Use of scintigraphy for assessment of fracture healing and early diagnosis of osteomyelitis following fracture repair in rabbits

OBJECTIVE: To evaluate use of technetium Tc 99m disodium hydroxymethylene diphosphonate (99m-Tc-HDP) for assessing fracture healing and 99m-Tc-HDP and technetium Tc 99m ciprofloxacin (99m-Tc-CIPRO) for early diagnosis of osteomyelitis in rabbits. ANIMALS: 32 skeletally mature New Zealand White rabbits. PROCEDURE: A femoral fracture defect stabilized with bone plates and cortical screws was used. Scintigraphy was performed 4, 8, 12, and 16 weeks after surgery. The 99m-Tc-CIPRO scan was performed 48 hours after the 99m-Tc-HDP scan. The uptake ratio of the experimental limb to the normal limb was calculated by use of multiple regions of interest. Results of radiography performed to determine external callus and lysis grade and percentage defect ossification at 16 weeks were compared with scintigraphy results. RESULTS: Infected fractures had a higher uptake ratio for 99m-Tc-HDP and 99m-Tc-CIPRO than noninfected fractures. Infected fractures could be differentiated from noninfected fractures late in healing by use of 99m-Tc-HDP. Although 99m-Tc-CIPRO was better than 99m-Tc-HDP for identifying infection, there was a high incidence of false positive and negative results with 99m-Tc-CIPRO. There was an association between 99m-Tc-HDP uptake ratio and callus formation and a good correlation between 99m-Tc-HDP uptake ratio and defect ossification after 4 weeks. CONCLUSIONS AND CLINICAL RELEVANCE: 99m-Tc-HDP and 99m-Tc-CIPRO may be useful for diagnosing osteomyelitis late in fracture healing; however, false positive and false negative results occur. Technetium Tc 99m disodium hydroxymethylene diphosphonate may be useful for evaluating fracture healing.     

Omentalisation as adjunctive treatment of an infected femoral nonunion fracture: a case report

A three-year-old male working border collie with an infected femoral nonunion fracture was managed in a two-stage procedure involving debridement and omentalisation, followed by stabilisation with a bone plate and an autogenous cancellous bone graft. Osseous union was documented radiographically 16 weeks after surgery. Telephone follow-up one year later revealed the dog had returned to full working function without evidence of lameness. To the authors' knowledge, this is the first clinical case described in the veterinary literature using omentalisation as an adjunct to the management of an infected, biologically inactive nonunion fracture.     

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)     

Correlation of serum alkaline phosphatase activity with the healing process of long bone fractures in dogs

BACKGROUND: Bone healing is monitored mainly by physical and serial radiologic examinations of the fracture site. However, it is sometimes difficult to distinguish a delayed union from a nonunion, and advanced imaging techniques may not be available. Serum biochemical markers of bone formation, such as alkaline phosphatase (ALP) activity, may be clinically useful in evaluating the progress of healing. OBJECTIVE: The purpose of this study was to correlate serial values of serum ALP activity with the process of fracture healing in dogs and to assess its potential as a postsurgical prognostic indicator. METHODS: Changes in serum ALP activity were studied in 83 dogs with closed long bone diaphyseal fractures treated surgically. Physical and radiologic examinations of the fracture site and determination of serum ALP activity and calcium (Ca) and phosphate (P) concentrations were performed on admission (day 0); postoperatively on days 10, 20, and 30; and subsequently on a monthly basis until bone union was completed or signs of nonunion were evident. The dogs were allocated into 3 groups with respect to the fracture healing progress as documented by physical and serial radiologic examination. RESULTS: Group A dogs (n=35) developed a medium-sized callus that led to bone union within 2 months. Group B dogs (n=36) had a hypertrophic callus and delayed union, within 3-5 months. Group C dogs (n=12) had slow progress in fracture healing, with minimal callus formation during a 2-month period. Changes in mean serum ALP activity followed the same pattern in groups A and B, reaching a maximum level on day 10. Group A values returned to normal within 2 months, at which point bone union was complete, whereas group B values remained increased and returned to normal within 3-5 months, thus correlating with delayed union. In Group C, mean serum ALP activities showed no significant changes during the 2-month follow-up period, consistent with failure of bone union (nonunion). Serum P and Ca changes followed a proportional and inverse pattern to ALP changes, respectively. CONCLUSION: Serial determination of serum ALP activity during fracture healing could be an additional tool in predicting fractures at risk of developing a nonunion, helping the clinician to choose the appropriate intervention.     

Serum concentrations of keratan sulfate,osteocalcin, and pyridinoline crosslinks after oral administration of glucosamine to standardbred horses during race training

OBJECTIVE: To determine the effects of orally administered glucosamine on concentrations of markers of bone and cartilage metabolism in Standardbred horses during race training. ANIMALS: Twenty 16- to 20-month-old Standardbreds beginning race training. PROCEDURE: Horses were randomly assigned to 2 groups. One group received glucosamine hydrochloride (4 g, PO, q 12 h), and the second (control) group received glucose (4 g, PO, q 12 h). Serum samples were obtained prior to onset of the study (baseline) and at regular intervals for 48 weeks for determination of concentrations of keratan sulfate (KS), osteocalcin (OC), and pyridinoline crosslinks (PYD). RESULTS: Osteocalcin concentrations changed significantly with time; mean serum concentrations were significantly higher than baseline values for samples obtained at 24 to 48 weeks after onset of the study. Although a significant effect of time was observed for mean concentration of KS, concentrations did not differ significantly from baseline values at any time during the study when groups were analyzed separately. However, pooled analysis revealed significant increases of mean serum KS concentration at weeks 24 and 30. Significant changes in serum PYD concentrations were not detected. Oral administration of glucosamine did not significantly affect serum concentrations of any of the markers. CONCLUSIONS AND CLINICAL RELEVANCE: Increased serum OC in clinically normal Standardbreds during race training may reflect bone formation that accompanies adaptive remodeling of the appendicular skeleton. For these experimental conditions, glucosamine did not appear to exert a detectable influence on serum concentrations of these 3 markers of connective tissue metabolism.     

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.     

Early Experience With the Use of an Interlocking Nail for the Repair of Canine Femoral Shaft Fractures

Static locked nailing was used to repair fractures of the femoral diaphysis in 15 dogs. The implant consists of a 5, 6, or 7 mm diameter stainless steel rod made up of two parts: the body of the nail, in which there are 13 threaded holes, and a piece without holes that contains a slot for anchoring the jig. Good limb function was obtained after less than 3 weeks in 12 dogs and these dogs remained sound throughout the study. Radiographic examination revealed fracture healing in 11 of the dogs, between 8 and 16 weeks after surgery. One dog was not returned for follow-up evaluation until 22 weeks after surgery; complete healing was apparent from radiographic examination. The remaining three dogs had to have additional operations, one because of lameness caused by excessive length of the distal screws, one because of a nonunion, and the third because of a sequestrum. Fracture healing in these dogs was observed at 18, 21, and 24 weeks respectively. Loosening of one screw and angulation of the bone occurred in one dog. These complications had no adverse effects on clinical outcome.     

Use of veterinary interlocking nails for diaphyseal fractures in dogs and cats: 121 cases

OBJECTIVE: To report clinical outcome after use of an interlocking nail (veterinary interlocking nail [VIN]) for stabilization of diaphyseal fractures in dogs and cats. STUDY DESIGN: Retrospective study. Animals: Seventy-eight dogs and 43 cats with diaphyseal fractures of the femur (n = 96), tibia (n = 14), or humerus (n = 11). METHODS: Interlocking nails (4 mm diameter [n = 72], 6 mm [n = 25] or 8 mm [n = 24]), were used in static (n = 106) or dynamic (n = 15) fixation mode. Cerclage wires also were used in 63 (52%) cases. Data about the patient (species, breed, weight, age), characteristics of the fracture, and details of the surgery and perioperative complications were recorded. The surgeon evaluated functional outcome, and fracture healing was quantified 6 weeks (W6) and 3 months (M3) after surgery with a radiographic index. RESULTS: Twelve cases had been unsuccessfully treated by another technique. Of 106 comminuted fractures, 60 were classified as unstable. Only 112 animals were evaluated at W6; 86 (77%) healed without complication and had a functional outcome considered excellent (n = 80, 93%), good (n = 5, 4%), or fair (n = 1). Twenty-six complications were noted: 16 (14%) patients did not require additional surgery and had a good or excellent outcome, whereas 10 (8%) patients needed surgical intervention to CONCLUSIONS: VINs can be used to repair diaphyseal fractures of the femur, tibia, and humerus in dogs and cats provided the implants are appropriately sized for the fractured bone. The high healing rate (even with unstable fractures), associated with a functional outcome, and low complication rate support the use of VINs for these fracture types. However, a period of training and the application of basic principles are necessary to ensure successful results. CLINICAL RELEVANCE: VINs should be considered as alternative technique for management of selected diaphyseal fractures of the femur, tibia, and humerus in dogs and cats.     

The effect of dietary soy daidzein on pig growth and viral replication during a viral challenge.

Twelve replications of four littermate pigs from a porcine reproductive and respiratory syndrome (PRRS) naive herd were weaned (11 +/- 2 d of age) and penned individually in isolation rooms. Pigs were randomly allotted within litter to one of four dietary soy daidzein concentrations (0, 200, 400, or 800 ppm) to quantify the effect of daidzein on growth and immune response during a PRRS challenge. Daidzein was provided as the soy aglycone. At 27 +/- 2 d of age (4.9 +/- 1.4 kg BW), pigs were oronasally inoculated with 10(4.3) PRRS virus/mL from strain JA142 in a 2-mL dose. Blood was collected every 4 d from d 0 to 24 after inoculation and analyzed for serum PRRS virus, interferon, and alpha-1-acylglycoprotein (AGP) concentrations. Serum virus and interferon peaked at 10(5.3) virus/mL and 79% protection, respectively, at 4 d after inoculation and then declined steadily. Serum AGP concentration peaked at 12 d after inoculation. Each log increase in serum virus was associated with an increase in serum interferon, which resulted in a decrease of pig ADG and daily feed intake of 0.019 kg and 0.023 kg, respectively, in 5.8-kg pigs and a feed intake reduction of 0.024 kg in 12.5-kg pigs. Dietary daidzein additions did not (P > 0.3) alter the serum concentration after inoculation of PRRS virus (10(1.79), 10(1.94), 10(1.86), 10(1.93) virus/mL of serum) or AGP. Serum concentrations of interferon responded cubically (30.3, 28.9, 29.4, and 31.1% protection) as dietary daidzein concentrations increased; however, the magnitude of the response decreased over time. Dietary daidzein additions resulted in improvements in daily pig gain, daily feed intake, and gain/feed during periods of peak viremia (d 4 to 16 after inoculation), but not in periods when systemic virus concentrations were minimized (d 16 to 24 after inoculation), resulting in a daidzein x days after inoculation interaction. Based on these data, the magnitude of the growth responses that occur in pigs infected with a virus is quantitatively related to the animal's serum concentration of the virus and interferon, and dietary soy daidzein at 200 or 400 ppm is a weak enhancer of body growth in virally challenged pigs.     

Early changes in biomarkers of skeletal metabolism and their association to the occurrence of osteochondrosis (OC) in the horse

REASON FOR PERFORMING STUDY: Diagnosis of osteochondrosis (OC) is based on clinical signs and radiography, but alternative methods for detection at an early stage would be useful. OBJECTIVES: To determine in the juvenile horse the relationship between serum concentrations of a number of biomarkers that reflect changes in cartilage and bone turnover and age, feeding level, growth, and the occurrence of OC. METHODS: Foals were assigned to a high (n = 20) or moderate (n = 19) feeding level group from birth to age 1 year. Bodyweight, withers height and cannon width were measured. Osteoarticular status was assessed radiographically at 5.5 and 11 months in all foals, and by necropsy at 12 months for 8 foals/group. Serum biomarkers of bone (osteocalcin, CTX-1) and cartilage (CPII, C2C) metabolism were assayed at 8 time points between ages 2 and 52 weeks. Ratios between biomarkers of tissue formation and degradation were calculated at each time point. RESULTS: Consistent age-related patterns in biomarker serum concentrates were found, indicating a markedly higher metabolism before age 20 weeks but concentrations were not affected by feeding level. Bodyweight was correlated negatively to C2C and CTX-1, and withers height was positively correlated to osteocalcin and the osteocalcin/CTX-1 and CPII/ C2C ratios. Osteocalcin concentration at 2 weeks and CPII/ C2C ratio at 20 weeks had strong positive correlations to OC, as diagnosed radiographically at 5.5 months. Osteocalcin had a strong correlation with radiographically detected OC at 11 months but at that time there was no significant relationship between CPII/C2C ratio and OC. CONCLUSIONS: Occurrence of OC lesions is significantly associated with anabolic changes in bone metabolism during the first weeks post partum, given the strong relation with osteocalcin. POTENTIAL RELEVANCE: Measuring osteocalcin concentrations during the first few weeks post partum may have potential value for the prediction of risk for OC development.     

Use of flexible intramedullary rods for fixation of femoral fractures in eight dogs

High-density, polysulfone rods were used to repair 4 comminuted and 4 short-oblique, mid-diaphyseal femoral fractures in 8 dogs. Bony union was achieved in 2 dogs at 10 and 12 weeks after surgery. In one dog, the femoral fracture was healing when amputation of the limb became necessary because of sciatic nerve damage secondary to an ipsilateral pelvic fracture. In a fourth dog, fracture repair resulted in nonunion, despite normal clinical function at 18 months after surgery. In the remaining 4 dogs (50%), the rods failed at 3.5, 4, 6, and 22 weeks after surgery. These fractures were then stabilized by use of other methods. Although several factors may have contributed to failure of the rods, multiple autoclaving of the thermoplastic implants may have caused embrittlement and subsequent breakage.     

Measurement of synovial fluid and serum concentrations of the 846 epitope of chondroitin sulfate and of carboxy propeptides of type II procollagen for diagnosis of osteochondral fragmentation in horses

OBJECTIVE: To determine whether serum or synovial fluid concentrations of chondroitin sulfate epitope 846 and carboxy propeptides of type II collagen (CPII) can be used to diagnose osteochondral fragmentation (OC) in horses. ANIMALS: 38 horses with unilateral OC of the radiocarpal (n = 31) or intercarpal (33) joints and 8 clinically and radiographically normal horses. Procedures-For horses with OC, serum and synovial fluid concentrations of epitope 846, CPII, and keratan sulfate (KS) were determined, along with synovial fluid WBC counts and total protein concentrations. Serum epitope 846, CPII, and KS concentrations were measured in control horses. RESULTS: Synovial fluid epitope 846 and total protein concentrations were significantly higher in the joints with OC than in unaffected joints, but CPII and KS concentrations and WBC counts were not. Synovial fluid total protein and 846 epitope concentrations were linearly related to grade of OC. Serum epitope 846 and CPII concentrations were significantly higher in horses with OC than in control horses. Discriminant analysis allowed 27 of 34 (79%) horses to be correctly classified as having or not having OC on the basis of serum epitope 846 and CPII concentrations. CONCLUSIONS: Results suggest that serum and synovial fluid concentrations of epitope 846 and CPII are associated with OC. Increases in concentrations of epitope 846 and CPII suggest that increased synthesis of cartilage aggrecan and type II procollagen may be associated with OC. CLINICAL RELEVANCE: Measurement of serum epitope 846 and CPII concentrations may be useful in the diagnosis of OC in horses.     

Treatment of severely comminuted diaphyseal fractures in the dog, using standard bone plates and autogenous cancellous bone graft to span fracture gaps: 11 cases (1979-1983)

Severely comminuted diaphyseal fractures in 11 dogs were repaired with standard bone plates that spanned a fracture gap filled with autogenous cancellous bone graft. Five dogs had closed injuries, 4 dogs had open fractures, and 2 dogs had infected nonunion fractures for which previous attempts at internal pin fixation had failed. A second autogenous cancellous bone graft was performed in 3 of the dogs during the healing period. The technique was successful in all dogs. The technique was considered a versatile and relatively simple alternative, compared with meticulous small fragment reconstruction and cortical bone allografts.     

Antebrachial fractures in four captive polar bears (Ursus maritimus)

OBJECTIVE: To identify common risk factors for antebrachial fractures of captive polar bears and to evaluate outcome after fracture repair. STUDY DESIGN: Retrospective study. ANIMALS: Four captive polar bears. METHODS: United States zoological collections were surveyed to determine the prevalence of fractures in captive polar bears. Medical records of captive polar bears that had antebrachial fractures were reviewed for signalment, history, physical and radiographic findings, fracture management, postoperative care, and outcome. Serum samples from healthy bears and bears with antebrachial fractures were assayed for 25-hydroxyvitamin D (25-OHD) concentrations. RESULTS: Nineteen fractures (12 polar bears) occurred from 1974 to 2002; 12 fractures involved the antebrachium. Management of 4 antebrachial fractures was reviewed; 3 were repaired by internal fixation and 1 by external coaptation. Fractures healed and bears were returned to exhibit on average 3 months postfracture. Of 11 serum samples assayed for 25-OHD concentrations, 6 were below normal, 1 was low normal and 4 were within normal reference intervals. The 7 bears with subnormal or low normal values were housed in 2 zoos. Subnormal vitamin D concentrations were identified in 2 of 3 bears with fractures. CONCLUSIONS: Fracture disease is not uncommon in captive polar bears. Additional research is necessary to explore the role of nutrition in polar bear fracture disease. CLINICAL RELEVANCE: Internal fixation of antebrachial fractures is feasible and reasonably well tolerated in captive polar bears.     

Biological osteosynthesis versus traditional anatomic reconstruction of 20 long-bone fractures using an interlocking nail: 1994-2001

ObJECTIVE: To observe differences in surgical and healing times as well as complication rates in dogs with a comminuted long-bone fracture stabilized with an interlocking nail (IN) using either anatomic or biologic repair. STUDY DESIGN: Retrospective study. ANIMALS: Twenty client-owned dogs with comminuted long-bone fractures. METHODS: Medical records for dogs with fractures repaired during a 7-year period were reviewed; 20 dogs had repair with an IN nail and radiographic evidence of healing. These 20 dogs where divided into 2 groups, anatomic (11 dogs) and biological (9) repair, for statistical evaluation. Surgical and healing time and complication rates were compared between groups. RESULTS: Median surgical times were: anatomic (95 minutes) and biologic (110 minutes; P=.06). Median healing times were anatomic (8 weeks) and biologic (6 weeks; P=.04). No statistical differences were observed in complication rates (the likelihood that a case required a second surgery [P=.58], the likelihood of a complication that was managed non-surgically [P=.27]). Use of a bone graft did not shorten healing times (P=.55). CONCLUSIONS: Biological osteosynthesis provides clinical advantages over anatomic reconstruction with respect to a reduction in surgical and healing time without increasing complication rates. CLINICAL RELEVANCE: Highly comminuted long-bone fractures can be successfully repaired using an IN without reconstructing the fracture fragments in dogs.     

Bovine trypanosomiasis: effect on the immune response of the infected host.

Yearling cattle were inoculated with a recently isolated field strain of Trypanosoma congolense. Dinitrophenylated ovalbumin, a bacteriophage, or bovine parainfluenza-3 virus injected into the cattle during the first 5 weeks of infection resulted in peak serum antibody titers lower but not much lower than those produced by noninfected cattle. Primary and secondary antibody responses of inoculated cattle required more time to reach peak titers. Peripheral blood lymphocyte concentrations decreased to 42% of preinfection base-line value 1 1/2 weeks after the onset of T congolense infection and thereafter plateaued at less than 75% of base-line value. Lymphocyte cultures prepared from infected and noninfected cattle gave no marked differences in [(3)H]thymidine uptake after stimulation with phytohemagglutinin or pokeweed mitogen. Differences in lymphpocyte responsiveness were not noticed in one-way mixed lymphocyte culture reactions, using mitomycin C-treated lymphocytes from noninfected cattle as stimulator cells.     

Treatment of open, delayed union, and nonunion fractures with external skeletal fixation.

ESF is useful in treatment of open fractures and delayed union and nonunion fractures. The fixation pins can be placed away from the fracture site to avoid disruption of blood supply. The appliance is well tolerated and inexpensive, and many of the parts can be reused. Adjustment of the splint is possible to permit correction of stabilization for optimal results. Gradual reduction of frame rigidity improves the quality of healing by increasing the stress on the bone. As stiffness of the healing fracture increases, return of limb function occurs. Early fixator removal reduces patient morbidity and permits a return to normal activity.     

Evaluation of nonunion fractures in dogs by use of B-mode ultrasonography, power Doppler ultrasonography, radiography, and histologic examination

OBJECTIVE: To investigate the use of ultrasonography to assess nonunion of fractures in dogs and to compare results of ultrasonography, radiography, and histologic examination. SAMPLE POPULATION: 8 nonunion fractures in 6 dogs (1 each in 5 dogs and 3 in 1 dog); dogs ranged from 7 to 94 months of age and weighed 6 to 30 kg. PROCEDURES: Diagnostic assessment consisted of complete clinical and orthopedic examinations, radiography, B-mode (brightness mode) ultrasonography, and power Doppler ultrasonography. Biopsy samples were obtained during surgery for histologic examination. They were stained with H&E and immunolabeled by use of anti-CD31 antibodies. Correlations of power Doppler score, power Doppler count, vessel area, and radiographic prediction with the mean number of vessels counted per hpf were derived. RESULTS: Radiographically, 7 of 8 nonunion fractures were diagnosed as atrophic and were therefore estimated to be nonviable. Vascularity of nonunion fractures during power Doppler ultrasonography ranged from nonvascularized to highly vascularized. Absolute vessel count during histologic examination ranged from 0 to 63 vessels/hpf; 5 nonunion sites had a mean count of > 10 vessels/hpf. Vascularity during power Doppler ultrasonography was highly correlated with the number of vessels per hpf, whereas the correlation between the radiographic assessment and histologic evaluation was low. CONCLUSIONS AND CLINICAL RELEVANCE: Radiographic prediction of the viability of nonunion fractures underestimated the histologically assessed vascularity of the tissue. Power Doppler ultrasonography provided a more accurate estimation of the viability of the tissue and therefore the necessity for debridement and autografts during revision surgery.     

Metabolic changes concerning the effect of castration on some blood constituents in male rabbits

This experiment was conducted to determine the effects of castration on some metabolic alterations concerning proteins, lipids and minerals metabolism in both immature and mature rabbits. Twenty male New Zealand White rabbits (10 immature and 10 mature) were used. Blood samples were collected from the immature and mature intact animals (control non castrated). Moreover, the castrated animal groups (immature and mature) were sampled at 2, 4, 6 and 8 weeks after castration. The obtained results revealed that, castration caused a significant decrease in serum total protein, albumin, alpha 1-globulins and alpha 2-globulins concentrations. Meanwhile, gamma-globulins level was decreased temporarily at 2 weeks after castration in mature rabbits. beta-globulins level revealed non significant decrease at 2 weeks after castration in immature rabbits followed by a non significant increase. In mature rabbits beta-globulins level non significantly increased. A significant decrease in serum total nucleic acid concentrations was observed after castration throughout the experimental periods, whereas the value of serum uric acid level markedly increased after castration. Serum lipids concentrations (total lipids, total cholesterol, phospholipids and non esterified fatty acids) were increased after castration. The value of serum trace elements including copper, iron, zinc and manganese concentrations showed a significant decrease after castration. The decrease in serum copper and zinc levels were markedly observed in mature castrated rabbits. Also, serum sodium and potassium concentrations were decreased after castration. Testosterone propionate administration in mature castrated rabbits restored most of the investigated serum blood parameters to the levels of intact non castrated mature rabbit. It could be concluded that castration (deficiency of testosterone) induced marked decrease in protein synthesis and increased protein degradation, but serum lipids markedly elevated after castration in both immature and mature animals. Also, castration caused a marked decrease in some serum minerals and trace elements.