Effect of Proximal Abducting Ulnar Osteotomy (Paul) on Thoracic Limb Alignment in a Canine Ex Vivo Simulated Weight-Bearing Model

Abstract Purpose Osteotomies represent well-established treatment-options for the redistribution of loads and forces within and around the knee-joint. Effects of these osteotomies on the remaining planes and adjacent joints are not fully understood. The aim of this study was to determine the influence of a distal-femoral-rotation-osteotomy on the coronal alignment of the ankle. It was hypothesized that supracondylar-external-rotation-osteotomy of the distal femur leads to a change in the coronal orientation of the ankle joint. Methods Long-leg standing radiographs and CT-based torsional measurements of 27 patients undergoing supracondylar-rotational-osteotomy of the femur between 2012 and 2019 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy-site. The hip-knee-ankle-angle (HKA), the mechanical-lateral-distal-femur-angle (mLDFA), and Tibia-Plafond-Horizontal-Orientation-Angle (TPHA) around the ankle were measured. Comparison between means was performed using the Wilcoxon-Mann–Whitney test. Results Twenty-seven patients with high femoral antetorsion (31.3° ± 4.0°) underwent supracondylar-external-rotation-osteotomy. The osteotomy led to a reduced antetorsion (17.4 ± 5.1; p < 0.001) and to a valgisation of the overall limb-alignment. The HKA decreased by 2.4° ± 1.4° (p < 0.001). The TPHA decreased by 2.6° (p < 0.001). Conclusions Supracondylar external rotation osteotomy of the femur leads to lateralization of the weight bearing line at the knee and ankle due to valgisation of the coronal limb alignment. The mobile subtalar joint has to compensate (inversion) for the resulting valgus orientation of the ankle to ensure contact between the foot and the floor. When planning a rotational osteotomy of the lower limb, this should be appreciated – especially in patients with a preexisting valgus alignment of the lower extremities or restricted mobility in the subtalar joint.

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Thoracic Limb Alignment in Healthy Labrador Retrievers: Evaluation of Standing Versus Recumbent Frontal Plane Radiography

Veterinary Surgery ◽

10.1111/j.1532-950x.2014.12140.x ◽

2014 ◽

Vol 43 (7) ◽

pp. 791-803 ◽

Cited By ~ 9

Author(s):

Zachary J. Goodrich ◽

Bo Norby ◽

Bunita M. Eichelberger ◽

Wade O. Friedeck ◽

Hollye N. Callis ◽

...

Keyword(s):

Frontal Plane ◽

Limb Alignment ◽

Thoracic Limb ◽

Labrador Retrievers

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A case of periosteal proliferative polyarthritis in a cat

Journal of the Hellenic Veterinary Medical Society ◽

10.12681/jhvms.15153 ◽

2017 ◽

Vol 55 (1) ◽

pp. 46

Author(s):

M. KARAYANNOPOULOU (Μ. ΚΑΡΑΓΙΑΝΝΟΠΟΥΛΟΥ) ◽

Z. S. POLIZOPOULOU (Ζ.Σ. .ΠΟΛΥΖΟΠΟΥΛΟΥ) ◽

A. F. KOUTINAS (Α. Φ. ΚΟΥΤΙΝΑΣ) ◽

M. N. PATSIKAS (Μ.Ν. ΠΑΤΣΙΚΑΣ) ◽

G. KAZAKOS (Γ. ΚΑΖΑΚΟΣ) ◽

...

Keyword(s):

Elbow Joint ◽

Complete Blood Count ◽

Weight Bearing ◽

Serum Biochemistry ◽

Adverse Side Effect ◽

Left Elbow ◽

Normal Limits ◽

Thoracic Limb ◽

History Of ◽

The Right

In this paper a case of periosteal proliferative polyarthritis in an 11-year old, female Siamese cat, that was admitted to the Surgery Clinic of the Veterinary School, A.U.Th., with a 6-month history of non-weight bearing lameness of the left thoracic limb, is described. At physical examination, restricted range of motion of the left elbow joint, local swelling and pain were detected. In the radiological examination of the affected joint the main finding was a periarticular extensive and irregular periosteal new bone formation. The results of the complete blood count and routine serum biochemistry were within normal limits and the cat was serologically negative for FeLV and FIV. Synovial fluid examination showed a lymphoplasmacytic pleocytosis, while the bacterial culture was negative. Prednisolone given at an anti-inflammatory dose for two consecutive weeks resulted in a marked improvement of the clinical sings. However, two months after the end of the treatment lameness reappeared, but this time in the contralateral thoracic limb, due to the involvement of the same joint. Radiology revealed the same type of lesions in the right elbow joint, whereas the left became ankylosed. Again, prednisolone, given at an immunosuppressive dose for two weeks, did not improve but fairly the clinical condition of the animal and the radiological changes as well. For this reason azathioprine at the dose of 1 mg/kg BW, every 48 hours, was added to therapy that lasted for 5 months. Transient mild leukopenia, that resolved after decreasing the dose of azathioprine by 25%, was the only adverse side effect noticed. At the end of the treatment, regression of the radiographical lesions in both elbows enabled the cat to walk with a stilted gait, despite the development of joint ankylosis bilaterally. The disease was kept in remission during the 12-month follow up period.

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Traumatic craniolateral shoulder luxation and fracture of the lesser tubercle of the humerus in a dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-11-03-0041 ◽

2011 ◽

Vol 24 (06) ◽

pp. 474-477 ◽

Cited By ~ 1

Author(s):

M. S. Bergh ◽

J. L. Huck

Keyword(s):

Surgical Repair ◽

Articular Surface ◽

Weight Bearing ◽

Complete Healing ◽

Joint Function ◽

Thoracic Limb ◽

Anatomic Reduction ◽

History Of ◽

The Right ◽

Displaced Fracture

SummaryA five-year old, spayed female, Bearded Collie was presented with a 24-hour history of non-weight-bearing lameness of the right thoracic limb after sustaining vehicular trauma. Radio-graphs revealed a craniolateral scapulohumeral luxation and a distally and medially displaced fracture of the lesser tubercle of the humerus. Open reduction and internal fixation of the fracture was achieved with lag screw fixation and an anti-rotational Kirsch-ner wire. Surgical repair resulted in compression across the fracture line, anatomic reduction of the articular surface, and a stable scapulohumeral joint following reduction of the humeral head in the glenoid. Six weeks postoperatively, the patient exhibited no evidence of pain or lameness on the right thoracic limb and radiographs revealed complete healing of the fracture and normal articulation of the scapulohumeral joint. This is the first report of a lesser tubercle fracture associated with a craniolateral shoulder luxation. Surgical intervention resulted in the return of full shoulder joint function in this dog.

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The weight-bearing scanogram technique provides better coronal limb alignment than the navigation technique in open high tibial osteotomy

The Knee ◽

10.1016/j.knee.2012.09.003 ◽

2014 ◽

Vol 21 (2) ◽

pp. 451-455 ◽

Cited By ~ 34

Author(s):

Dae-Hee Lee ◽

Seoung-Bum Han ◽

Kwang-Jun Oh ◽

Jun Seop Lee ◽

Jae-Ho Kwon ◽

...

Keyword(s):

High Tibial Osteotomy ◽

Weight Bearing ◽

Tibial Osteotomy ◽

Limb Alignment

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Epoxy putty external skeletal fixation in a tibiotarsal fracture of a wild choroy parakeet (Enicognathus leptorhynchus)

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/1678-4162-7474 ◽

2015 ◽

Vol 67 (3) ◽

pp. 671-678 ◽

Cited By ~ 2

Author(s):

J. I. Arias ◽

C. Beato ◽

A. Espinoza

Keyword(s):

Ex Vivo ◽

Weight Bearing ◽

External Fixators ◽

X Rays ◽

Bone Necrosis ◽

Cerclage Wire ◽

Epoxy Material ◽

Bone Callus ◽

Primary Bone ◽

Transverse Fractures

Tibiotarsal fractures are common in birds because in most birds this is the longest, most exposed bone in the leg. Transverse fractures are most common and rotational and shear forces must be stabilized in order to achieve good bone regeneration. A 230g male Slender-billed Parakeet or Choroy parakeet (Enicognathus leptorhynchus), with more than five years of age, was received with non-weight bearing lameness with 24 hours duration. X-rays were taken, and these revealed a closed, complete, non-comminuted transverse fracture of the distal diaphysis of the left tibiotarsal bone. Fixation was planned with 10-minute fast-setting epoxy putty. In order to assess the temperature of polymerization of the epoxy dough and the possibility of heat-bone necrosis, the temperature was recorded every 30 seconds for 12 minutes with three different amounts of the epoxy material in an ex vivo test. The temperature of the pieces reached a peak of 50-60ºC, where the highest peak corresponds to the highest amount of material. When approximately 6g of putty were used, the peak temperature reached only 51ºC. This peak changed to 58ºC when 4 times more epoxy was mixed and measured. If the temperature of the pins inserted in the bone exceeds 70ºC, bone necrosis could occur. In light of these results, the fracture was treated with 6 g of epoxy putty that was allowed to polymerize over a 1A 2/2 external skeletal fixation, with 1-mm pins bent at 90º and joined together with cerclage wire. At 6 weeks after surgery the bird had formed a good primary bone callus, and the external fixators were therefore removed. With this approach a satisfactory recovery of the patient was achieved with normal use of the affected limb.

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Effect of a calcaneo-tibial screw on medial and lateral stability of the canine tarsocrural joint ex vivo

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-16-12-0160 ◽

2017 ◽

Vol 30 (05) ◽

pp. 331-338

Author(s):

Janis Bridges ◽

Andrew Worth ◽

Kevin Frame

Keyword(s):

Ex Vivo ◽

Screw Fixation ◽

Weight Bearing ◽

Ligament Injury ◽

Collateral Ligaments ◽

Collateral Ligament ◽

Injured Limb ◽

Significant Difference ◽

Adequate Method ◽

Intact Limb

SummaryObjective: To evaluate the use of a temporary calcaneo-tibial screw for stabilization of the tarsocrural joint in dogs with surgically treated collateral ligament injury.Methods: The degree of varus and valgus laxity of the tarsocrural joint in various states of injury and stabilization was measured in paired cadaveric limbs of Greyhound dogs. The angle of varus or valgus laxity was calculated following simulated collateral ligament injury (long collateral ligament only, long and short collateral ligaments, and bilateral long and short collateral ligaments) and stabilization with a calcaneo-tibial screw.Results: The joint was significantly more stable after placement of a calcaneo-tibial screw compared to limbs with any combination of injured collateral ligaments. There was not a significant difference between stability of the intact limb compared to the injured limb with calcaneo-tibial screw fixation.Clinical significance: Calcaneo-tibial screw fixation appears to be an adequate method of stabilizing the tarsocrural joint following collateral ligament injury, and warrants clinical evaluation as a less expensive alternative to external skeletal fixation application. It is likely that this method would need to be supplemented with a cranial half cast to prevent screw failure during weight bearing.

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Can Deep Learning Using Weight Bearing Knee Anterio-Posterior Radiograph Alone Replace a Whole-Leg Radiograph in the Interpretation of Weight Bearing Line Ratio?

Journal of Clinical Medicine ◽

10.3390/jcm10081772 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1772

Author(s):

Hyun-Doo Moon ◽

Han-Gyeol Choi ◽

Kyong-Joon Lee ◽

Dong-Jun Choi ◽

Hyun-Jin Yoo ◽

...

Keyword(s):

Deep Learning ◽

Lower Limb ◽

Assessment Tool ◽

Weight Bearing ◽

Absolute Error ◽

Limb Alignment ◽

Lower Limb Alignment ◽

Test Set ◽

Cumulative Score ◽

Validation Set

Weight bearing whole-leg radiograph (WLR) is essential to assess lower limb alignment such as weight bearing line (WBL) ratio. The purpose of this study was to develop a deep learning (DL) model that predicts the WBL ratio using knee standing AP alone. Total of 3997 knee AP & WLRs were used. WBL ratio was used for labeling and analysis of prediction accuracy. The WBL ratio was divided into seven categories (0, 0.1, 0.2, 0.3, 0.4, 0.5, and 0.6). After training, performance of the DL model was evaluated. Final performance was evaluated using 386 subjects as a test set. Cumulative score (CS) within error range 0.1 was set with showing maximum CS in the validation set (95% CI, 0.924–0.970). In the test set, mean absolute error was 0.054 (95% CI, 0.048–0.061) and CS was 0.951 (95% CI, 0.924–0.970). Developed DL algorithm could predict the WBL ratio on knee standing AP alone with comparable accuracy as the degree primary physician can assess the alignment. It can be the basis for developing an automated lower limb alignment assessment tool that can be used easily and cost-effectively in primary clinics.

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