自体胸腰椎筋膜嵌片修复犬慢性三头肌腱断裂

VCOT Open Pub Date : 2021-01-01 DOI:10.1055/s-0041-1725056
C. Wood, R. G. Cashmore
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摘要

摘要一只5岁的38公斤雄性德国牧羊犬在三头肌肌腱修复失败后5周出现持续性非负重左胸肢跛行。体格检查显示肱三头肌机制完全不正常,鹰嘴近端有明显的大缺损,当肩部伸展固定时,肘关节可以完全屈曲。臂远端尾侧可见化脓性引流道。分阶段肌腱修复被推迟到感染的解决,以允许改善愈合。手术探查创伤区并切除窦道和中间纤维肉芽肿组织后培养未见生长。最终肱三头肌肌腱修复增强了自体胸腰椎筋膜嵌盖移植物。术后用脊柱夹板保护修复,左胸肢固定,肘关节保持伸展位6周。7个月后复查显示患者无跛行。肱三头肌肌腱断裂是一种罕见的肌腱损伤,慢性肱三头肌肌腱断裂与谨慎的预后相关。据作者所知,肌腱损伤的成功手术修复结合使用自体胸腰椎筋膜垫移植物以前没有描述过。
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Repair of a Chronic Triceps Tendon Rupture in a Dog Using an Autogenous Thoracolumbar Fascia Onlay Graft
Abstract A 5-year-old 38 kg entire male German Shepherd dog was referred for persistent non-weight bearing left thoracic limb lameness 5 weeks following failed triceps tendon repair. Physical exam revealed complete incompetence of the triceps mechanism with a large palpable defect proximal to the olecranon and when the shoulder was fixed in extension, the elbow could be fully flexed. A purulent draining tract was present on the caudolateral aspect of the distal brachium. Staged tendon repair was delayed until resolution of infection to allow for improved healing. Culture following surgical exploration of the traumatized area with resection of sinus tract and interposed fibro-granulomatous tissue yielded no growth. Definitive triceps brachii tendon repair was augmented with an autogenous thoracolumbar fascia onlay graft. Postoperatively, the repair was protected with a spica splint and the left thoracic limb immobilized with the elbow maintained in an extended position for 6 weeks. Re-evaluation 7 months later revealed the patient to be free of lameness. Disruption of the triceps brachii tendon is a rarely reported tendon injury with chronic disruption of triceps tendon associated with a guarded prognosis. To the authors knowledge, successful surgical repair of tendinous injury incorporating the use of an autogenous thoracolumbar fascia onlay graft has not previously been described.
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