An in vitro biomechanical comparison of two interlocking-nail systems for fixation of ostectomized equine third metacarpal bones.

OBJECTIVE: To compare the mechanical properties of 2 interlocking-nail systems for fixation of ostectomized equine third metacarpi (MC3): (1) a standard interlocking nail with 2 parallel screws proximal and distal to a 1-cm ostectomy; and (2) a modified interlocking nail with 2 screws proximal and distal to a 1-cm ostectomy with the screws offset by 30 degrees. ANIMAL OR SAMPLE POPULATION: Twelve pairs of adult equine forelimbs intact from the midradius distally. METHODS: Twelve pairs of equine MC3 were divided into 2 test groups (6 pairs each): torsion and caudocranial 4-point bending. Standard interlocking nails (6-hole, 13-mm diameter, 230-mm length) were placed in 1 randomly selected bone from each pair. Modified interlocking nails (6-hole, 13-mm, 230-mm length, screw holes offset by 30 degrees) were placed in the contralateral bone from each pair. All bones had 1-cm mid-diaphyseal ostectomies. Six construct pairs were tested in caudocranial 4-point bending to determine stiffness and failure properties. The remaining 6 construct pairs were tested in torsion to determine torsional stiffness and yield load. Mean values for each fixation method were compared using a paired t test within each group. Significance was set at P <.05. RESULTS: Mean (+/-SEM) values for the MC3-standard interlocking-nail composite and the MC3-modified interlocking-nail composite, respectively, in 4-point bending were: composite rigidity, 3,119 +/- 334.5 Nm/rad (newton. meter/radian) and 3,185 +/- 401.2 Nm/rad; yield bending moment, 205.0 +/- 18.46 Nm and 186.7 +/- 6.17 Nm; and failure bending moment, 366.4 +/- 21.82 Nm and 378.1 +/- 20.41 Nm. There were no significant differences in the biomechanical values for bending between the 2 fixation methods. In torsion, mean (+/-SEM) values for the MC3-standard interlocking-nail composite and the MC3-modified interlocking-nail composite were: composite rigidity, 135.5 +/- 7.128 Nm/rad and 112.5 +/- 7.432 Nm/rad; gap stiffness, 207.6 +/- 10.57 Nm/rad and 181.7 +/- 12.89 Nm/rad; and yield load, 123.3 +/- 2.563 Nm and 107.5 +/- 8.353 Nm, respectively. Composite rigidity and gap stiffness for standard interlocking-nail fixations were significantly higher than the modified interlocking-nail fixation technique in torsion. Yield load had a tendency to be higher for the standard interlocking-nail fixation (P =.15). CONCLUSIONS: No significant differences in biomechanical properties were identified between a standard interlocking nail and one with the screw holes offset by 30 degrees in caudocranial 4-point bending. The standard interlocking nail was superior to the modified interlocking nail in torsional gap stiffness and composite rigidity. The torsional yield load also tended to be higher for the standard interlocking nail. CLINICAL RELEVANCE: The standard interlocking nail with parallel screw holes is superior to a modified interlocking nail with the screw holes offset by 30 degrees in ostectomized equine MC3 bones in vitro when tested in torsion.

Treatment of methicillin-resistant Staphylococcus epidermidis infection following repair of an ulnar fracture and humeroradial joint luxation in a horse.

A 27-month-old Rocky Mountain Horse was examined because of a fracture of the proximal portion of the ulna and luxation of the humeroradial joint (Monteggia fracture). Open reduction was performed, using a mechanical distractor, and the ulnar fracture was stabilized by application of a bone plate and screws. After surgery, the horse developed an infection of the surgical site, and bacterial culture of fluid from the surgical site yielded a pure growth of methicillin-resistant Staphylococcus epidermidis susceptible to oxytetracycline, erythromycin, rifampin, and vancomycin. Treatment with oxytetracycline did not result in a favorable clinical response. Therefore, the horse was treated systemically with vancomycin and rifampin, and vancomycin-impregnated polymethyl methacrylate beads were implanted at the surgical site. Six months after surgery, the horse was sound at a walk or trot, and bony union was evident on radiographs of the elbow joint.

Diagnosis and surgical repair of patellar luxations in a flock of sheep.

Eleven sheep with a common ancestry were evaluated for clinical signs of hind limb lameness. Physical examination revealed advanced forms of patellar luxation. Radiography confirmed the diagnosis of patellar luxation; flexed dorsoproximal-dorsodistal radiographic views were obtained and revealed hypoplasia of the femoral trochlea. Because of the advanced form of patellar luxation and trochlear hypoplasia, surgical intervention was recommended in the form of recession trochleoplasty and a modified tibial tuberosity transposition, along with imbrication and releasing incisions. Sheep may have a genetic predisposition for patellar luxation.

Ultrasonographic appearance of exogenous isobutane gas in the mammary glands of dairy cows.

OBJECTIVE: To determine whether exogenous isobutane gas infused into the udders of dairy cattle could be detected ultrasonographically, and if so, what effects volume of gas infused and infusion pressure had on how long after infusion exogenous isobutane gas could be detected. DESIGN: Randomized block design. ANIMALS: 8 Holstein cows 28 to 32 days after parturition. PROCEDURE: In each cow, 1 mammary gland was not treated and the other 3 received 1 of 3 treatments by means of intramammary infusion: low volume-high pressure, low volume-low pressure, and high volume-high pressure infusion of isobutane gas. Mammary glands were examined ultrasonographically 1 hour before and 1, 3, 12, 24, 36, 48, 72, and 96 hours after treatment. RESULTS: After intramammary infusion of isobutane gas, bright echoes and associated acoustic shadows were seen ultrasonographically; echoes were no longer seen 72 hours after gas infusion. Percentages of mammary glands in which bright echoes were detected were not significantly different among the 3 treatment groups at any time during the study. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that exogenous isobutane gas infused into the mammary glands to enhance the appearance of the udder of show dairy cattle can be readily detected by ultrasonography.

Cardiopulmonary changes associated with abdominal insufflation of carbon dioxide in mechanically ventilated, dorsally recumbent, halothane anaesthetised horses.

The use of laparoscopy for the diagnosis or therapeutic management of abdominal disease in the horse has distinct advantages when it allows the horse to remain standing. However, distending the abdomen by insufflation of a biologically active gas in an anaesthetised horse may add to the physiological challenge of general anaesthesia and recumbency. The cardiopulmonary responses to abdominal insufflation with carbon dioxide (CO2) to 15 mmHg pressure were evaluated in 6 horses in dorsal recumbency anaesthetised with halothane in oxygen and subjected to laparoscopic colopexy. Vaporiser settings targeted a fractional expired halothane of 1.5 MAC and a clinically acceptable depth of anaesthesia. Pressure and rate controlled positive pressure ventilation was adjusted to an ETCO2 of 35 mmHg before abdominal insufflation and was not changed thereafter. Cardiopulmonary data were collected before, at 30 and 60 min during and 30 min after CO2 insufflation. ANOVA for repeated measures followed by Tukey's protected t test were used to determine differences. Partial pressure of oxygen and pH of arterial blood, tidal volume and systemic vascular resistance decreased during abdominal insufflation and laparoscopic surgery whereas mean arterial blood pressure, right atrial pressure, cardiac index, stroke index, partial pressure of CO2 in arterial blood and end tidal respiratory gases, and calculated physiological shunt increased significantly. Only systemic vascular resistance returned to the pre-insufflation level after desufflation. The hypercapnia, acidosis and apparent increase in cardiac work that accompany CO2 pneumoperitoneum for laparoscopic surgery could place the anaesthetised horse at additional risk of perioperative complications.

Laparoscopic colopexy in horses.

OBJECTIVE: To describe a technique for laparoscopic colopexy in horses. STUDY DESIGN: Description of a technique to perform laparoscopic colopexy in horses. ANIMALS: Six healthy adult horses between 3 and 23 years of age and weighing between 440 and 636 kg. METHODS: Horses were positioned in dorsal recumbency, and the abdomen was insufflated to an intraabdominal pressure of 15 mm Hg. A laparoscope portal was placed at the umbilicus, and instrument portals were placed cranial to the laparoscope and lateral to midline. The lateral taenia of the left ventral colon was laparoscopically identified and retracted with Babcock forceps to the peritoneal surface and sutured with two strands of size 2 monofilament nylon in a continuous pattern via laparoscopic observation. All horses were euthanatized 90 days after surgery, and the colopexy adhesion was examined histologically. RESULTS: Laparoscopic colopexy was successful in all six horses. There were no intraoperative or postoperative complications. Initial abdominal insufflation to 15 mm Hg required an average of 38 L (range 32 to 46 L) of carbon dioxide and 9.8 minutes (range 9 to 11 minutes) to be completed. A total of 132 L of carbon dioxide (range 64 to 196 L) was needed for the entire procedure. The laparoscopic colopexy procedure required 95 minutes (range 60 to 142 minutes) to perform. Laparoscopic colopexy resulted in a firm, fibrous adhesion of the colon to the abdominal tunic. Microscopically the colopexy adhesion was mature fibrous tissue with no evidence of inflammation. CONCLUSIONS: Laparoscopic colopexy can be successfully performed in horses with minimal abdominal invasion.

Clinical and radiographic findings, treatment, and outcome in cattle with osteochondrosis: 29 cases (1986-1996).

OBJECTIVE: To summarize the radiographic and clinical findings, treatment, and outcome in cattle with osteochondrosis diagnosed radiographically. DESIGN: Retrospective case series. SAMPLE POPULATION: 29 cattle with radiographic evidence of osteochondrosis. PROCEDURES: Medical records were reviewed, and owners or referring veterinarians were contacted for outcome assessment. Data were analyzed for potential interactions between osteochondrosis classification (osteochondritis dessicans vs subchondral cyst-like lesions), clinical and radiographic findings, treatment, and outcome, using Fisher's exact test and descriptive statistics. RESULTS: Osteochondrosis was associated with young, male, purebred cattle, clinical evidence of lameness, and radiographic evidence of concurrent degenerative joint disease. Osteochondritis dissecans and subchondral cyst-like lesions had similar clinical findings and outcomes but varied significantly in their radiographic distribution among joints. Osteochondrosis often manifests clinically as a unilateral condition, but bilateral lesions were often found (88%) when limbs were radiographically examined. Cattle managed conservatively tended to be culled (within 6 months of diagnosis because of lameness) more often than those managed surgically, despite the lack of treatment bias. CLINICAL IMPLICATIONS: Osteochondrosis in cattle is often associated with lameness or degenerative joint disease. Conservative management does not result in a favorable clinical prognosis for long-term, lameness-free survival, and more studies need to be completed to evaluate the efficacy of surgical treatment of osteochondrosis in cattle.

Isolation of methicillin-resistant Staphylococcus aureus from a postoperative wound infection in a horse.

Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from a postoperative wound infection in a horse. Methicillin-resistant S aureus infections in animals have been reported. In human beings, MRSA is an important cause of hospital-acquired (nosocomial) infections. Infections caused by MRSA respond poorly to beta-lactam treatment, and resistance of MRSA to multiple antimicrobials, including aminoglycosides, macrolides, clindamycin, and tetracyclines, is common. Identification of MRSA by routine susceptibility testing may be difficult; therefore, techniques for MRSA detection should be incorporated by clinicopathology laboratories. Because the number of hospital and community-acquired MRSA infections in human beings is increasing, it seems likely that MRSA infections in animals will also become more frequent.

Management of a transverse fracture in the distal phalanx of a horse.

A yearling horse was presented with a septic, transverse fracture in the frontal plane of the distal phalanx. The fracture fragment was surgically removed from the parent bone via the sole. The foot was managed by corrective farriery and the horse was able to be ridden for pleasure.

Signs of sympathetic denervation associated with a thoracic melanoma in a horse.

Sympathetic denervation in a 20-year-old, gray, Thoroughbred-Percheron gelding was manifested by cutaneous hyperthermia and sweating over the right side of the body, demarcated by a line from the withers to the elbow and extending cranially. There was cutaneous hyperthermia over the right side of the head, but other signs of Horner's syndrome (sweating, ptosis, miosis, enophthalmos) were not present. The pattern of cutaneous hyperthermia and sweating was consistent with sympathetic denervation localized to the cervicothoracic ganglion, and thoracic radiographs revealed increased density in the craniodorsal thorax. Cytologic evaluation of a sample of pleural effusion revealed mesothelial cells containing melanin and cells suggestive of melanocytes or melanoblasts. Treatment with oral cimetidine and intrapleural cisplatin was not successful. A necropsy was not performed, but the clinical findings supported a diagnosis of thoracic melanoma involving the cervicothoracic ganglion.

Prepubic urethrostomy for relief of urethral obstruction in a sheep and a goat.

Urethral obstruction is common in castrated male small ruminants. Perineal urethrostomy is the recommended treatment in animals not intended for breeding; however, stricture formation is a common complication, and few surgical options are available once a stricture has formed. Prepubic urethrostomy has been used successfully in dogs and cats to treat urethral trauma or stricture formation, and in this report, use of prepubic urethrostomy in 2 small ruminants to treat urethral strictures that developed alter perineal urethrostomy is described. Both animals maintained urinary continence and were able to void urine normally. Complications after prepubic urethrostomy included recurrent cystitis in sheep and urethral stricture in goats. Prepubic urethrostomy may be considered in as an alternative for treatment of urethral disorders in small ruminants.

Fractures of the femur.

Fractures of the femur in cattle are second in frequency only to fractures to the metacarpal and metatarsal bones. Common clinical presentations and the diagnosis of femur fractures are described. Treatment options, prognosis, postoperative complications are discussed for conservative therapy and for various forms of external and internal fixation.

Fracture biology, biomechanics, and internal fixation.

The success of orthopedic surgery in ruminants is directly related to the surgeon's knowledge and understanding of bone physiology and mechanics. The relationship of the macro and micro structure and function of bone as it relates to fracture physiology and repair is discussed. A basic review of the biomechanical principles of bone, bone fracture, and fracture repair are presented. The clinical and biomechanical principles of internal fixation are described for fracture repair in ruminants.

Use of antimicrobial-impregnated polymethyl methacrylate beads for treatment of chronic, refractory septic arthritis and osteomyelitis of the digit in a bull.

A 6-year-old 895-kg Angus bull was evaluated for a 6-month history of left hind limb lameness that was refractory to antimicrobial treatment. On physical examination, there was soft-tissue swelling associated with the lateral digit. Radiography revealed septic arthritis of the distal interphalangeal joint and osteomyelitis of the distal and middle phalanges. Treatment included debridement and lavage. Bacteriologic culture of debrided tissues yielded aerobic and anaerobic organisms. Antimicrobials were administered parenterally and locally in the form of antimicrobial-impregnated polymethyl methacrylate beads. The limb also was placed in a cast to promote ankylosis. The bull recovered, and the digit was salvaged.

Suture sinus formation following closure of ventral midline incisions with polypropylene in three horses.

Suture sinuses formed in 3 horses following closure of ventral midline incisions with size-2 polypropylene. Suture sinuses healed after the suture material was removed. Suture sinus formation following closure with polypropylene may be related to the suture material's mechanical, rather than its chemical, properties. If polypropylene is used to close the linea alba in horses, the amount of tissue incorporated in the suture loops, suture tension, and knot volume should be minimized to decrease the risk of suture sinus formation.