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Orthopaedics and fracture management

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01 January 2009, at 12:00am

Prevalence and risk factors for hip dysplasia and cranial cruciate disease 

Tige Witsberger and others, University of Missouri 

Hip dysplasia and cranial cruciate ligament deficiency (CCLD) are the two most common orthopaedic conditions in dogs. Dogs affected by one of these conditions can be concurrently or subsequently affected by the other. 

The authors assess the prevalence of each condition and attempt to identify risk factors for their occurrence in the clinical records for 1.24 million dogs included on the US Veterinary Medical Database, which has been collecting data from 26 US veterinary schools since 1964. 

Odds ratio analyses show that castrated male dogs are significantly more likely than other dogs to have hip dysplasia, while castrated male and spayed female dogs were significantly more likely to develop CCLD. Both conditions were more common in large and giant breed dogs and the prevalence of both increased significantly over the four decades for which data were available. 

Journal of the American Veterinary Medical Association 232 (12): 1,818- 1,824. 

Tension band stabilisation of acetabular physeal fractures in kittens 

Sorrel Langley-Hobbs and others, University of Cambridge 

Acetabular fractures are a common pelvic injury in cats which may heal with conservative management, albeit with a high incidence of problems such as hip and muscle atrophy or pelvic canal narrowing. The authors describe the surgical repair of acetabular physeal fractures in four kittens using a screw and tension band technique. They conclude that in kittens aged 16 weeks or older the prospects for normal acetabular development is good but for younger animals there is a risk of premature fusion of the acetabular bone. 

Journal of Feline Medicine and Surgery 9 (3): 177-187. 

Triage and stabilisation of fracture cases in small animal practice 

Chris Shales, University of Bristol 

Developments in internal fixation techniques are not the only way that fracture management has evolved over the past 50 years. The emphasis has changed from anatomically accurate reconstruction to “biological fracture fixation” with its emphasis on preserving the fracture environment, including the surrounding soft tissue. The author discusses triage and stabilisation procedures with the aim of encouraging clinicians to consider fractures as part of the entire animal rather than as a single entity. 

In Practice 30 (6): 314-320.

Dicondylar humeral fracture stabilisation in a dog 

K. Au and others, University of Gainesville 

A 15-week-old intact female pitbull terrier was presented with a fractured distal right humerus sustained two days earlier after falling into a hole. Radiography showed a complete sagittal Salter-Harris type IV fracture of the humeral condyle with associated simple oblique fractures of the supracondylar region. Interfragmentary compression of the intracondylar component of the fracture was achieved with a transilial rod and locking joints. Fracture healing was confirmed radiographically five weeks postoperatively and there were no signs of lameness one year later. 

Journal of Small Animal Practice 49 (3): 148-151. 

Correlation of histology with ultrasound and radiography in healed fractures 

Marije Risselada and others, University of Ghent, Belgium 

Radiography is the standard method for both diagnosing long bone fractures in small animals and assessing healing following plate osteotomy. However, in human medicine B-mode ultrasonography has been shown to provide earlier confirmation of closure of the fracture gap. The authors took surgical biopsies from the fracture site in eight adult dogs and compared the histological findings with the results of radiography and ultrasound scans. Their results show that ultrasound can be used to diagnose healing in plated fractures. 

Journal of Small Animal Practice 49 (5): 226-232. 

Early diagnosis and treatment options for canine hip dysplasia 

Aldo Vezzoni, Clinica Veterinaria, Via Massarotti, Cremona, Italy 

Hip dysplasia is the leading cause of osteoarthritis in dogs. A definitive diagnosis can be made radiographically when signs of osteoarthritis due to joint incongruity become apparent but by that stage it is too late to prevent degenerative changes. In the first paper of a special issue based on a FECAVA symposium on hip dysplasia, the author analyses the value of predictive clinical and radiographic signs in young dogs. He goes on to examine the use of the preventive surgical techniques, triple pelvic osteotomy and juvenile pubic symphysiodesis. 

European Journal of Companion Animal Practice 17 (2): 126-132. 

Surgical treatment of carpal flexural deformity in horses 

Robyn Charman and Jim Vasey, Goulburn Valley Equine Hospital, Victoria 

Carpal flexural deformities are common in foals and can be either congenital or acquired. Most foals may flex in the carpal region but are able to stand, although severe cases may be unable to stand and suckle. Surgical treatment consists of tenotomy of the ulnaris lateralis and flexor carpi ulnaris muscles. The authors review the results of 135 surgical procedures in 72 horses – there was a 100% success rate in restoring a straight palmar carpal angle in low severity grade 1 cases but only a 57% success rate in more severe grade 3 cases. 

Australian Veterinary Journal 86 (5): 195-199. 

Mandibular fracture in a Lhasa Apso with renal secondary hyperparathyroidism 

Philippe Roux, University of Berne, Switzerland 

A three-year-old female Lhasa Apso was presented with facial trauma following a fight with another dog. Clinical examination showed a dropped jaw, ptyalism and pain on mandibular manipulation. Intra-oral radiographs revealed a marked generalised decrease in bone density with loss of trabecular structure and absence of the lamina dura. Laboratory analyses showed severe anaemia and azotaemia, compatible with chronic renal disease. The overall findings were consistent with a diagnosis of renal secondary hyperparathyroidism. 

Schweiz Arch. Tierheilkd. 146 (6): 277- 279. 

Clinical features of multiple epiphyseal dysplasia in 19 dogs 

Magnus Rorvik and others, Norwegian School of Veterinary Medicine, Oslo 

Multiple epiphyseal dysplasia is a rare form of inherited osteochondrodysplasia first reported in a miniature poodle in 1956; further cases have been reported in beagles and golden retrievers. The condition is characterised by a deficiency in ossification of the epiphyses, apophyses and cuboidal bones of the appendicular skeleton and the epiphyses of the vertebrae. The authors describe the clinical and radiographic findings in 19 cases in dogs of four different breeds. They suggest that the disease may be an autosomal recessive condition. 

Journal of the American Veterinary Medical Association 233 (4): 600-606. 

Elbow joint luxation without concomitant ulnar or radial fracture in a foal 

L. Rubio-Martinez and others, University of Zaragoza, Spain 

Elbow luxation is rare in horses and is usually associated with other abnormalities such as concomitant fractures of the proximal radius or separation of the radius and ulna. The authors describe a case without any of those features in a one-month-old Andalusian colt. Conservative treatment with closed reduction and full limb bandaging appeared successful initially but the luxation recurred. Open reduction and surgical placement of prosthetic collateral ligaments also failed to provide sufficient stability and the foal was euthanased. 

Australian Veterinary Journal 86 (1): 56- 59.