scholarly journals Colocephalectomy for the Treatment of Capital Physeal Fracture of the Femoral Head in Pony

2020 ◽  
Vol 48 ◽  
Author(s):  
Andressa Duarte Lorga ◽  
Peterson Triches Dornbusch ◽  
Anny Raissa Carolini Gomes ◽  
Mariana Cocco ◽  
Flávia Do Prado Augusto Amaro ◽  
...  

Background: Femoral capital physeal fractures occur in young animals and are generally associated with trauma. They have a poor prognosis and surgical therapy is the most indicated. There are few studies describing surgical treatment and postoperative results, so the objective of the present report was to present the first case in Brazil of a colocefalectomy for the treatment of femoral capital physeal fracture in a young pony, the post-surgical and the results obtained with the technique employed.Case: An 18-month-old pony, male, not castrated, , weighing 136 kg was referred to the Veterinary Hospital of the Federal University of Paraná (HV-UFPR) with a history of trauma for 4 days. On physical examination, the animal presented lameness grade 5 of the right pelvic limb, shortening and lateral deviation of the limb, crackling and painful sensation on abduction, and slight atrophy of the gluteal muscles on the affected side. In the radiographic examination, a femoral capital physeal fracture was found in the oblique ventro-dorsal projection. Once the diagnosis was performed, a colocefalectomy was realized, as the patient is a light and short horse. The patient underwent general anesthesia and was placed in the left lateral position. The access to the coxofemoral joint was made through the lateral face of the right hindlimb. The muscles of the region were incised and deviated, so a partial myotomy was performed in the deep gluteal and vastus lateralis. This procedure allowed to visualize the fracture, where the head of the femur remained congruent to the acetabulum. A hammer and a curved osteotome were used to section the round ligament, allowing the dislocation of the femoral head and with the aid of an oscillating orthopedic saw was performed the femoral neck ostectomy. Previously to the synthesis of the muscular planes and the skin, a passive tubular drain was fixed, in order to avoid the accumulation of exudate and consequent dehiscence of stitches, which was removed on the 6th postoperative day. For postoperative analgesia, epidural morphine was administered for 6 days and intravenous phenylbutazone for 3 days. Antibiotic therapy was performed with Ceftiofur and Metronidazole. The stitches were removed on the 15th postoperative day, after the correct healing of the surgical wound. The patient’s return to activity was gradual and he was pasture sound on the 42nd postoperative day. After medical discharge, contact with the owner was kept until the fifth postoperative month, and he related that the animal remained walking well and maintaining his reproductive function.Discussion: Femoral capital physeal fractures can occur in young animals, and are not common in clinical surgical care. Clinical signs are crackle of the joint on manipulation and presence of swelling in the affected region. The patient in question, in addition to evident lameness, had crackling and painful sensation during the abduction of the limb, but there was no local swelling, but an atrophy of the musculature of the limb, that occurs in cases of chronic femoral injury. Surgical intervention is the indicated method of treatment and should be performed as soon as possible after the injury has occurred, avoiding the worsening of bone and joint degeneration. Femoral head ostectomy is more suitable for animals less than 12 months old and weighing up to 100 kg. The technique has as a postoperative complication the contamination of the surgical wound, however the implantation of the passive tubular drain allowed rapid evolution of healing. Physical rehabilitation in the postoperative period is variable according to the progress of the animal’s locomotion. Therefore, the colocefalectomy technique aims to maintain the patient’s quality of life, even as in the case reported, it allowed the animal to maintain the reproductive function.

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S88-S89
Author(s):  
A Lazim ◽  
R Kuklani ◽  
D Sundararajan

Abstract Introduction/Objective Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic tumor representing 3 to 7% of all odontogenic tumors. This tumor was first reported as adeno-ameloblastoma by Bernier and Tiecke in 1950 as it was initially assumed to be a type of ameloblastoma. In 1969, Philipsen and Bern proposed the term adenomatoid odontogenic tumor which was subsequently adopted by WHO and became the accepted terminology for this tumor. AOT is classified as a tumor of odontogenic epithelium but occasionally abnormal hard tissues consistent with dentinoid material may also be present as part of the tumor. AOT tends to occur in younger patients and 50% of the cases are diagnosed in teenagers. It occurs twice as commonly in females and frequently involves the anterior maxilla. Radiographically, AOT can appear as a radiolucent or mixed lucent-opaque lesion and may be associated with an impacted tooth. Methods/Case Report We report two unusually large expansile lesions of AOT that presented in the mandible. In the first case, the tumor presented as an expansile radiolucent lesion involving the right posterior mandible in a 32 year old female. In the second case, the tumor presented as an expansile mixed lucent-opaque lesion involving the left anterior mandible in a 21 year old female. The clinical presentation, radiographic and imaging findings, histopathologic features and treatment of these two cases will be discussed. The recommended treatment for AOT is surgical excision. The prognosis is good as this tumor seldom recurs after excision. Results (if a Case Study enter NA) NA Conclusion AOT is considered to be a non-aggressive, non-invasive and slow growing benign neoplasm. It is usually discovered on routine radiographic examination as the lesion is usually small and asymptomatic at the time of diagnosis but occasional cases that are larger in size have been reported in the literature.


2021 ◽  
Vol 12 ◽  
Author(s):  
Noriya Enomoto ◽  
Kenji Yagi ◽  
Shunji Matsubara ◽  
Masaaki Uno

Bow hunter's syndrome (BHS) is most commonly caused by compression of the vertebral artery (VA). It has not been known to occur due to an extracranially originated posterior inferior cerebellar artery (PICA), the first case of which we present herein. A 71-year-old man presented with reproducible dizziness on leftward head rotation, indicative of BHS. On radiographic examination, the bilateral VAs merged into the basilar artery, and the left VA was predominant. The right PICA originated extracranially from the right VA at the atlas–axis level and ran vertically into the spinal canal. During the head rotation that induced dizziness, the right PICA was occluded, and a VA stenosis was revealed. Occlusion of the PICA was considered to be the primary cause of the dizziness. The patient underwent surgery to decompress the right PICA and VA via a posterior cervical approach. Following surgery, the patient's dizziness disappeared, and the stenotic change at the right VA and PICA improved. The PICA could be a causative artery for BHS when it originates extracranially at the atlas–axis level, and posterior decompression is an effective way to treat it.


1997 ◽  
Vol 10 (02) ◽  
pp. 101-110 ◽  
Author(s):  
J. Dupuis ◽  
G. Beauregard ◽  
N. H. Bonneau ◽  
L. Breton ◽  
J. Planté

SummaryThe efficiency of conservative treatment, excision arthroplasty of the femoral head and neck and triple pelvic osteotomy for the treatment of hip dysplasia in the immature dog were compared using locomotor, physical and radiographic examinations and owner’s evaluation. Cases selected for this study were dogs diagnosed with bilateral hip dysplasia, initially admitted with clinical signs (lameness, pain), immature at the beginning of the treatment (less than 12 months of age), with both hips subjected to the same treatment (conservative treatment, excision arthroplasty of the femoral head and neck or triple pelvic osteotomy). These dogs never showed any musculoskeletal problems other than hip dysplasia and the surgical treatment had been completed at least 20 months prior to re-evaluation time. Fourteen hips were re-evaluated in the conservative group, 16 in the triple pelvic osteotomy group and ten in the excision arthroplasty group. Locomotor, physical and owner’s evaluations demonstrated the superiority of the triple pelvic osteotomy. These evaluations also showed that excision arthroplasty was more efficient than conservative treatment. Radiographic examination demonstrated the obvious superiority of the triple pelvic osteotomy over conservative treatment.Locomotor, physical and owner’s evaluations demonstrated the superiority of the triple pelvic osteotomy over conservative treatment and excision arthroplasty for the treatment of hip dysplasia in the immature dog. Radiographic examination demonstrated the obvious superiority of the triple pelvic osteotomy over conservative treatment for joint congruence and control of degenerative joint disease.


2019 ◽  
Vol 47 ◽  
Author(s):  
Paulo Sérgio Scorsato ◽  
Sheila Canevese Rahal ◽  
Thainan Lima Teixeira ◽  
Mateus Feital Scorsato

Background: The management of malunion of pelvic fracture and its complications may require from conservative to surgical methods, depending on the severity and temporal evolution. Thus, the aim of this present report is to describe the treatments adopted in a cat with severe pelvic stenosis.Case: An approximately 3-year-old neutered male crossbreed cat, weighing 3 kg, was presented due to difficulty in defecation in the previous eight months. According to its tutor, the cat was adopted one year earlier, with a history of pelvic fracture due to a run over, which had been treated conservatively. The tutor also mentioned that since the appearance of dyschezia, the cat had only been treated with enemas, but without success. In abdominal palpation, there was presence of pain and a mass of firm content in descending colon topography. The radiographic examination of the pelvis presented an exuberant bone callus, characterizing an old fracture, a consolidation with change of bone axis in the right ischium, together with megacolon and fecaloma. It was initially decided that a liquid glycerin-based enema would be performed, in conjunction with clinical treatment with administration of cisapride, dimethicone and lactulose. Although the medical treatment initially helped improve the clinical picture, the cat presented fecaloma two months later. Surgical treatment was then performed, in which distraction of the pubic symphysis with use of a heterologous cortical bone graft (canine tibia stored in glycerin 98%) was performed, as the tutor was not favorable to colectomy as the first option. However, after one month of intervention, despite good evolution, the animal again showed signs of dyschezia. At this point the tutor agreed to colectomy, which was subtotal with preservation of the ileocolic valve.Discussion: The initial treatment of the cat in this report, with administration of prokinetic, antifoaming agent and laxative was insufficient, as the cat again developed fecaloma after two months of use of such medications. In general, cats presenting dyschezia, with constipation and megacolon over a period of more than 6 months, may present irreversible lesion due to damage to the smooth muscle of the colon, with presence of hypertrophy and neuromuscular degeneration of the organ. The problem had already been explained to the tutor, who preferred the medical treatment, as until then the cat had only been treated with enemas. Several techniques have been used to promote the widening of the pelvic canal, including the pelvic symphysiotomy and use of spacers. Although the autograft stimulates osteogenesis more rapidly, there is difficulty in obtaining bones of adequate size and strength, one of the reasons why the heterologous bone was used in the present case. Even with adequate widening of the pelvic canal, the lesion’s evolution over time may have predisposed to irreversible damage of the colon in this case. Among existing techniques for resolution of megacolon in cats, coloplasty, partial colectomy, and subtotal colectomy can be cited. The latter technique was undertaken in the present case, in conjunction with ileocolic junction preservation, which has the advantage of a lower incidence of diarrhea. Thus, thesigns of dyschezia had ceased. In conclusion, the combination of procedures adopted for distraction of the pelvic symphysis and subsequent subtotal colectomy allowed adequate recovery of the animal without relapses during a follow-up period of five years. The use of the heterologous graft (canine tibia) for distraction of the pelvic symphysis behaved as a spacer of adequate size and resistance.


2006 ◽  
Vol 75 (2) ◽  
pp. 247-250 ◽  
Author(s):  
G. Muhammad ◽  
M. Saqib ◽  
M. Athar

The present report describes a case of fatal actinobacillosis in a dairy buffalo (Bubalus bubalis). Clinical signs included a large multilobular, firm abscess located caudo-ventral to the right ear base, submandiblar and prescapular lymphadenopathy, fever and dyspnoea. Haemogram revealed an accelerated erythrocyte sedimentation rate and erythropenia. Provisional diagnosis of actinobacillosis was confirmed by the demonstration of a Gram-negative pleomorphic organism in pus, microscopic examination of a compression preparation of a sulphur granule as well as growth of the organism on blood agar. Intraperitoneal inoculation of pus in guinea pigs was fatal at around 48 hours post-injection. The LD50 of the Actinobacillus lignieresii isolate in mice was 104 colony forming unit per milliliter of Hank's balanced salt solution. The animal died 12 hours after the initiation of surgical drainage of the abscess and administration of iodide, antibiotics and steroids. Necropsy findings included interlobular pneumonia, pulmonary abscessation and mediastinal lympadenopathy that were ascribed to metastatic spread of the organisms to the lungs which probably led to the death of the animal. This case report appears to be the first documentation of fatal actinobacillosis in the dairy buffalo.


2019 ◽  
Vol 64 (No. 02) ◽  
pp. 92-99
Author(s):  
JH Song ◽  
TS Hwang ◽  
HC Lee ◽  
DH Yu ◽  
BJ Seung ◽  
...  

A seven-year-old Toy Poodle was presented for progressive ataxia and seizure episodes. Magnetic resonance imaging revealed inflammatory lesions in the cerebrum and brainstem. Management with imatinib mesylate, prednisolone and hydroxyurea were initiated and resulted in complete resolution of the clinical signs. In regular magnetic resonance imaging scans, the overall appearance of the lesions deteriorated but improved again after an increase in the imatinib mesylate dose. The patient had not shown any neurological signs until death and survived for 1052 days after initial presentation. On histopathological examination, the patient was diagnosed with disseminated granulomatous meningoencephalitis involving the cerebrum and brainstem. Immunohistochemical staining was performed on the five types of tyrosine kinase (PDGFR-α, PDGFR-ß, VEGFR-2, c-Kit and c-Abl proteins), which constitute therapeutic targets for conventional multitargeted tyrosine kinase inhibitors. The immunohistochemical analysis revealed that all these tyrosine kinases were expressed in the brain samples. The present report describes the first case of the use of imatinib mesylate therapy for granulomatous meningoencephalitis in the dog. Therapy with imatinib mesylate plus glucocorticoids appears promising as a new therapeutic intervention in meningoencephalitis of unknown aetiology.


2009 ◽  
Vol 22 (04) ◽  
pp. 332-335 ◽  
Author(s):  
N. M. Girard ◽  
J. O’Riordan ◽  
N. Fitzpatrick ◽  
T. J. Smith

SummaryIn this report, a case of cranial cruciate ligament (CrCL) rupture treated by tibial plateau levelling osteotomy (TPLO), in a 36-month-old male breeding alpaca, is described. The alpaca was presented with the complaint of acute onset of right pelvic limb lameness. The findings of our clinical and radiographic examinations were consistent with CrCL insufficiency of the right stifle joint. The right tibial plateau angle measured prior to surgery was 19°. A TPLO was performed and this eliminated cranial tibial thrust. Culture of a swab taken from the surgical site prior to wound closure was positive for Pseudomonas aeruginosa. Enrofloxacin was administered parenterally for two weeks postoperatively. There were not any clinical signs of infection noted. Outcome assessments included veterinary examination (two and six weeks) and owner assessment (28 months). At two weeks the animal walked with a grade 2/5 lameness, and at six weeks radiographic examination showed progression of bone healing at the site of tibial osteotomy. A return to full breeding fitness occurred by eight weeks after the surgery. The alpaca remained free from lameness 28 months later, according to the owner.


2021 ◽  
Vol 32 (6) ◽  
pp. 115-123
Author(s):  
Wesley Fernandes Gonçalves ◽  
Lucas da Fonseca Roberti Garcia ◽  
Daniela Peressoni Vieira-Schuldt ◽  
Eduardo Antunes Bortoluzzi ◽  
Luiz Carlos de Lima Dias-Júnior ◽  
...  

Abstract This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.


2021 ◽  
Vol 49 ◽  
Author(s):  
Daniel Munhoz Garcia Perez Neto ◽  
Leonardo Augusto Lopes Muzzi ◽  
Fernando Yoiti Kitamura Kawamoto ◽  
Caio Afonso dos Santos Malta ◽  
Laura Lourenço Freitas ◽  
...  

Background: Hip dysplasia (HD) is the most common non-traumatic orthopedic disease in large breed dogs. Treatment is chosen according to the severity of the condition, the age of the dog and the involvement of osteoarthritis (OA). For puppies up to 20-weeks-old, surgical treatment by the juvenile pubic symphysiodesis (JPS) technique can be performed. This procedure promotes the ventrolateral rotation of the acetabulum over the femoral head, which improves hip joint congruence and stability. The objective of this study is to report the case of a young dog with HD treated with JPS and pectineus myectomy. Clinical and radiographic outcomes were assessed for up to one year after surgery.Case: A 17-week-old Saint Bernard puppy was attended at the University Veterinary Hospital showing abnormal weight bearing and lameness in pelvic limbs, without history of previous trauma. On orthopedic examination, there was a marked hypotrophy of the pelvic limb muscles, severe pain and laxity in the hip joints, and positive feature in the Ortolani test. The hip joint subluxation angle (SA) and reduction angle (RA) were measured. A radiographic study was carried out to evaluate the hip joints and measure the Norberg angle (NA), distraction index (DI), acetabular angle (AA) and dorsal acetabular rim angle (DARA). The 20-week-old dog underwent surgical treatment by JPS technique. A ventral surgical approach to the pubis was performed and the pubic symphysis was cauterized with electrocautery. Partial pectineus myectomy technique was also performed. Drug therapy and restriction of physical activities were indicated in the early postoperative. The dog was evaluated by clinical and radiographic examinations at 4 months and 1 year after the surgical procedure. In the reassessment after 4 months of surgical treatment, the patient showed improvement in clinical signs, with mild lameness and absence of painful sensitivity in the movement of the hip joints. Radiographically, hip joint incongruity was observed, but with progressive improvement in the values of the measured variables. In the clinical examination 1 year after the procedure, the dog showed satisfactory weight bearing with slight lameness in pelvic limbs in the running gait. There was improvement in the thigh muscles and no painful signs were observed in the hip joints, but a positive result was detected in the Ortolani test. In the radiographic examination, bilateral articular incongruity was still observed, however, there was a mild improvement in the coverage of the acetabulum over the femoral head. The measured angles and indices showed favorable results regarding the recovery of hip joint stability and proper development.Discussion: Studies evaluating the JPS technique for the treatment of HD have shown to be a relatively simple and effective procedure, which allows altering the acetabular coverage, reducing the development of HD and the progression of OA. The need for an early diagnosis of this condition is essential, so that the JPS technique can be used in young dogs and offer effective results. In the present report, in the late postoperative period, the dog showed improvement in clinical signs, with favorable weight bearing and ambulation in pelvic limbs, recovery of limb muscles, absence of pain in the hip joints and decrease in RA and SA. Radiographically, the reduction in joint subluxation, improvement in acetabular coverage over femoral heads, increase in NA and AA, reduction in DI and DARA are evidence of the favorable outcome of ventrolateral rotation of the acetabulum after surgical treatment. The surgical technique used was effective, which enabled the dog to recover the functional use of the pelvic limbs and improve the quality of life.Keywords: hip dysplasia, juvenile pubic symphysiodesis, hip joint, osteoarthritis, dog.Título: Sinfisiodese púbica juvenil associada à miectomia do pectíneopara tratamento de displasia coxofemoral em cãoDescritores: displasia coxofemoral, sinfisiodese púbica juvenil, coxofemoral, osteoartrite.


2021 ◽  
Vol 49 ◽  
Author(s):  
Michelly Amanda Barssalho ◽  
Guilherme Henrique Fernandes Barranco ◽  
Karina Padula ◽  
Diego Alaska Almeida ◽  
Gracila Heitor de Oliveira ◽  
...  

Background: The giant anteater is considered a species vulnerable to trauma due to being slow and, therefore, vulnerable to long bone fractures, such as femoral fracture. Locking plates have the potential to restore and maintain fractured bone stability, as well as reduce damage to the vascular supply. This study aims at reporting cases of two giant anteaters subjected to femoral osteosynthesis using locking plates. Cases:Two giant anteaters presenting non-weight bearing lameness on the right pelvic limbs were evaluated, diagnosed with femoral fracture of unknown etiology and submitted to osteosynthesis. A clinical evaluation was performed under chemical restraint for the adult animal and physical restraint for the young one. Crepitation and swelling in the right femur topography led to a radiographic examination, which showed a complete and transverse diaphyseal fracture of the right femur in both cases. The first one was an adult male and was subjected to osteosynthesis of the right femur using a locking plate. Once anesthetized, the animal was placed in left lateral recumbency, and the right pelvic limb was clipped and sterilized. A craniolateral incision was made to expose the femoral diaphysis. A large amount of fibrous-looking tissue was found and removed. Subsequently, the fracture was reduced and the locking plate system was positioned on the craniolateral side of the femur. An osteotomy of the femoral trochanteric crest was required to position the implant. The overlying fascia lata was closed using monofilament suture in a simple continuous pattern. The closure of the subcutaneous tissue and skin was performed using a Cushing pattern and simple interrupted pattern, respectively. Immediate postoperative radiographic examinations showed fracture reduction and bone axis alignment, with a properly positioned implant. The surgical wound was cleaned daily with 0.5% aqueous chlorhexidine solution. Seven days after surgery, the animal had a partial dehiscence at the suture site, with bone and plate exposure. Wound healing by second intention was initiated. At 127 days after surgery, a radiographic examination showed periosteal bone proliferation in the middle third of the right femur and that the bone implants were well-positioned. The second case was of a young 3.68 kg female anteater. The surgery was performed as described for the adult one, but there was no fibrosis at the fracture site and the osteotomy of the femoral trochanteric crest was not required. Closure of the fascia lata, subcutaneous tissue, and skin was performed as in Case 1. An immediate postoperative radiographic examination showed fracture reduction, bone axis alignment, and a properly positioned implant. The surgical wound was cleaned daily with 0.5% aqueous chlorhexidine solution. On the day of the surgery, the animal could already bear weight on its right pelvic limb, presenting discrete lameness with gradual improvement. Twenty-three days after surgery, a radiographic examination showed moderate periosteal bone proliferation in the middle third of the right femur. The bone implant was still well-positioned and bone healing was achieved around the 40th post-operative day.Discussion:The cases are very similar, but the younger anteater's femoral trochanteric crest didn't prevent positioning the plate. The fibrosis observed on the adult specimen is indicative of a chronic fracture, which may explain, in conjunction with the post-surgical complications, the longer time required for bone healing in the adult animal. Even so, both animals recovered fully and it's safe to deduce that the locking plate is an adequate option for internal fixation in transverse diaphyseal femoral fractures in both adult and young giant anteaters.


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