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.     

Bone plate fixation of distal radius and ulna fractures in small- and miniature-breed dogs.

Bone plate fixation was reviewed in 29 distal radial fractures of small- and miniature-breed dogs. Twenty-two fractures in 18 dogs were available for follow-up. Number of complications and return to function were evaluated. Complications occurred in 54% of the fractures. Catastrophic complications occurred in 18% of fracture repairs with follow-up, while minor complications occurred in 36%. Sixteen (89%) of 18 dogs had a successful return to function. Bone plate fixation is a successful repair method for distal radius and ulna fractures in small-breed dogs, compared to previously reported methods.     

Single transphyseal screws for the correction of moderate to severe angular limb deformities in 28 Thoroughbred foals

This study reports on the effective use of a single transphyseal screw for the treatment of moderate to severe angular limb deformities (ALDs) of the fetlocks and carpi of 28 young Thoroughbred foals. The objective was to evaluate the surgical management of foals with moderate to severe ALDs treated with single transphyseal screws. Evaluation of medical records of 28 Thoroughbred foals treated with single transphyseal screws placed across the distal radial, metacarpal and metatarsal physes was undertaken. The angle of joint deviation was measured prior to implantation and at removal of the implants, and the degree of improvement was calculated. A total of 39 screws were placed: 24 in the distal metacarpus or metatarsus and 15 in the distal radial physis. Varus or valgus deformities in the fetlock improved by 4–5° over a period of 15–30 days. Varus or valgus deformities in the carpi improved by 8–11° in 11–56 days. One case failed to improve adequately due to implant infection. Single transphyseal screws were effective in treating moderate to severe varus and valgus ALD of the fetlocks and carpi in young Thoroughbred foals. Further investigation into their use in the distal radius in young foals is needed. While single transphyseal screws are almost exclusively used by some clinics in the distal metatarsal and metacarpal physes, many clinicians do not use them in the distal radial physis of young foals due to fear of over‐correction, physitis and metaphyseal collapse. This was not observed in any of our cases.     

A review of angular limb deformities

This article provides some guidelines for the evaluation and management of angular limb deformities in young horses. It begins by looking at factors that influence conformation and that should be taken into consideration when making a decision as to the significance of a particular conformational trait. Perinatal and acquired deformities are then discussed separately with an emphasis on the latter. Options for their correction are described as well as the results of recent publications using these techniques. Finally the approach to management of deformities at each of the most commonly encountered locations is described.     

Complications after two transphyseal bridging techniques for treatment of angular limb deformities of the distal radius in 568 Thoroughbred yearlings

Reasons for performing study: Surgical correction of carpal angular limb deformities by growth retardation is commonly undertaken with a screws and tension band wire loop technique (S&W) or a single transphyseal screw (STS). This study compares complications after S&W and STS bridging in the distal radius of Thoroughbred yearlings. Objective: To compare the prevalence of complications serious enough to require follow‐up radiographs following either S&W or STS surgery for growth manipulation in the distal radius of Thoroughbred yearlings. Methods: Medical records and radiographs from Thoroughbred yearlings (age range 261–457 days) treated for carpal angular limb deformities at a single hospital over 2 years were reviewed. Each of the techniques was used exclusively during a single year. The complication threshold criterion for inclusion was the need for nonroutine radiographs of the operated site anytime after implant insertion or removal. Results: Of 568 horses, 253 received S&W and 315 received STS. Horses were of similar age at the time of surgery for STS and S&W. Single transphyseal screws were left in place for a significantly shorter amount of time (16 days). Sex, the limb(s) treated and medial vs. lateral placement were not significantly different between techniques. Complications included physitis post implant removal, metaphyseal collapse post implant removal, infection, overcorrection and seroma formation severe enough to require radiography. Physitis and metaphyseal collapse occurred significantly more frequently with STS compared with S&W. Infection, overcorrection and seromas were not significantly different between techniques. Conclusion: The STS and S&W techniques are both viable treatment options for correction of carpal angular limb deformities. However, horses treated with the STS technique have a significantly increased risk of developing physitis or metaphyseal collapse. Potential relevance: Horses treated with STS bridging have a significantly increased risk of developing the post correction complications of moderate to severe physitis and metaphyseal collapse compared with horses treated with S&W bridging.     

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 results and fertility following correction of vesicovaginal reflux in mares

Objective To evaluate the surgical results and fertility of mares bred at various intervals relative to surgical management of urovagina. Design Sixty-one mares underwent surgery to correct vesicovaginal reflux. Surgery was performed at varying times relative to breeding and postoperative fertility was evaluated. Results Five mares were lost to follow-up and a further four were electively not bred. Of the remaining 52 mares, seasonal pregnancy and live foaling rates were 67% (35/52) and 54% (26/48), respectively. When mares were bred in the same cycle as the surgery, the first cycle following surgery, the second cycle following surgery or the following breeding season after surgery the seasonal pregnancy rates were 89% (8/9), 63% (10/16), 67% (2/3) and 63% (15/24), respectively. After censoring four mares that died of natural causes pre-foaling, the foaling rates were 88% (7/8), 50% (7/14), 0% (0/3), 52% (12/23), respectively. All mares bred in the same cycle as surgery or in the next cycle were bred once only that season, so the pregnancy rate per cycle of 72% (18/25) was identical to the seasonal pregnancy rate. Conclusions Good fertility (comparable to a normal population of mares) was achieved following surgery and the results suggest that delaying breeding until the following breeding season is not necessary. In addition, breeding in the same cycle as surgical repair is a previously unreported technique that should be considered to maintain a yearly foaling interval.