Laterally applied single bone plate option for fixation of complete diaphyseal fracture of a third metatarsal bone in a circus work pony.

BACKGROUND: Complete fractures of the third metacarpal/metatarsal bones (Mc/t3) are not common, but can occur in various situations and all types of horses, contributing for approximately one third of all long bone fractures in the horse, mostly related to external trauma or to high energy injuries. To stabilize Mc/t3 fractures in the horse, conservative management with walking casts and/or open reduction and internal fixation techniques are referred in the scientific literature, these last one generally by double platting application to bone surface in 90 degrees. In the present case will be described a Mt3 complete diaphyseal fracture stabilization on an adult pony from a circus by applying only one bone plate. This work pony could return to its previous activity fully recovered 3 months after fracture stabilization. CASE DESCRIPTION: A 7-year-old, male, Shetland pony (103 kg), used for performance work at a circus was admitted to the Veterinary Teaching Hospital of University of Tras-os-Montes and Alto Douro, presenting on lateral recumbency after being struck by a truck. On physical examination, a penetrating wound of small dimension was detected at the medial aspect of the right hindlimb. After radiographic examination, a complete diaphyseal fracture with slight obliquity of the right Mt3 was confirmed. The owner opted for surgical repair thus fracture stabilization was achieved by the placement of just a single 8-hole 4.5 mm broad dynamic compression plate applied to the lateral face of Mt3 in compression function with 7 cortical screws (4.5 mm). Post-operatively a full limb cast was performed and maintained for 4 weeks, while the animal was kept under movement limitation at the hospital facilities for this period of time although the animal stayed until his full recovery 3 months' post-surgery. CONCLUSION: A complete recovery was achieved and the animal returned to the previous level of exercise without any significant postoperative complications or degree of lameness. In the authors knowledge, this is the first case report where stabilization of a complete Mt3 diaphyseal fracture was attain using a single compression plate contoured to the lateral face of the bone, instead of double plating, on an adult work pony from a circus subjected to a very demanding and intense physical activity.

Surdez súbita como primeira manifestaçäo da síndrome da imunodeficiência adquirida / Sudden hearing loss as first manifestation of acquired immunodeficiency syndrome

A disacusia neurossensorial em pacientes HIV soro-positivos, pode apresentar-se de forma súbita e ser consequência de acometimento viral primário do VIII par, que pode ocorrer em qualquer fase da doença. Ocorre, também, por infecçöes do sistema nervoso central produzidas por germes oportunistas que atingem mais freqüentemente pacientes em fase avançada de imunodepressäo. Apresentamos um caso clínico de surdez súbita neurossensorial, como primeira manifestaçäo clínica da síndrome da imunodeficiência adquirida (SIDA), e também primeira manifestaçäo de toxoplasmose central. Nosso objetivo é chamar a atençäo para a surdez súbita neurossensorial como primeiro sintoma de SIDA com infecçäo do sistema nervoso central, auxiliando no diagnóstico e tratamento precoces e possibilitando o aumento da sobrevida destes pacientes