Partial scapulectomy for treatment of an articular fracture of the scapula in a cat

2011 ◽  
Vol 24 (06) ◽  
pp. 468-473 ◽  
Author(s):  
S. French ◽  
S. Nykamp ◽  
P. B. Ringwood ◽  
R. L. Plesman

SummaryA seven-month-old cat was referred, after having been missing for one week, for evaluation and treatment of a right forelimb injury and facial fractures. On physical examination, a moderate partial weight-bearing lameness of the right forelimb was present, with palpable crepitus in the glenohumeral joint. Dental radiographs revealed a midline palatal fracture and rostral fractures of the left maxillary canine alveolar bone. Radiographs of the right shoulder revealed a Type III or intraarticular fracture of the scapula with moderate displacement of the fracture at the articular surface. Early fibrous healing of the fracture was observed and the caudal aspect of the medial glenohumeral ligament was ruptured. Due to the chronicity, reduction and stabilization was not attempted. Instead, the caudal aspect of the medial glenohumeral ligament was incised along its origin and approximately 30% of the glenoid was removed. The caudal glenohumeral ligament was attached to the subscapularis muscle. Three years after surgery, the owner reported that the cat continued to experience no visible lameness and led an active lifestyle. This case report demonstrates that a partial caudal scapulectomy can result in full return of function of the forelimbs in cats with scapular fractures, especially when joint involvement is severe and the articular cartilage is affected. To the authors’ knowledge, this is the first report of a partial scapulectomy, utilized for fracture management, in the veterinary literature.

Author(s):  
Margaret L. Gourlay ◽  
Linda L. Gourlay

Abstract Because the pathophysiology of knee osteoarthritis is poorly understood, optimal evidence-based clinical management is uncertain. Sibling comparison studies can help inform a clinical model to guide preventive care. We compared the 8-year clinical outcomes in 2 sisters with a family history of osteoarthritis, normal BMI, and absence of knee pain at baseline. Both patients had Kellgren–Lawrence grade 1 in the affected knee at the time of twisting knee injuries leading to osteoarthritis diagnoses at age 50 (patient 1) and 51 (patient 2). Patient 1 developed a chronic right knee effusion, and progressed to Kellgren–Lawrence grade 3 bilaterally by the time she had a right total knee replacement at age 58. Patient 2 had subchondral fractures of the right knee with transient effusion, which healed after 1 year of partial weight-bearing with crutches and subsequent daily use of knee sleeves. Patient 2 had Kellgren–Lawrence grade 0 bilaterally upon surveillance imaging at age 58. The terms “osteoarthritis and knee and diagnostic imaging and subchondral bone and pathophysiology” were searched in the PubMed database to identify original research articles to inform a clinical model consistent with the patients’ outcomes. A fluid model of osteoarthritis was the best explanatory model for the discordant clinical trajectories of the age-matched siblings. Patient recommendations are presented based on these findings.


2009 ◽  
Vol 16 (2) ◽  
pp. 10-14
Author(s):  
N V Zagorodniy ◽  
E Sh Lomtatidze ◽  
Sergey Sergeevich Nikitin ◽  
A Yu Semenistyy ◽  
G V Fedoruk ◽  
...  

Outcomes of surgical treatment of 97 patients with intraarticular fractures of proximal tibial metaepiphysis were analyzed. In all patients internal osteosynthesis without arthrotomy and under either electro-optical transducer or arthroscopic control was performed. Cannulated screws and plates with angular stability were used for osteosynthesis. In fractures with impression of articular surface plasty of bone tissue defects using either autograft from the upper flaring portion of the ilium or -tricalcium phosphate was performed. In postoperative period partial weight bearing on the operated extremity was allowed starting from the 6th week. Complete weight bearing in fractures with impression was allowed in 10 week and in 6 weeks - in fractures without impression. Treatment results were followed up at terms from 6 to 70 months (mean - 35 months). Roentgenologic and functional evaluation was performed by Rusmussen and Resnik-Niwoyama systems. Achieved roentgenologic results were excellent in 57.7% of patients, good - in 24.7%, satisfactory - in 15.5% and unsatisfactory in 2.1% of patients. It was showed that at treatment of such fractures the application of modern fixators and arthroscopic control enabled to perform adequate reposition of the articular surface and visualize injuries of intraarticular structures. Plasty of subchondral bone defects and application of plates with angular stability eliminated the probability of secondary displacement of fragments thus creating the possibility of early functional treatment and rehabilitation.


2013 ◽  
Vol 26 (03) ◽  
pp. 233-237 ◽  
Author(s):  
N. Singh ◽  
T. Singh ◽  
A. Gopinathan ◽  
J. Mohindroo ◽  
K. Atri ◽  
...  

SummaryA two-and-half-year-old cow was presented with a defect nonunion of the right metatarsal III/IV bone following a severely comminuted open fracture two months previously. The animal underwent open fixation using a 4.5 mm, broad, 10-hole, dynamic compression plate and autogenous cancellous bone graft collected from the contralateral iliac shaft. The animal started partial weight bearing after the third postoperative day and resumed complete weight bearing after the 10th day. Fracture healing was complete and the implants were removed after the 120th postoperative day. Stable fixation by means of a bone plate in conjunction with a cancellous bone graft facilitated complete healing and restoration of the bone column of the defect and the metatarsal fracture. The animal made a complete recovery.


Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Matthias Meyer ◽  
Günther Maderbacher ◽  
Jan Reinhard ◽  
...  

Abstract Background Femoral component subsidence is a known risk factor for early failure of total hip arthroplasty (THA) using cementless stems. The aim of the study was to compare an enhanced recovery concept with early full weight-bearing rehabilitation and partial weight-bearing on stem subsidence. In addition, the influence of patient-related and anatomical risk factors on subsidence shall be assessed. Methods One hundred and fourteen patients underwent primary cementless THA and were retrospectively analyzed. Sixty-three patients had an enhanced recovery rehabilitation with early full weight-bearing and 51 patients had rehabilitation with partial weight-bearing (20 kg) for 6 weeks. Postoperative subsidence was analyzed on standing pelvic anterior–posterior radiographs after 4 weeks and 1 year. Subsidence was measured in mm. Anatomical and prosthetic risk factors (stem size, canal flare index, canal fill ratio as well as BMI and demographic data) were correlated. Results Femoral stem subsidence rate was significantly higher for the group with an enhanced recovery concept compared to the group with partial weight-bearing at the first radiological follow up after 4 weeks [2.54 mm (SD ± 1.86) vs. 1.55 mm (SD ± 1.80)] and the second radiological follow up after 1 year [3.43 mm (SD ± 2.24) vs. 1.94 (SD ± 2.16)] (p < 0.001, respectively). Stem angulation > 3° had a significant influence on subsidence. Canal flare index and canal fill ratio showed no significant correlation with subsidence as well as BMI and age. Conclusion In the present study, cementless stem subsidence was significantly higher in the group with enhanced recovery rehabilitation compared to partial weight-bearing. Small absolute values and differences were demonstrated and therefore possibly below clinical relevance. Anatomical radiological parameters and anthropometric data did not appear to be risk factors for stem subsidence.


2018 ◽  
Vol 4 (1) ◽  
pp. e000326 ◽  
Author(s):  
Stephen G Thompson ◽  
Rhodri D Phillip ◽  
Andrew Roberts

AimTo compare the interpretation of toe touch weight bearing (TTWB) and partial weight bearing (PWB) among orthopaedic surgeons, rehabilitation professionals and patients.Methodology78 consultant and middle-grade orthopaedic surgeons in the UK completed a questionnaire. 64 rehabilitation professionals (including physiotherapists) at Defence Medical Rehabilitation Centre Headley Court were also recruited. Both groups provided their interpretation of TTWB and PWB as a percentage of total body weight (%TBW). Each rehabilitation professional, then applied what they interpreted to be TTWB and PWB using a Lasar Posture weighing device. The predicted values were compared with the actual values demonstrated.ResultsThere was no significant difference between orthopaedic surgeons and rehabilitation professionals in their interpretation of TTWB and PWB, however there was a wide range of responses. There was a significant difference between the predicted %TBW and the actual values demonstrated by the ‘educated patient’ (mean difference 4.8 (TTWB) and 22.9 (PWB)).ConclusionHealthcare professionals vary greatly in their interpretation of the terms TTWB and PWB. Therefore, for a consistency in rehabilitation delivery the terms should not be used in isolation without a further descriptor. Static measures of weight application are lower than people think they are applying. We encourage the use of loading practice with a scale to reassure and educate patients.


SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 16 ◽  
Author(s):  
Hélder Fonte ◽  
Ricardo Rodrigues-Pinto

Introduction: Femoral neck stress fractures are uncommon and depending on their location, can be at high risk for non-union and significant morbidity.  Their prevalence is higher among runners and military recruits, and women seem to be at higher risk. Methods: A 27-year-old female, who was enrolled in military recruit, reported left side groin pain after a strenuous running exercise. Due to persistent pain an X-Ray was ordered, which revealed no signs of acute lesions. Further imaging studies with CT scan and MRI identified a compression-type femoral neck stress fracture. Results: The patient was submitted to conservative treatment consisting of restricting from full weight-bearing. Six weeks after she initiated partial weight-bearing, becoming asymptomatic at seven months. Follow-up imaging studies revealed union of the fracture. Discussion: This diagnosis should be considered when evaluating military and athlete populations. Early recognition of these injuries is crucial because complication and morbidity rates are high.


1970 ◽  
Vol 21 (2) ◽  
pp. 132-134
Author(s):  
Sayed Ahmed ◽  
Debashis Roy ◽  
S Uddin Ahmed ◽  
M Enamul Haque ◽  
Moshidur Rahman

From July 1998 to October 2004 forty-seven patients with open tendo-Achilles injuries were treated pull down the proximal tendon with no.1 prolene. In this surgical method no.1 prolene was threaded through the proximal tendon and the same suture material passed through the distal tendon and its bilateral ends were tightened over the rubber button either under the heel or by the sides of the heel. Box sutures apposed cut ends of the tendon. The ankle was placed in the cast in near neutral position. At six weeks the cast was removed and active flexion program was started. Partial weight bearing was allowed at seven weeks and full bearing was allowed at ten weeks after surgery. The average follow up period is 1.8 years. All the patients exhibited full range of motion at the final follow-up. doi: 10.3329/taj.v21i2.3792 TAJ 2008; 21(2): 132-134


2020 ◽  
Vol 140 (12) ◽  
pp. 1947-1954
Author(s):  
Johannes Becker ◽  
M. Winkler ◽  
C. von Rüden ◽  
E. Bliven ◽  
P. Augat ◽  
...  

Abstract Introduction Aim of this study was to biomechanically compare two different acetabular cup fixation constructs in terms of fracture fixation for displaced acetabular fractures involving the anterior column with hemitransverse fracture under partial and full weight-bearing conditions. Methods Two different reinforcement rings designed as cages for primary THA were biomechanically tested in terms of managing a complex acetabular fracture. Single-leg stance cyclic loading was performed to assess fracture gap movement and fragment rotation. Twelve hemi pelvis Sawbones were divided into two groups: primary THA with acetabulum roof reinforcement plate (ARRP) (n = 6) and primary THA with Burch–Schneider reinforcement cage (BSRC) (n = 6). Results During loading under partial weight-bearing (250 N) fracture gap movement tended to be larger in the BSRC group as compared to the ARRP group. Under full weight-bearing conditions, the ARRP showed 60% significantly less motion (p = 0.035) of the os ilium to os ischii gap compared to BSRC. Fracture gap movements between the os ilium and spina iliaca fragments were significantly reduced by 76% (p = 0.048) for ARRP in contrast to BSRC. The ARRP group also demonstrated significantly less movement in the fracture gaps os ischii to quadrilateral plate (62% reduction, p = 0.009) and quadrilateral plate to spina iliaca (87% reduction, p < 0.001). Significantly less rotational movement of the quadrilateral plate to the os ilium was exhibited by the ARRP group (p = 0.015). Conclusions The presented acetabulum roof-reinforcement plate (ARRP) provides stable conditions at the acetabular component with adequate stabilization of a displaced acetabular fracture.


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