Radiographic Evaluation of the Anconeal Process in Skeletally Immature Dogs

Objective: To determine if a secondary center of ossification (SCO) of the anconeal process is present in skeletally immature dogs that do not develop an ununited anconeal process (UAP). Study Design: Case series. Animals: Dogs 77–154 days of age with conditions other than developmental disease of the elbow (n=78 dogs; total elbows=100). Methods: Mediolateral radiographic projections of the elbow were reviewed for presence or absence of a SCO of the anconeal process. Results: A SCO was radiographically evident in 16% of elbows from breeds that have been reported to be affected by UAP. The appearance of the SCO was different to an UAP fragment. None of the elbows with SCO of the anconeal process developed UAP. A SCO was not present in any small breed dogs. Conclusions: A SCO of the anconeal process is uncommon in medium and large breed dogs and the presence of a SCO does not indicate that UAP will develop. Clinical Relevance: Because radiographic diagnosis of a SCO of the anconeal process and UAP lesions have distinct appearances, an earlier diagnosis of UAP is possible.     

Laser Vaporization of the Dorsal Turbinate as an Alternative Method of Accessing and Evaluating the Paranasal Sinuses

Objective: To report a technique for stoma creation into the conchofrontal sinus (CFS) through the dorsal turbinate and to evaluate stoma as a site for sinoscopy. Study Design: Prospective experimental study. Animals: Cadaveric equine heads (n=2) and normal adult horses (5). Methods: Technique feasibility was established on 2 cadaver heads. A diode laser fiber with a contact probe was passed into the nasal passage through a custom built, laser introducer rod (LIR). A videoendoscope was passed ventral to the LIR. A site on the caudal, medial aspect of the turbinate overlying the dorsal conchal sinus (DCS) was identified. A stoma to facilitate endoscope passage was created through the turbinate and sinoscopy performed to identify structures within the CFS and caudal maxillary sinus (CMS) and to evaluate the quality of the approach. The procedure was then performed in standing, sedated horses. Time required, laser energy used and complications were recorded. Endoscopy was performed ≥5 weeks postoperatively to assess stoma size and long‐term effects of the procedure. Results: A stoma was successfully created through the turbinate in both cadaveric skulls and in 4 horses; the stoma persisted for ≥5 weeks. The location of the stoma in 1 horse precluded sinoscopy. Conclusions: Laser vaporization of the dorsal turbinate through the nasal passage creates a stoma that lasts for at least 5 weeks providing a portal to the paranasal sinuses. Based on experience in 1 horse stoma location is critical to ensure adequate endoscope manipulation and sinoscopy. Clinical Relevance: Standing endoscopic sinusotomy within the nasal cavity through the DCS is an alternative to more invasive sinusotomy techniques with fewer potential complications and a cosmetic result.     

In Vitro Mechanical Comparison of 2.0 and 2.4 Limited‐Contact Dynamic Compression Plates and 2.0 Dynamic Compression Plates of Different Thicknesses

Objective: To compare the bending structural stiffness and bending strength of thick and thin 2.4 mm limited contact dynamic compression plates (2.4 LC‐DCP), 2.0 mm LC‐DCP (2.0 LC‐DCP), and 2.0 dynamic compression plates (2.0 DCP). Study Design: In vitro mechanical study. Methods: Two thicknesses of 2.4 LC‐DCP, 2.0 LC‐DCP, and 2.0 DCP stainless‐steel plates were tested in 4‐point bending. Data were collected during bending until implants plastically deformed. Bending structural stiffness and bending strength were determined from load displacement curves. Mechanical properties were compared between plates and the effects of plate type, size, and thickness on stiffness and strength were assessed using ANOVA. Results: The thick 2.4 LC‐DCP implant was the stiffest and strongest; the thin 2.0 DCP implant was most compliant and weakest. Larger sized plates, thicker plates, and limited contact design of plates enhanced stiffness and strength. For the plates studied, plate size had a larger effect than plate type or thickness on stiffness and strength. Conclusion: Increasing the size (width) and thickness of plates increases both the bending structural stiffness and strength. For the plates studied, LC‐DCP implants were stiffer and stronger than DCP implants. Clinical Relevance: Plate bending structural stiffness and strength can be most effectively enhanced by using a larger sized plate, but gains can also be achieved by using a thicker plate and/or an LC‐DCP instead of a DCP implant when possible.     

Use of the Kishigami Atlantoaxial Tension Band in Eight Toy Breed Dogs with Atlantoaxial Subluxation

Objective— To determine the applicability, complications, and long-term functional outcome of the Kishigami Atlantoaxial Tension Band (Kishigami AATB) for management of congenital and traumatic atlantoaxial (AA) instability in toy breed dogs.
Study Design— Case series.
Animals— Toy breed dogs (n=8) with congenital or traumatic AA instability.
Methods— The AA joint of each dog was surgically stabilized through a dorsal approach using the original or a modified version of the Kishigami AATB. Pre- and postoperative neurologic status, radiographs, and complications were reviewed. Follow-up examination was performed at 1 and 12 months.
Results— Functional improvement occurred in 5 dogs; 1 dog did not improve or worsen and 2 dogs were euthanatized at owner request. Adequate reduction and stabilization was achieved in 7 dogs based on immediate postoperative radiographs; failure of reduction was evident in 1 dog. No relevant complications occurred.
Conclusions— Kishigami AATB may be acceptable as an alternative method for dorsal stabilization of AA subluxation in toy breed dogs in which use of ventral screws or pins is challenging. Experience with this technique in a larger population is necessary to compare our results to those reported by ventral approach.
Clinical Relevance— The surgical technique described is effective, safe, and simple in the surgical treatment of AA subluxation in toy breed dogs.