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Abstract

CASE DESCRIPTION

3 juvenile (4 to 5 months of age) medium- to large-breed or crossbred dogs were evaluated for sudden unilateral non–weight-bearing lameness in a pelvic limb after a fall during strenuous activity.

CLINICAL FINDINGS

All dogs had non–weight-bearing lameness (n = 2) or bore minimal weight (1) on the affected pelvic limb, had soft tissue swelling over the cranial aspect of the stifle joint in the affected limb, seemed to resist manipulation of the affected joint, and had tibial tuberosity avulsion fracture confirmed with radiography.

TREATMENT AND OUTCOME

Each dog underwent surgical fracture reduction and stabilization with a hybrid circular-linear external skeletal fixator construct with interfragmentary Kirschner wires used to stabilize the avulsed tibial tuberosity. Successful fracture reduction and stabilization were achieved, and only minor postoperative complications occurred. Construct removal 2 weeks postoperatively resulted in no displacement of the tibial tuberosity in 2 dogs and only minor proximal displacement in the remaining dog, allowed for continued unencumbered growth through the apophysis and proximal tibial epiphysis in all dogs, and did not result in tibial conformational anomalies. Clinical outcome was considered excellent in 2 dogs with complete resolution of lameness and good in 1 dog with subsequent occasional mild lameness.

CLINICAL RELEVANCE

Our findings suggested that the described hybrid external skeletal fixator construct could be used as a minimally invasive strategy to successfully manage tibial tuberosity avulsion fractures in dogs and may be advantageous in very young medium- to large-breed dogs in which premature closure of the tibial tuberosity apophysis could result in distal translocation of the tibial tuberosity and deformity of the tibial plateau.

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in Journal of the American Veterinary Medical Association
History

An adopted 1-year-old 22-kg (48.4-lb) neutered male mixed-breed dog was referred to the University of Florida Small Animal Hospital because of an inability to completely open its mouth. The dog had been adopted from a shelter 6 months prior to hospital admission. At the time of the adoption, no information was available on the dog's history. The owners noticed dysphagia when they acquired the dog; however, the dog was able to prehend and chew dry dog food. No treatment had been attempted before referral.

At the time of hospital admission, the dog was thin with a body condition score

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in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate mediolateral, axial, torsional, and craniocaudal bending behavior of 6 distal ring-block configurations commonly used to stabilize short juxta-articular bone segments in small animals.

Sample Population—8 circular external skeletal fixator constructs of each of 6 distal ring-block configurations. The distal ring-block configurations were composed of combinations of complete rings, incomplete rings, and drop wires.

Procedure—Constructs were nondestructively loaded in axial compression, craniocaudal bending, mediolateral bending, and torsional loading by use of a materials testing machine. Gap stiffness was determined by use of the resultant load displacement curve.

Results—Circular external skeletal fixator configurations and constructs significantly affected gap stiffness in all testing modes. Within each loading mode, gap stiffness was significantly different among most configurations. In general, complete ring configurations were significantly stiffer than similar incomplete ring configurations, and addition of a drop wire to a configuration significantly increased stiffness of that configuration.

Conclusions and Clinical Relevance—When regional anatomic structures permit, the use of complete ring configurations is preferred over incomplete ring configurations. When incomplete ring configurations are used, the addition of a drop wire is recommended. (Am J Vet Res 2004;65:393–398)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To compare in vitro axial compression, abaxial compression, and torsional stiffnesses of intact and plated radii from small- and large-breed dogs.

Sample—Radii from 18 small-breed and 9 large-breed skeletally mature dogs.

Procedures—3 groups were tested: large-breed dog radii plated with 3.5-mm limited-contact dynamic compression plates (LCDCPs), small-breed dog radii plated with 2.0-mm dynamic compression plates (DCPs), and small-breed dog radii plated with 2.0/2.7-mm cut-to-length plates (CTLPs). The axial compression, abaxial compression, and torsional stiffnesses of each intact radius were determined under loading with a material testing machine. An osteotomy was performed, radii were plated, and testing was repeated. The stiffness values of the plated radii were expressed as absolute and normalized values; the latter was calculated as a percentage of the stiffness of the intact bone. Absolute and normalized stiffness values were compared among groups.

Results—The absolute stiffnesses of plated radii in axial and abaxial compression were 52% to 83% of the intact stiffnesses in all fixation groups. No difference was found in torsion. There was no difference in normalized stiffnesses between small-breed radii stabilized with CTLPs and large-breed radii stabilized with LCDCPs; however, small-breed radii stabilized with DCPs were less stiff than were any other group.

Conclusions and Clinical Relevance—Plated radii of small-breed dogs had normalized stiffnesses equal to or less than plated radii of large-breed dogs. The complications typically associated with plating of radial fractures in small-breed dogs cannot be ascribed to an overly stiff bone-plate construct.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To identify risk factors for successful surgical management of dogs with atlantoaxial subluxation (AAS).

Design—Retrospective study.

Animals—46 dogs managed surgically for AAS.

Procedure—Age at onset of clinical abnormalities, duration of clinical abnormalities prior to surgery, radiographic appearance of the dens, type (dorsal or ventral procedure) and number (1 or 2) of surgeries performed, grade of postoperative atlantoaxial joint reduction, and neurologic status prior to surgery (preoperative), when dogs were discharged from the hospital (postoperative), and during a follow-up evaluation (final) were obtained from the dogs' medical records. Risk factors for surgical success and degree of neurologic improvement were identified and analyzed for predictive potential.

Results—Age at onset of clinical abnormalities ≤ 24 months was significantly associated with greater odds of a successful first surgery and final outcome and a lower postoperative neurologic grade. Duration of clinical abnormalities ≤ 10 months was significantly associated with greater odds of a successful final outcome and a lower final neurologic grade. A preoperative neurologic grade of 1 or 2 was significantly associated with a lower final neurologic grade. Potential risk factors that did not affect odds of a successful outcome included type of surgery performed, grade of atlantoaxial joint reduction, radiographic appearance of the dens, or need for a second surgery.

Conclusions and Clinical Relevance—Age at onset of clinical abnormalities, duration of clinical abnormalities prior to surgery, and preoperative neurologic status are risk factors for success of surgical management of AAS in dogs. (J Am Vet Med Assoc 2000; 216:1104–1109)

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in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 10-year-old spayed female Jack Russell Terrier and a 7-year-old neutered male mixed-breed dog were evaluated because of acute, progressive, unilateral forelimb lameness associated with signs of pain and turgid antebrachial swelling.

Clinical Findings—For either dog, there were no salient pathological or diagnostic imaging abnormalities. A diagnosis of compartment syndrome was confirmed on the basis of high caudal antebrachial compartmental pressure in the affected forelimb.

Treatment and Outcome—Both dogs underwent surgical exploration of the affected forelimb. In each case, an intramuscular tumor (mast cell tumor in the Jack Russell Terrier and suspected sarcoma in the mixed-breed dog) was detected and presumed to be the cause of the high compartmental pressure. At 6 months following tumor excision, the dog with the mast cell tumor did not have any clinical signs of disease. The dog with a suspected sarcoma underwent tumor excision and forelimb amputation at the proximal portion of the humerus followed by chemotherapy; the dog was euthanized approximately 1 year following treatment because of pulmonary metastasis.

Clinical Relevance—Compartment syndrome is a serious but rarely reported condition in dogs and is typically ascribed to intracompartmental hemorrhage. These 2 cases illustrate the potential for expansile intramuscular antebrachial tumors to cause compartment syndrome in dogs.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the influence of stifle joint flexion angle, cranial cruciate ligament (CrCL) integrity, tibial plateau leveling osteotomy (TPLO), and cranial tibial subluxation on the distance between the location of the origin and insertion of the CrCL (CrCLd) in dogs.

Samples—4 pairs of pelvic limbs from adult dog cadavers weighing 23 to 34 kg.

Procedures—Mediolateral projection radiographs of each stifle joint were obtained with the joint flexed at 90°, 105°, 120°, 135°, and 150°. Radiopaque markers were then placed at the sites of origin and insertion of the CrCL. Afterward, radiography was repeated in the same manner, before and after CrCL transection, with and without TPLO. Following CrCL transection, radiographs were obtained before and after inducing overt cranial tibial subluxation. Interobserver variation in measuring the CrCLd without fiduciary markers was assessed. The effect of CrCL integrity, cranial tibial subluxation, flexion angle, and TPLO on CrCLd was also determined.

Results—Interobserver agreement was strong, with an intraclass correlation coefficient of 0.859. The CrCLd was significantly shorter (< 1 mm) at 90° of flexion; otherwise, flexion angle had no effect on CrCLd. Cranial tibial subluxation caused a 25% to 40% increase in CrCLd. No effect of TPLO on CrCLd was found, regardless of CrCL integrity, forced stifle joint subluxation, or flexion angle.

Conclusions and Clinical Relevance—Overt cranial tibial subluxation in CrCL-deficient stifle joints can be detected on mediolateral projection radiographs by comparing CrCLd on neutral and stressed joint radiographs at joint angles between 105° and 150°, regardless of whether a TPLO has been performed.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To determine short- and long-term outcomes and complications of dogs undergoing surgical correction of grade IV medial patellar luxation (MPL).

DESIGN Retrospective case series.

ANIMALS 24 dogs (29 stifle joints) that underwent surgical correction of grade IV MPL between March 2008 and April 2014.

PROCEDURES Medical records of all dogs were reviewed. When available, long-term follow-up information was obtained for each dog via the orthopedic surgeon (results of orthopedic examination and radiographic interpretation) and the dog's owner (responses to a questionnaire regarding postsurgical outcomes). Types of postsurgical complications and intervals to follow-up data collection were recorded. Recurrence of MPL was recorded separately. Successful outcome was defined as one without catastrophic complication, with owner-reported full or acceptable return to function and a surgeon- and owner-assigned pain or lameness score < 3.

RESULTS 24% (7/29) of stifle joints had major complications, and 21% (6) of joints required surgical revision. Grade II to IV recurrence of MPL was identified in 21% (6) of stifle joints. One dog had a catastrophic complication requiring limb amputation. For all other dogs, owner-reported return to function was full or acceptable. Surgeon-assigned pain and lameness scores for all dogs at the final follow-up evaluation were < 2/5 (0 = pain or lameness free). Surgical correction of grade IV MPL had an overall success rate of 93% (27/29).

CONCLUSIONS AND CLINICAL RELEVANCE Surgical correction of grade IV MPL in dogs had a favorable overall success rate; however, owners should be counseled regarding the high rate of complications associated with surgery.

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in Journal of the American Veterinary Medical Association