Principles of fracture fixation in growing animals.

Changes in bone structure and conformation can occur very rapidly in growing animals. Injury to the bones or articular surfaces warrant special consideration because of the potential devastating consequences of secondary growth deformities in the animal. Disturbance of normal growth plate activity, imperfect fixation of an articular fracture, and conformational defects in long bones may create lifelong problems for the animal.     

Histomorphometry of fragmented medial coronoid process in dogs: a comparison of affected and normal coronoid processes

OBJECTIVE: To determine if fatigue microdamage is associated with fragmented medial coronoid process (FMCP). STUDY DESIGN: Prospective study. ANIMALS: Thirty-eight dogs were admitted for subtotal coronoid ostectomy as treatment for FMCP. Surgical specimens of medial coronoid process (MCP) were retrieved from treated dogs. Normal MCP were collected from 5 age- and breed-matched dogs and 2 age-matched research beagles that were euthanatized for reasons other than elbow disease. METHODS: MCP specimens from affected elbows were classified into 4 groups based on disease severity. Specimens were bulk-stained for microdamage using 1% basic fuchsin, embedded in polymethylmethacrylate and sectioned at 130 microm. Specimens were evaluated using epifluorescent microscopy (425-440 excitation, 475 nm barrier filter) for diffuse damage (D.DX), osteocyte loss, and porosity. Cartilage thickness was evaluated using bright field microscopy. Qualitative observations were also made. RESULTS: MCP specimens from affected elbows had increased D.Dx, increased osteocyte loss, and greater porosity than normal groups. Specimens classified as severe FMCP (Classes 3, 4) had the most fatigue microdamage. Some Class 1 specimens, defined as having no visible fissuring of the articular cartilage (AC), had large microcracks in trabecular bone. CONCLUSIONS: Accumulation of subchondral fatigue microdamage, is associated with MCP fragmentation. Fissuring occurs in the subchondral bone before gross fibrillation of articular cartilage develops. CLINICAL RELEVANCE: Accumulation of fatigue microdamage in the MCP is important in the pathogenesis of FMCP. The underlying cause of this microdamage accumulation must be identified before treatment plans that will prevent further osteoarthritis of the elbow joint can be designed.     

Femoral bone adaptation to unstable long-term cemented total hip arthroplasty in dogs

OBJECTIVE: To evaluate femoral adaptation after unstable long-term cemented total hip arthroplasty (cTHA) in dogs. STUDY DESIGN: Clinical study. ANIMALS: Four dogs. METHODS: Paired femurs were examined from client-owned dogs that were donated to a retrieval program after death from causes unrelated to their cTHA. Mean (+/-SEM) dog age was 10.0+/-1.5 years and implant duration was 6.0+/-1.4 years. Implanted femurs had radiographic changes associated with implant loosening and gross mechanical instability at femur retrieval. Femurs were evaluated at 3 levels relative to implant length. Cortical area and medullary area were measured at each level, and cortical porosity was assessed at each level in 4 quadrants and in 3 regions. Implanted femurs were compared with the contralateral non-implanted femurs. RESULTS: Cortical area and cortical porosity were increased at all levels in femurs with unstable implants. Implanted femurs had increased porosity in all quadrants and regions at the proximal 2 levels, and increased porosity in only the cranial quadrant and mid-cortical area at the distal level, when compared with contralateral non-implanted femurs. Corresponding medullary areas were not different. CONCLUSIONS: Significant histomorphometric changes occur in femurs after unstable cTHA. The patterns of periosteal bone formation and endosteal bone resorption support mechanisms of stress shielding and wear debris-mediated osteolysis as factors that may contribute to femoral adaptation and implant loosening. CLINICAL RELEVANCE: Despite popularity and excellent return to function with cTHA, aseptic loosening remains a serious long-term complication. Substantial net bone loss and unfavorable environment with unstable cTHA may make revision surgery less successful.     

MAGNETIC RESONANCE IMAGING OF THE CANINE ABDOMEN: EFFECT OF PULSE SEQUENCE ON DIAGNOSTIC QUALITY

Motion artifact is an important limiting factor for abdominal magnetic resonance imaging (MRI) in veterinary patients. The purpose of this study was to determine the effects of pulse sequence on abdominal MRI diagnostic quality in dogs. Ten normal dogs were each scanned using 16 MRI pulse sequences. Sequences included breath‐holding sequences, respiratory navigation sequences, and traditional spin‐echo sequences. Four observers independently scored diagnostic quality for each sequence based on the appearance of specific organs, overall diagnostic quality, and degree of artifactual interference. Signal‐to‐noise ratio and contrast‐to‐noise ratio were also calculated for each sequence. The sequence with the highest overall mean diagnostic quality score was the dorsal T2 turbo spin echo (TSE) with fat saturation and breath‐holding. The sequence with the lowest mean diagnostic quality score was the dorsal T2 fast spin echo. The sequence with the highest signal‐to‐noise ratio for all evaluated organs was the sagittal T1 spin echo. Signal‐to‐noise and contrast‐to‐noise ratios did not correlate with subjective assessment of overall diagnostic quality for the majority of the sequences evaluated (P < 0.05). The three sequences considered to have the highest diagnostic quality for the cranial abdomen were the dorsal T2 TSE with fat saturation and breath‐hold, transverse T1 turbo fast low‐angle shot gradient echo with breath‐hold, and dorsal T2 half‐Fourier acquisition single shot TSE with respiratory navigation. These sequences had short acquisition times, yielded studies of similar diagnostic quality, provided complementary information, and are therefore recommended for routine canine abdominal MRI protocols.     

Collagen fragmentation in ruptured canine cranial cruciate ligament explants

Collagen fragmentation in cranial cruciate ligament (CCL) explants and stifle synovial fluid was investigated in dogs with ruptured and intact CCL. Cathepsin K and tartrate-resistant acid phosphatase (TRAP) activities were determined in CCL explant supernatants. Formation of collagen fragments was determined in explant supernatants and stifle synovial fluid. Cathepsin K(+) and TRAP(+) cells were stained specifically in histological sections of CCL. Formation of telopeptide collagen fragments was increased in ruptured CCL explants and stifle synovial fluid from dogs with ruptured CCL. In ruptured CCL explants, release of collagen fragments was associated with extracellular release of TRAP and the presence of cathepsin K(+) cells within CCL tissue. Cathepsin K(+) and TRAP(+) cells were only seen in ruptured CCL. It was concluded that infiltration of the CCL with TRAP(+) cells in dogs with CCL rupture is associated with increased collagenolysis. It is hypothesized that recruitment and activation of TRAP(+) mononuclear cells within the synovium and CCL precipitates CCL rupture through upregulation of collagenolytic enzymes and collagen degradation.     

COMPARISON OF COMPUTED TOMOGRAPHY, TANGENTIAL VIEW RADIOGRAPHY, AND CONVENTIONAL RADIOGRAPHY IN EVALUATION OF CANINE PELVIC TRAUMA

Thirteen dogs with fractures requiring surgical repair were evaluated by standard two-view (i.e., lateral and ventrodorsal) radiography, tangential view (ventro 20 degrees cranial-dorsocaudal [inlet] and ventro 20 degrees caudal-dorsocranial [outlet]) radiography, and computed tomography (CT). Radiographic and CT examinations were reviewed independently by the three authors, and specific anatomic sites were graded for the presence or possibility of lesions. The results of radiographic interpretations were compared to CT scan interpretations. Eighty-one percent of skeletal lesions detected by CT scans were diagnosed definitively radiographically. Differences between the interpretation of CT and radiographic examinations included abnormalities associated with soft-tissue structures (P < 0.0001), the sacroiliac joints (P = 0.02), and the acetabula (P = 0.04). Interpretation of the lateral/ventrodorsal and inlet/outlet radiographic series were not statistically different, although inlet views may be complimentary to the standard radiographic examination. Its use deserves further study. Reader variation was less on evaluation of CT examinations than radiographic examinations. CT multiplaner reformations and three-dimensional reconstructions were useful for surgical planning in seven dogs. CT scanning is superior to survey radiography in assessing skeletal and soft-tissue injuries in dogs with pelvic trauma, although all clinically significant surgical lesions were described accurately radiographically. Based on this small series, the routine CT examination of dogs with pelvic trauma may not be justifiable for diagnosis but may be advantageous for surgical planning, especially if acetabular fractures are suspected on radiographs.     

The effects of femur and implant position on the radiographic assessment of total hip femoral implants in dogs

OBJECTIVE: To determine the effect of femur positioning and femoral implant placement on the radiographic assessment of total hip femoral implants in dogs. STUDY DESIGN: Cadaveric study. ANIMALS: Five canine femurs. METHODS: Five canine femurs were fitted with total hip implants, in predetermined locations, postmortem. Each femur was moved through a defined range of motion and radiographed at specific intervals. Radiographs were then digitized, and implant position was measured using previously described methods. Regression analysis was conducted to determine whether varied femoral position resulted in a consistent (linear) pattern of change in the value of each particular measurement. RESULTS: Change in the position of the femur relative to the film cassette caused significant variation in the perceived position of the implant. The placement of the implant within the femur determined which measurements were affected and to what degree. CONCLUSIONS: The information obtained from standard clinical radiographs and conventional methods of quantitative analysis does not consistently provide an accurate assessment of the placement of the femoral implant within the femoral canal. Such data cannot be used to correlate implant position with implant failure.     

Pharmacokinetics of oxfendazole in red deer (Cervus elaphus)

The pharmacokinetics of oxfendazole (OFZ) in red deer (Cervus elaphus) was examined. OFZ, administered per os at 4.53 mg kg-1, was extracted in ether from plasma and identified and concentrations estimated by high pressure liquid chromatography. Irrespective of whether the animals were fed concentrates indoors as pellets or grass while on pasture, OFZ was absorbed rapidly. Concentrations of OFZ in plasma reached maxima within 20 hours (0.83 and 1.005 mg litre-1 respectively) and were undetectable 36 hours after administration. Fenbendazole was not detected at any time in the chromatograms. Metabolism of OFZ occurred rapidly producing the sulphone metabolite. In comparison with published data for OFZ in sheep, red deer appear to metabolise OFZ and excrete OFZ sulphone at much faster rates. Consequently, anthelmintic efficacy is likely to vary from species to species.