properties of the Ilizarov fixator and the biological osteoinductive properties of cancellous bone autograft. The young age of the dog was considered to make it an optimal candidate for salvage in spite of its highly excitable temperament. Fully functional fracture union with resolution of osteomyelitis was achieved at eight weeks following revision without recourse to intercalary transportation or cortical grafting. Problems with postoperative management of the dog resulted in minor complications and mechanical failure of some of the frame components.     

Calcification of the intervertebral discs and curvature of the radius and ulna: a radiographic survey of Finnish miniature dachshunds

The vertebral column of 124 randomly selected miniature dachshunds, representing 4.5% of the population registered by the Finnish Kennel Club during the years 1988 to 1996, were radiographed. The front legs were also radiographed in order to evaluate the curvature of the radius and ulna. Calcified discs were found in 75.9% of the longhaired miniature dachshunds and in 86.7% of the wirehaired ones. The occurrence of signs associated with IDD was 16.5% in longhaired and 15.6% in wirehaired miniature dachshunds. The occurrence of signs of IDD in dogs with calcified discs was 20.0% and 17.9% in longhaired and wirehaired miniature dachshunds, respectively. In dogs without calcifications only one dog showed signs of IDD. The curvature of the radius and the ulna did not differ between the dogs with signs of IDD and the healthy ones, or between the dogs with and without intervertebral calcifications. Our results indicate that radiographic eradication based on the presence of intervertebral calcifications is not suitable for breeding purposes for the Finnish miniature dachshund population because the percentage of dogs without calcifications is small.