Safe corridors for external skeletal fixator pin placement in feline long bones

2021 ◽  
pp. 1098612X2110573
Author(s):  
Ivana Prackova ◽  
Vaclav Paral ◽  
Michal Kyllar
Keyword(s):  
Bone Fractures ◽  
Long Bone ◽  
Successful Outcome ◽  
Long Bones ◽  
Biological Fixation ◽  
Anatomical Structures ◽  
Knowledge Based ◽  
History Of ◽  
Outcome Knowledge ◽  
Angular Deformities

Objectives External skeletal fixation is an established technique in cats for biological fixation of long bone fractures, stabilisation of the joints, and treatment of shearing injuries and angular deformities. As appropriate and accurate pin insertion is imperative for a successful outcome, knowledge of topographic anatomy and areas that are safe (safe corridors) for pin placement is integral to successful surgery. At present, however, safe corridors have not been determined fully in feline orthopaedics, with surgeons having to rely on knowledge based on canine orthopaedics. This study was performed to determine safe corridors for pin placement in feline long bones. Methods The limbs of six feline cadavers were frozen. Only limbs with no history of orthopaedic conditions were used. Transverse sections through the limbs were examined, and anatomical structures were determined in relation to the bone. These structures were compared with those of the contralateral limbs, which were dissected for topographic assessment. Safe corridors were defined as topographic areas where no vital structures, muscles or joints were present. Results Examination of the humerus revealed safe corridors at its proximal craniolateral aspect and on the medial and lateral humeral condyles. Safe corridors of the antebrachium were identified on the lateral aspect of the olecranon, the distal two-thirds of the medial antebrachium and the distal third of the lateral antebrachium. Safe corridors in the femur consisted of a small area lateral to and just below the major trochanter, and on the medial and lateral femoral condyles. Evaluation of the tibia revealed safe corridors on the medial aspect of the entire tibia, the cranial aspect of the proximal tibia on the tibial crest and the area just proximal to the lateral malleolus. Conclusions and relevance Safe corridors for pin placement during external skeletal fixation in feline limbs differed from those in canine limbs. Knowledge of canine anatomy may be inapplicable to pin placement in feline limbs undergoing external skeletal fixation.

Classification of Fractures of Long Bones in the Dog and Cat: Introduction and Clinical Application

1990 ◽  
Vol 03 (02) ◽  
pp. 41-50 ◽  
Author(s):  
M. Unger ◽  
P. M. Montavon ◽  
U. F. A. Heim
Keyword(s):  
Bone Fractures ◽  
Reliable Data ◽  
Long Bone ◽  
Small Animals ◽  
Long Bones ◽  
Coding System ◽  
Fracture Classification ◽  
Fracture Criteria ◽  
Filing System

AbstractA computer filing system for the classification of fractured long bones in dogs and cats is described. It includes definitions of terms and a method of classification, based on fracture criteria seen on radiographs. This fracture classification was adapted from the AO/ASIF classification in man, to accomodate the special requirements of small animals. The localization and morphology of fractures were characterized with defined conventional terms, in order to assign an alpha-numeric code to each fracture. This coding system may also be used for computer filing of the data. With this classification system, the fractures are ranked in increasing severity and complexity for the various anatomical locations. This provides some prognostic and therapeutic informations. The system was used to code 1038 radiographically documented long bone fractures in dogs and cats. The distribution of fractures, with regard to their localization and morphology, was recorded. The system was easy to apply and proved to be able to supply valuable and reliable data.A computer filing system for the classification of fractured long bones in dogs and cats is described.

scholarly journals Transgenic expression of dentin phosphoprotein inhibits skeletal development

2016 ◽  
Vol 60 (1) ◽  
Author(s):  
H. Zhang ◽  
P. Liu ◽  
S. Wang ◽  
C. Liu ◽  
P. Jani ◽  
...  
Keyword(s):  
Transgenic Mice ◽  
Type I Collagen ◽  
Bone Fractures ◽  
Skeletal Development ◽  
Long Bone ◽  
Type I ◽  
Long Bones ◽  
Transgenic Expression ◽  
Terminal Fragment ◽  
Dentin Phosphoprotein

Dentin sialophosphoprotein (DSPP) is proteolytically processed into an NH<sub>2</sub>-terminal fragment called <em>dentin sialoprotein</em> (DSP) and a COOH-terminal fragment known as <em>dentin</em> <em>phosphoprotein</em> (DPP). These two fragments are believed to perform distinct roles in formation of bone and dentin. To investigate the functions of DPP in skeletal development, we generated transgenic mice to overexpress hemagglutinin (HA)-tagged DPP under the control of a 3.6 kb type I collagen (Col1a1) promoter (designated as <em>Col1a1-HA-DPP</em>). The Col1a1-HA-DPP transgenic mice were significantly smaller by weight, had smaller skeletons and shorter long bones than their wild type littermates, as demonstrated by X-ray radiography. They displayed reduced trabecular bone formation and narrower zones of proliferative and hypertrophic chondrocytes in the growth plates of the long bones. Histological analyses showed that the transgenic mice had reduced cell proliferation in the proliferating zone, but lacked obvious defects in the chondrocyte differentiation. In addition, the transgenic mice with a high level of transgene expression developed spontaneous long bone fractures. In conclusion, overexpressing DPP inhibited skeletal development, suggesting that the balanced actions between the NH<sub>2</sub>- and COOH-terminal fragments of DSPP may be required for normal skeletal development.

scholarly journals Management of Open Fractures in Low-Income Countries: a Daunting Task

2021 ◽  
Vol 2 (3) ◽  
pp. 9-16
Author(s):  
Jean Baptiste Ramampisendrahova ◽  
Mamisoa Bodohasina Rasamoelina ◽  
Tsiahoana Jean Floris Tata ◽  
Rado Razafimahatratra ◽  
Gaëtan Duval Solofomalala
Keyword(s):  
Low Income ◽  
Bone Fractures ◽  
Insurance Coverage ◽  
Open Fractures ◽  
University Hospital ◽  
Low Income Countries ◽  
Long Bone ◽  
Definitive Treatment ◽  
Long Bones ◽  
Daunting Task

Abstract The management of open fractures was a challenge from antiquity to the present day. The objective of this study is to report the difficulties of the management of open fractures of long bones in low-income countries. This was a retrospective cohort study of the files of patients admitted for open fracture of long bones in the Department of Orthopedic Surgery and Traumatology of the Anosiala University Hospital Center for four years. Forty-two open long bone fractures were collected. The average age of the patients was 36.3 years of which 73.8% were subject of working age in the age group of 20 to 60 years and 73.8% of the cases were following the accident of the road. Most of the wounded had arrived at the hospital by bush taxi. The tibia was the most affected bone (71.4%). Gustilo IIIA type open fractures were the most observed (38.1%). Only 26.3% of patients had received surgical debridement before the sixth hour. 76.2% had no care before arriving at the hospital, 14.3% had emergency care at the basic health center and 9.5% were already being treated by the traditional healer. Definitive treatment of the fracture was dominated by the external fixator (38.1%) and orthopedic treatment (26.2%).               In low-income countries, the management of open fractures remains a daunting task. The main factors limiting the management of open fractures were the poverty of the population, the lack of health insurance coverage and the retard in arriving at the hospital. Keywords: open fractures, management, low-income, country 

scholarly journals Management of infected non-union of lower limb long bone fractures using ilizarov technique: a study of outcomes

2017 ◽  
Vol 3 (3) ◽  
pp. 557 ◽  
Author(s):  
Hrishikesh Pande ◽  
Chander Mohan Singh ◽  
Anjan Prabhakara ◽  
Vivek Mathew Philip ◽  
Mohd Shezan Iqbal ◽  
...  
Keyword(s):  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bones ◽  
Ilizarov Technique ◽  
Infected Nonunion ◽  
Ring Fixator ◽  
Long Bone Fractures ◽  
Ilizarov Ring Fixator

<p class="abstract"><strong>Background:</strong> Nonunion of long bone fractures is a common condition treated by an orthopaedic surgeon. Many nonunions can be treated effectively by internal fixation with or without bone grafting but, an infected nonunion can prove to be a tough challenge. The Ilizarov method is effective in managing infected nonunion of long bones. This study aims to assess the outcome of management of infected nonunions of long bones of lower limb with Ilizarov Ring fixator using bone and functional results as per Association for the Study and Application of Methods of Ilizarov (ASAMI) Scoring System.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 18 patients (16 Male: 2 Female; Mean age 43.2 years) managed with Ilizarov technique for an infected tibial or femoral nonunion between 01 January 2013 and 31 December 2014. They were followed up for an average of 25.4 months after removal of fixator. They were assessed for functional and Bone (radiological) outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 17 limbs were salvaged and union could be achieved. One limb required amputation due to severe persistent intractable infection. None required any additional skeletal stabilisation after removal of fixator frame except casting in a few patients for a period of 6 weeks. Mean time to union was 211.83 days (range 136 - 320days/median 184) or 7.01 months. As per the ASAMI score, Bone results were excellent in 10, good in 5, fair in 2 and poor in 1. Functionally 7 were graded as excellent, 6 as good, 3 as fair and 1 as poor and 1 patient underwent amputation.</p><p><strong>Conclusions:</strong> The Ilizarov’s method remains one of the most versatile and successful means of achieving bone healing in infected nonunions of long bones of lower limbs with additional benefits of correcting bone defects, deformities and limb length inequalities. </p>

scholarly journals Results of Conversion Osteosynthesis in Treatment of Patients with Long Bone Fractures

2019 ◽  
Vol 23 (3) ◽  
pp. 257-270
Author(s):  
Ya. M. Alsmadi ◽  
N. V. Zagorodniy ◽  
E. I. Solod ◽  
A. F. Lazarev ◽  
M. A. Abdulkhabirov ◽  
...  
Keyword(s):  
External Fixation ◽  
Soft Tissues ◽  
Bone Fractures ◽  
Damage Control ◽  
Traumatic Shock ◽  
Long Bone ◽  
Optimal Time ◽  
Long Bones ◽  
Results Of Treatment ◽  
Post Traumatic

Аbctract. Treatment of long bones fractures of the extremities has a particular relevance in modern traumatology due to their high frequency, as well as a large number of deaths in patients with polytrauma. It is dangerous to perform an urgent final osteosynthesis in severe patients because of the possibility of shock and the deterioration of the condition of the injured. Therefore, the principle of Damage control with urgent fixation of damaged segments by external fixation and their subsequent replacement (converse) to intramedullary osteosynthesis had a particular relevance in the treatment of patients with long bones fractures. Purpose: Improving treatment outcomes for patients with long bones fractures. Materials and methods. In the present study, a retrospective analysis of using conversion osteosynthesis in the treatment of 120 patients with long bones extremities fractures in a multidisciplinary hospital was carried out. For a better analysis of the results of treatment, we divided the patients into two groups: The first group 44 patients with fractures of the long bones with polytrauma according to the ISS severity scale> 17. The second group consists of 76 patients with closed isolated unstable comminuted fractures of the long bones with severe post-traumatic edema, who have a high risk of significant trauma of soft tissues. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 7-12 days, which prevented the occurrence of traumatic shock; and for patients with closed isolated unstable fractures of long bones with significant of post-traumatic edema for conversion osteosynthesis, the optimal time was 3-7 days after injury, which prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with diaphyseal fractures. The use of the technique of transferring the fixation of fragments by the external fixation device to the internal osteosynthesis (conversion) contributed to a reduction in the duration of inpatient treatment of patients with fractures of the long bones.

scholarly journals The advent of elastic stable intramedullary nailing for the treatment of long bone fractures in skeletally immature patients

2021 ◽  
Vol 27 (4) ◽  
pp. 406-412
Author(s):  
A. Andreacchio ◽  
◽  
F. Alberghina ◽  
F. Canavese ◽  
◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
Early Mobilization ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Long Bones ◽  
Skeletally Immature ◽  
Fractures In Children

Introduction Management of pediatric long bones fractures is a complex and rapidly evolving field. Traditionally, casting and conservative techniques played a key-role in the management of fractures in skeletally immature patients. However, the surgical approach has evolved steadily over the past four decades or so and increasing evidence has been published supporting the advantages of fixation techniques over conservative methods. The purpose of this narrative review is to outline how innovations in orthopedic surgery have changed the rationale of treating long bones fractures in children and adolescents with focus on surgical techniques, particularly elastic stable intramedullary nailing (ESIN). Material and methods We aimed to describe the main trends in pediatric long bones fractures management and to identify its specificities and difficulties as well as the best standard of care. Results The introduction of ESIN has profoundly influenced the management of pediatric upper and lower extremity fractures. Overall, in comparison to conservative techniques, advantages of ESIN include minimally invasiveness, short hospital stay, primary bone union, early mobilization and progressive weight bearing, and good outcome with low complication rate. Moreover, the flexible nail can be used as a closed reduction tool itself. Conclusions Irrespective of the technique performed, the key-concepts remain 1) the proper understanding of the injury to treat; 2) the identification the main characteristics of the patient; 3) the pros and cons of each technique; and 4) the potential complications.

scholarly journals Pycnodysostosis with the focus on clinical and radiographic findings

2012 ◽  
Vol 16 (2) ◽  
pp. 74-76 ◽  
Author(s):  
Benjamin Wybrand Barnard ◽  
Wim Hiddema
Keyword(s):  
Bone Turnover ◽  
Autosomal Recessive ◽  
Bone Fractures ◽  
Autosomal Recessive Disorder ◽  
Long Bone ◽  
Radiographic Findings ◽  
Rare Autosomal Recessive Disorder ◽  
Long Bone Fractures ◽  
History Of ◽  
Brittle Bones

Pycnodyostosis is a rare autosomal recessive disorder that manifests as generalised osteosclerosis of the skeleton as a result of decreased bone turnover. Patients tend to suffer from numerous fractures owing to dense, abnormally brittle bones. The syndrome has a number of characteristic clinical and radiographic signs that differentiate it from other osteosclerotic conditions. This report is of a young man with a history of long bone fractures.

scholarly journals STRUCTURE AND MECHANOGENESIS OF LONG BONE FRACTURES IN LOWER EXTREMITIES DUE TO FALL

2020 ◽  
Vol 20 (3) ◽  
pp. 179-184
Author(s):  
V.K. Sokol
Keyword(s):  
Bone Fractures ◽  
Body Height ◽  
Lower Extremities ◽  
Mechanical Injury ◽  
The Body ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bones ◽  
Upper Limbs ◽  
Pelvic Bones

Background. The study of the structure and mechanogenesis of falls is necessary to elucidate causal relationships in criminal catatrauma. Purpose of the study was to analyze the structure of mechanical injury resulting in fractures of the long bones of the lower extremities, and the mechanisms of their formation in victims as a result of a fall, according to the primary forensic examination. Material and methods. The study was carried out based on 130 reports of primary forensic examinations of victims with fractures of the femur and / or shin bones due to mechanical injury for the period February – June 2018. All victims were divided into 4 groups: group 1 included individuals sustaining mechanical injury; group 2 involved individuals sustaining injuries in car accidents; group 3 included patients with traumas from the fall, and group 4 included individuals with gunshot fractures. The methodology of the study was based on applying retrospective analysis, descriptive statistics. Results. In cases of catatrauma, the proportion of fractures of the lower extremities makes up 52%, while the proportions of fractures of the upper limbs, ribs and pelvic bones constitute 16% each; in case of car accident the fractures of low legs make up 82.1%, while the fractures of the upper limbs, ribs and pelvic bones constitute 7.8%; 2.4% and 7.7% each, respectively. There are two types of catatrauma included found out in this study: 1) household falls from the own body height (n = 4), and 2) falls from the height not exceeding 3 m (n = 9). The catatrauma mechanisms included the following: 1) active free uncoordinated fall from the own body height with the phase of primary collision with some isolated primary direct injuries; 2) passive free direct predominantly uncoordinated fall from a height of up to 3 m resulting in multiple combined injuries in the phase of primary collision (n = 4), and in the phases of primary and secondary collision of the body (n = 3). Conclusions. In the structure of mechanical injuries of the long bones in the lower extremities according to the initial forensic medical examination, falls from various heights rank the second position among the most frequent criminal injury (10%) after road traffic injuries (89,2%). Falls from own body height and from the height of up to 3 m were free, straight, and mostly uncoordinated, resulted in mainly primary direct injuries as the fractures of the long bones of the upper and lower limbs, ribs, pelvis, brain concussion, chest bruises and abdominal traumas.

scholarly journals Use of Dabigatran Etexilate for Prevention of Venous Thromboembolic Complications in Long Bone Fractures

2015 ◽  
Vol 22 (1) ◽  
pp. 70-75
Author(s):  
A. M Miromanov
Keyword(s):  
Bone Fractures ◽  
Vitamin K Antagonists ◽  
Dabigatran Etexilate ◽  
Long Bone ◽  
Long Bones ◽  
Thromboembolic Complications ◽  
Orthopaedic Patients ◽  
Venous Thromboembolic ◽  
Comparative Group ◽  
Direct Anticoagulants

Complex dynamic examination of 68 patients with fractures of lower extremities long bones. In first comparative group (36 patients, mean age 36.3±1.4 years) prevention of thromboembolic complications was performed with parenteral direct anticoagulants followed by vitamin K antagonists. In second group (32 patients, mean age 39.3±2.0 years) dabigatran etexilate was used. Duration of anticoagulant therapy made up 30 days. It was noted that in fractures of long bones of the extremities application of dabigatran etexilate ensured effective, prognosticating, stable anticoagulant action and did not require routine control of coagulation parameters that enabled to recommend that drug for wider use in trauma and orthopaedic patients.

scholarly journals Humerus Diaphysis Fracture in a Newborn during Vaginal Breech Delivery

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Baris Kaya ◽  
Korkut Daglar ◽  
Ayse Kirbas ◽  
Abdullah Tüten
Keyword(s):  
Bone Fractures ◽  
Breech Presentation ◽  
Long Bone ◽  
Long Bones ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Long Bone Fractures ◽  
The Family ◽  
Long Term Prognosis

While most obstetricians are familiar with fracture of the clavicle in newborns during birth, an unlucky minority of obstetricians has encountered long-bone fractures in newborns as well. This complication is traumatic not only for the neonate, but also for the family and the obstetrician; it is also difficult to explain. Fortunately, the long-term prognosis for fracture of the long bones is excellent. Both vaginal and cesarean breech deliveries and maneuvers can be responsible for birth traumas, including long-bone fractures. This case report presents a newborn with breech presentation delivered vaginally that resulted in humerus diaphysis fracture.

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