Tratamento do rádio curvo em cão jovem com associação das técnicas de grampeamento fisário radial, ostectomia ulnar e fixador externo dinâmico transarticular / Treatment of radius curvus in a young dog with association of radial physeal stapling, ulnar ostectomy and transarticular dynamic external fixator techniques

Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...

Tratamento do rádio curvo em cão jovem com associação das técnicas de grampeamento fisário radial, ostectomia ulnar e fixador externo dinâmico transarticular / Treatment of radius curvus in a young dog with association of radial physeal stapling, ulnar ostectomy and transarticular dynamic external fixator techniques

Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the mostcommon physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the techniqueof stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radiuscurvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranialportions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3-Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 months. There was a history of possible traumatic event on the front limb, in addition to providing nutritionalsupplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of theulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbowjoint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the staplingof the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgicalstaples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnardiaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed.Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of theulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. Thefirst pin was proximal to the supracondilar...(AU)

Reconstrução cirúrgica da tíbia em fratura mal consolidada em um cão / Surgical reconstruction of tibia in poorly consolidated fracture in a dog

Objetiva-se com este trabalho relatar um caso de reconstrução cirúrgica tibial em uma fratura mal consolidada em um canino, salientando a versatilidade do fixador esquelético externo (FEE) e a importância do enxerto esponjoso como coadjuvante da cicatrização. Para a reconstrução cirúrgica da tíbia, esta foi refraturada, e em seguida, alinhada com o auxílio de pino intramedular de Steinmann temporário. Empregou-se fixação esquelética externa associada à enxertia óssea esponjosa autógena coletada da asa do ílio. No protocolo pós-cirúrgico, foi recomendado os mesmos cuidados e medicações de uma osteossíntese habitual. Decorridos 35 dias da cirurgia, observou-se perda da linha de fratura e formação de calo ósseo, permitindo a remoção do FEE. O animal voltou a apoiar o membro normalmente, apenas com um leve encurtamento do mesmo, mas sem prejuízo à deambulação.(AU)

The aim of this study is to report a case of tibial surgical reconstruction in a poorly consolidated canine fracture, emphasizing the versatility of the external skeletal fixator (ESF) and the importance of the cancellous graft as an adjunct to healing. For surgical reconstruction of the tibia, it was refracted and then aligned with support by temporary Steinmann intramedullary pin. External skeletal fixation was applied in association with bone grafting of spongy autogenous tissue collected by iliac wing. In the post-surgical protocol, the same care and medications as usual for osteosynthesis were recommended. Fracture line loss and bone callus formation were observed thirty-five days after the surgery, allowing the removal of the ESF. The animal returned to support the limb normally, only with a slight shortening of the limb, but without prejudice to the walking.(AU)

Reconstrução cirúrgica da tíbia em fratura mal consolidada em um cão / Surgical reconstruction of tibia in poorly consolidated fracture in a dog

Objetiva-se com este trabalho relatar um caso de reconstrução cirúrgica tibial em uma fratura mal consolidada em um canino, salientando a versatilidade do fixador esquelético externo (FEE) e a importância do enxerto esponjoso como coadjuvante da cicatrização. Para a reconstrução cirúrgica da tíbia, esta foi refraturada, e em seguida, alinhada com o auxílio de pino intramedular de Steinmann temporário. Empregou-se fixação esquelética externa associada à enxertia óssea esponjosa autógena coletada da asa do ílio. No protocolo pós-cirúrgico, foi recomendado os mesmos cuidados e medicações de uma osteossíntese habitual. Decorridos 35 dias da cirurgia, observou-se perda da linha de fratura e formação de calo ósseo, permitindo a remoção do FEE. O animal voltou a apoiar o membro normalmente, apenas com um leve encurtamento do mesmo, mas sem prejuízo à deambulação.

The aim of this study is to report a case of tibial surgical reconstruction in a poorly consolidated canine fracture, emphasizing the versatility of the external skeletal fixator (ESF) and the importance of the cancellous graft as an adjunct to healing. For surgical reconstruction of the tibia, it was refracted and then aligned with support by temporary Steinmann intramedullary pin. External skeletal fixation was applied in association with bone grafting of spongy autogenous tissue collected by iliac wing. In the post-surgical protocol, the same care and medications as usual for osteosynthesis were recommended. Fracture line loss and bone callus formation were observed thirty-five days after the surgery, allowing the removal of the ESF. The animal returned to support the limb normally, only with a slight shortening of the limb, but without prejudice to the walking.

Tratamento conservativo e cirúrgico em 22 ruminantes com fraturas em membros / Conservative and surgical treatment in 22 ruminants with limb fractures

O objetivo do presente trabalho foi relatar os principais locais de fraturas em membros de 22 ruminantes e determinar a eficiência dos tratamentos utilizados. Foram incluídos no estudo oito caprinos, oito ovinos e seis bovinos Em casos de fraturas distais, o tratamento conservativo com imobilização foi o método de eleição. Em casos de fraturas proximais e fraturas expostas de metatarso ou metacarpo, os ruminantes foram tratados cirurgicamente. Observou-se maior frequência de fraturas envolvendo o metacarpo ou metatarso (54,5%), seguido por fraturas de tíbia (22,7%), fêmur (9%) e casos isolados de fraturas de falange medial, úmero, rádio e ulna (4,5% cada). O índice de recuperação total alcançou 95,4%. A imobilização com gesso associada à tala de Thomas, ou apenas com talas de madeira em animais jovens, foi eficiente na redução de fraturas de metacarpo, metatarso, tíbia, úmero e rádio nos ruminantes tratados. Enquanto no caso de fratura de falange medial, a imobilização com uso apenas de gesso foi suficiente para proporcionar reparação óssea adequada. A fixação esquelética externa ou interna deve ser considerada uma opção no tratamento de fraturas metacárpicas, metatársicas, tibiais e femorais em ruminantes, principalmente quando o animal for de baixo peso corporal.(AU)

The aim of the present study was to report the main locations of limb fractures in 22 ruminants and to determine the efficiency of the treatment choices. Eight goats, eight sheep and six cattle were included. In cases of distal fractures, the conservative treatment with immobilization was the method of choice. In cases of proximal, exposed metatarsal or metacarpal fractures, the ruminants were treated surgically. The higher frequency of fractures involved the metacarpal or metatarsal (54.5%) followed by fractures of the tibia (22.7%), femur (9%) and isolated cases of medial phalanx, humerus, radius and ulna fractures (4.5% each). Total recovery rate reached 95.4%. Immobilization with plaster associated with Thomas splint, or just with wooden splints in young animals, was efficient in reducing fractures of metacarpal, metatarsal, tibia, humerus, and radio in the treated ruminants. In the case of medial phalanx fracture, immobilization using only plaster was sufficient to provide adequate bone repair. The internal or external skeletal fixation should be considered an option in the treatment of metacarpal, metatarsal, tibial and femoral fractures in ruminants, especially in low body weight animals.(AU)

Tratamento conservativo e cirúrgico em 22 ruminantes com fraturas em membros / Conservative and surgical treatment in 22 ruminants with limb fractures

O objetivo do presente trabalho foi relatar os principais locais de fraturas em membros de 22 ruminantes e determinar a eficiência dos tratamentos utilizados. Foram incluídos no estudo oito caprinos, oito ovinos e seis bovinos Em casos de fraturas distais, o tratamento conservativo com imobilização foi o método de eleição. Em casos de fraturas proximais e fraturas expostas de metatarso ou metacarpo, os ruminantes foram tratados cirurgicamente. Observou-se maior frequência de fraturas envolvendo o metacarpo ou metatarso (54,5%), seguido por fraturas de tíbia (22,7%), fêmur (9%) e casos isolados de fraturas de falange medial, úmero, rádio e ulna (4,5% cada). O índice de recuperação total alcançou 95,4%. A imobilização com gesso associada à tala de Thomas, ou apenas com talas de madeira em animais jovens, foi eficiente na redução de fraturas de metacarpo, metatarso, tíbia, úmero e rádio nos ruminantes tratados. Enquanto no caso de fratura de falange medial, a imobilização com uso apenas de gesso foi suficiente para proporcionar reparação óssea adequada. A fixação esquelética externa ou interna deve ser considerada uma opção no tratamento de fraturas metacárpicas, metatársicas, tibiais e femorais em ruminantes, principalmente quando o animal for de baixo peso corporal.(AU)

The aim of the present study was to report the main locations of limb fractures in 22 ruminants and to determine the efficiency of the treatment choices. Eight goats, eight sheep and six cattle were included. In cases of distal fractures, the conservative treatment with immobilization was the method of choice. In cases of proximal, exposed metatarsal or metacarpal fractures, the ruminants were treated surgically. The higher frequency of fractures involved the metacarpal or metatarsal (54.5%) followed by fractures of the tibia (22.7%), femur (9%) and isolated cases of medial phalanx, humerus, radius and ulna fractures (4.5% each). Total recovery rate reached 95.4%. Immobilization with plaster associated with Thomas splint, or just with wooden splints in young animals, was efficient in reducing fractures of metacarpal, metatarsal, tibia, humerus, and radio in the treated ruminants. In the case of medial phalanx fracture, immobilization using only plaster was sufficient to provide adequate bone repair. The internal or external skeletal fixation should be considered an option in the treatment of metacarpal, metatarsal, tibial and femoral fractures in ruminants, especially in low body weight animals.(AU)

Tarsometatarsal partial arthrodesis with use of circular skeletal fixator on a dog / Artrodese parcial tarsometatársica com uso de fixador esquéletico externo circular em cão

Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fi xation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fi xator on the left pelvic limb of a dog.Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Arti

Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fi xation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fi xator on the left pelvic limb of a dog.Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Arti

Tarsometatarsal partial arthrodesis with use of circular skeletal fixator on a dog / Artrodese parcial tarsometatársica com uso de fixador esquéletico externo circular em cão

Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fi xation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fi xator on the left pelvic limb of a dog.Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Arti

Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fi xation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fi xator on the left pelvic limb of a dog.Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Arti

Artrodese parcial tarsometatársica com uso de fixador esquéletico externo circular em cão / Tarsometatarsal Partial Arthrodesis with Use of Circular Skeletal Fixator on a Dog

Background: Trauma to the canine foot may result in injury to soft tissue or bone or both. Foot injury often results in fractures and joint instability because of disruption to carpal or tarsal ligaments. Several fixation methods have been described for stabilizing tarsometatarsal arthrodesis. The aim of this paper is to report the case of a unilateral tarsometatarsal arthrodesis with use of circular skeletal fixator on the left pelvic limb of a dog. Case: A 5-year-old intact male dog weighting 25 kg was referred to the veterinary hospital with a left tarsal degloving injury. The previous history revealed that the dog had been bitten by another dog seven days prior to the referral. On physical exam it had swelling and severe pain on the left foot, crepitus of the intertarsal/tarsometatarsal region, instability, bone exposure and myiasis larvae on the wound. The dog was non-weight-bearing on the affected limb. No other abnormalities were found. Radiographs revealed it to be an open fracture of the left tarsal distal line with tarsometatarsal luxation. Adherent dressings were changed for seven days to minimize the contamination before surgery. The dog was treated by open reduction and internal fixation using a circular skeletal fixator. After general anesthesia was induced, a lateral approach to the tarsometatarsal joint was made. The tarsometatarsal joint then was exposed. Articular cartilage was removed with a pneumatic burr. Manual reduction was performed. There were placed two rings proximal to the fracture and one distal with Kirschner wires were angled 45° between them through the bone. One of them was a semi-ring in the shape of a horseshoe. The 1,5 mm Kirschner wires were tensioned by a dynamometer loaded at 30 kg. For wound closure a free skin graft from the thorax was used. Articular anchylosis was reached in three months but the implant removal was posterior to that time due to the owner's choice. Discussion: Traumatic injury is the most important cause for fracture and instability of the tarsometatarsal joint and was the cause of injury for this case. Partial arthrodesis is considered the treatment of choice for tarsal instabilities with ligament disruption. Implant problems following union can complicate arthrodeses stabilized with internal fixation, and they may require a second surgery for implant removal. In this case the size of the rings conformed well to the proximal tarsus, and allowed sufficient space for wire placement in the metatarsal bones and did not interfere with ambulation. The dog recovered good limb function soon after the surgery and articular anchylosis was reached within three months as expected. In a study three of ten dogs undergoing tarsometatarsal arthrodesis due to continued lameness after bony union, using a laterally applied plate required a second surgery for implant removal. Implant failure is a common complication of tarsocrural and tarsometatarsal arthrodeses stabilized with bone screws, Steinmann pins or plate fi xation. Tarsometatarsal partial arthrodesis with use of circular skeletal fixator is a proper option for contaminated wounds without enough skin for closure. The limiting factor is the surgeon experience for this choice of fixation, material availability and the owner's commitment with the treatment.