Factors associated with early tibial tuberosity fracture after tibial plateau leveling osteotomy.

OBJECTIVE: To determine factors contributing to tibial tuberosity fracture (TTF) after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Retrospective case-control study. ANIMALS: Dogs (n = 2490) with cranial cruciate ligament rupture that underwent 3000 TPLO surgeries. METHODS: Radiographs of 3000 stifles from dogs that underwent TPLO were reviewed for evidence of TTF. Two ratios were generated: (1) the height of the tuberosity over the width of the tibia at the most distal extent of the osteotomy (TW) and (2) the width of the narrowest point of the tuberosity over TW. RESULTS: Twenty-three (0.77%) cases of fracture were identified. Factors that correlated with increased odds of fracture were placement of antirotational pins distal to the insertion of the patellar ligament (PL), tuberosities with the narrowest point below the insertion of PL, placement of multiple pins distal to the PL, and bilateral simultaneous TPLO. Tuberosities that fractured were significantly taller and narrower than those that did not fracture. Rotation past the "safe point" and presence of a gap at the osteotomy were not correlated with fracture. CONCLUSION: Placement of multiple pins, pin placement distal to the insertion of the PL, location of the narrowest point of the tibial tuberosity distal to the insertion of the PL, and simultaneous bilateral TPLO were all associated with TTF in this study CLINICAL SIGNIFICANCE: Preoperative planning and postoperative assessment of TPLO should take into consideration the predisposing factors identified in this study to prevent TTF.

Effect of laser treatment on first-intention incisional wound healing in ball pythons (Python regius).

OBJECTIVE: To evaluate effects of laser treatment on incisional wound healing in ball pythons (Python regius). ANIMALS: 6 healthy adult ball pythons. PROCEDURES: Snakes were sedated, a skin biopsy specimen was collected for histologic examination, and eight 2-cm skin incisions were made in each snake; each incision was closed with staples (day 0). Gross evaluation of all incision sites was performed daily for 30 days, and a wound score was assigned. Four incisions of each snake were treated (5 J/cm(2) and a wavelength of 980 nm on a continuous wave sequence) by use of a class 4 laser once daily for 7 consecutive days; the other 4 incisions were not treated. Two excisional skin biopsy specimens (1 control and 1 treatment) were collected from each snake on days 2, 7, 14, and 30 and evaluated microscopically. Scores were assigned for total inflammation, degree of fibrosis, and collagen maturity. Generalized linear models were used to investigate the effect of treatment on each variable. RESULTS: Wound scores for laser-treated incisions were significantly better than scores for control incisions on day 2 but not at other time points. There were no significant differences in necrosis, fibroplasia, inflammation, granuloma formation, or bacterial contamination between control and treatment groups. Collagen maturity was significantly better for the laser-treated incisions on day 14. CONCLUSIONS AND CLINICAL RELEVANCE: Laser treatment resulted in a significant increase in collagen maturity at day 14 but did not otherwise significantly improve healing of skin incisions.