髓内钉钉与带夹板固定小笼鸟胫跗骨骨折的实验研究

H. Jalilpour, A. Meimandi-Parizi, A. Khodakaram-Tafti, M. Ahrari-Khafi, S. Hashemi
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摘要

目的:胫骨是小型伴侣鸟类最常见的长骨骨折。由于解剖结构的限制,治疗方案基本上仅限于用胶带固定腿部。本研究的目的是研究髓内钉扎(IM钉)作为一种替代治疗方案。设计-实验研究动物-30只平均体重为30g的成熟虎皮鹦鹉。程序-这些鸟接受了中轴胫骨截骨,每组通过胶带夹板或IM钉固定治疗骨折。术后第21天取出IM钉和夹板。在手术后0、7、14、21和28天进行放射学检查。在第28天对标本进行组织病理学和生物力学评估。记录触诊稳定性、跛行评分和死亡率。结果:与夹板组存在畸形愈合和畸形相比,IM钉组的X线片显示骨愈合良好。组织病理学显示IM pin组的骨愈合更为先进,其特征是新骨小梁和新皮质形成占主导地位,纤维组织很少。生物力学测试显示,IM钉组的屈服载荷、极限载荷、刚度和吸收能量显著更高(p<0.05)。胶带夹板组的跛行评分显著更好(p<0.05),夹板组的死亡率为0,而IM钉组为33%。结论和临床相关性-尽管IM钉扎在放射学、组织病理学和生物力学方面显示出更高的骨愈合水平,但较高的死亡率和较高的跛行评分使其成为宠物鸟不太理想的选择。IM钉扎技术并没有证明像胶带拼接技术那样安全。胶带夹板仍然是治疗虎皮鹦鹉胫骨跖骨骨折的黄金标准,因为它具有低风险和高可接受性。
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Intramedullary Pining versus Tape Splinting for Fixation of Tibiotarsal Fractures in Small Cage Birds: An Experimental Study
Objective- Tibiotarsal bone is the most commonly fractured long bone in small companion birds. The treatment options are basically limited to tape splinting the leg due to anatomical limitations. The goal of this study was to investigate intramedullary pinning (IM pin) as an alternative treatment option. Design- Experimental study Animals- Thirty mature budgerigars with an average weight of 30 g.  Procedures- The birds underwent mid shaft tibiotarsus osteotomy and the fractures were managed by tape splinting or IM pining in each group. The IM pins and splints were removed at 21st day after surgery. Radiology was performed at 0, 7, 14, 21 and 28 days after surgery. Histopathological and biomechanical evaluations were performed on specimens by day 28. Stability on palpation, lameness scores and mortality rate were recorded. Results- Radiography showed perfect bone healing in the IM pin group versus the presence of malunion and deformity in the splint group. Histopathology demonstrated a more advanced bone healing in the IM pin group, characterized by the dominance of new bone trabeculae and new cortex formation with very little fibrous tissue. Biomechanical tests revealed significantly higher yield load, ultimate load, stiffness, and absorbed energy in the IM pin group (p <0.05). Lameness scores were significantly better in the tape splint group (p <0.05) and the mortality rate was 0 in the splint group versus 33% in the IM pin group. Conclusion and Clinical relevance- Although IM pinning showed a more advanced level of bone healing radiographically, histopathologically, and biomechanically, the higher mortality rate and higher lameness scores make it a less desirable choice for pet birds. IM pinning technique did not prove to be as safe as the tape splintage technique. Tape splinting remains the gold standard in managing the fractures of the tibiotarsal bone in budgerigars as it offers low risk and high acceptability.
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