Intraoperative Distraction Device for Open Reduction of Nascent Lateral Humeral Condylar Fractures in Five Dogs

VCOT Open Pub Date : 2023-05-25 DOI:10.1055/s-0043-1771399
Jackie D. Cornell, S. W. Frederick, B.E. Shessel, A. Cross
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Abstract

Abstract Lateral humeral condylar (LHC) nascent malunion fractures are challenging to treat because of extensive callus formation, scar tissue and contracture of surrounding tissues. The objective of this retrospective case series is to describe the novel procedural use of an intraoperative distraction device to aid in the reduction and anatomical alignment of nascent malunion LHC fractures along with long-term functional outcomes in these cases. Medical records of five consecutive cases of dogs with seven nascent malunion LHC fractures that were treated between 2015 and 2018 with the aid of an intraoperative distraction device were reviewed. Relevant clinical and radiographic data, forelimb circumference, elbow goniometry and clinical outcome were evaluated. Anatomic reduction and fixation with complete healing were achieved in all seven cases. Implants were removed in four cases to resolve persisting lameness. Three dogs (4 cases) were available for long-term follow-up: mean circumference and range of motion were decreased in the operated limbs as compared with the contralateral normal limbs. One dog (with bilateral fractures) was euthanized due to poor outcome. In the other five elbows, outcome was acceptable. Based on the results of this case series, use of an intraoperative distraction device to aid in anatomical reduction and fixation of nascent malunion LHC fractures should be considered.
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术中牵张装置治疗新生肱骨外侧髁骨折5例
摘要:肱骨外侧髁(LHC)新生畸形愈合骨折由于周围组织形成广泛的骨痂、瘢痕组织和挛缩,治疗具有挑战性。本回顾性病例系列的目的是描述术中牵引装置的新方法,以帮助新生畸形愈合的LHC骨折复位和解剖对准,以及这些病例的长期功能结果。回顾2015年至2018年连续5例犬伴7例初生LHC畸形骨折,采用术中牵张装置治疗的病历。评估相关临床和影像学资料、前肢围度、肘关节测量和临床结果。所有7例均实现解剖复位和固定并完全愈合。4例患者移除植入物以解决持续性跛行。3只犬(4例)进行长期随访,手术肢体的平均周长和活动范围均比对侧正常肢体减少。一只狗(双侧骨折)因预后不佳而被安乐死。另外5个肘部的结果是可以接受的。基于本病例系列的结果,应考虑使用术中牵引装置帮助新生畸形愈合的LHC骨折进行解剖复位和固定。
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