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Analysis of outcomes following treatment of craniodorsal hip luxation with closed reduction and Ehmer sling application in dogs

Ariel N. Schlag1Department of Surgery, Colonial Veterinary Hospital, 2369 N Triphammer Rd, Ithaca, NY 14850, and Animal Medical Center, 510 E 62nd St, New York, NY 10065.

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Galina M. Hayes2Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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A. Q. Taylor3Department of Clinical Studies, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Sharon C. Kerwin4Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

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Danielle R. Dugat5Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078.

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Molly A. Vitt6College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

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Deborah T. Stratton7Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Daniel J. Duffy7Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.
1Department of Surgery, Colonial Veterinary Hospital, 2369 N Triphammer Rd, Ithaca, NY 14850, and Animal Medical Center, 510 E 62nd St, New York, NY 10065.
2Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
3Department of Clinical Studies, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
4Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.
5Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078.
6College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.
7Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Abstract

OBJECTIVE To describe outcomes for dogs after treatment of craniodorsal hip luxation with closed reduction and Ehmer sling placement and investigate potential risk factors for sling-associated tissue injury or reluxation of the affected hip at or near the time of sling removal.

DESIGN Retrospective multicenter cohort study.

ANIMALS 92 dogs.

PROCEDURES Case information was solicited from 10 veterinary medical facilities through electronic communications. Data on patient demographic information, cause of injury, presence of concurrent injuries, details of Ehmer sling placement and management, and outcome at sling removal were collected. Data were analyzed for associations with outcomes.

RESULTS 40 of 92 (43.5%) dogs had reluxation of the affected hip joint at or near the time of sling removal. Odds of reluxation occurring for dogs that had the initial injury attributed to trauma were 5 times those for dogs without known trauma (OR, 5.0; 95% confidence interval, 1.3 to 18.7). Forty-six (50%) dogs had soft tissue injuries secondary to sling use; 17 of these dogs had injuries classified as severe, including 1 dog that required limb amputation. Odds of severe sling injury for dogs that had poor owner compliance with home care instructions noted in the record, those that had the sling placed by an intern rather than a board-certified surgeon or resident, and those that were noted to have a soiled or wet bandage on ≥ 1 occasion were 12.5, 4.0, and 5.7 times those for dogs without these findings, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE Placement of an Ehmer sling following closed reduction of a craniodorsal hip luxation had a low success rate and high complication rate.

Abstract

OBJECTIVE To describe outcomes for dogs after treatment of craniodorsal hip luxation with closed reduction and Ehmer sling placement and investigate potential risk factors for sling-associated tissue injury or reluxation of the affected hip at or near the time of sling removal.

DESIGN Retrospective multicenter cohort study.

ANIMALS 92 dogs.

PROCEDURES Case information was solicited from 10 veterinary medical facilities through electronic communications. Data on patient demographic information, cause of injury, presence of concurrent injuries, details of Ehmer sling placement and management, and outcome at sling removal were collected. Data were analyzed for associations with outcomes.

RESULTS 40 of 92 (43.5%) dogs had reluxation of the affected hip joint at or near the time of sling removal. Odds of reluxation occurring for dogs that had the initial injury attributed to trauma were 5 times those for dogs without known trauma (OR, 5.0; 95% confidence interval, 1.3 to 18.7). Forty-six (50%) dogs had soft tissue injuries secondary to sling use; 17 of these dogs had injuries classified as severe, including 1 dog that required limb amputation. Odds of severe sling injury for dogs that had poor owner compliance with home care instructions noted in the record, those that had the sling placed by an intern rather than a board-certified surgeon or resident, and those that were noted to have a soiled or wet bandage on ≥ 1 occasion were 12.5, 4.0, and 5.7 times those for dogs without these findings, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE Placement of an Ehmer sling following closed reduction of a craniodorsal hip luxation had a low success rate and high complication rate.

Contributor Notes

Address correspondence to Dr. Hayes (gmh59@cornell.edu).