Tibial tuberosity fracture as a complication of tibial tuberosity advancement

2014 ◽  
Vol 27 (02) ◽  
pp. 148-154 ◽  
Author(s):  
J. Aisa ◽  
D. Chase ◽  
P. Garcia-Fernandez ◽  
F. San Roman ◽  
D. Bennett ◽  
...  
Keyword(s):  
Medical Records ◽  
Incidental Finding ◽  
Weight Bearing ◽  
Sudden Onset ◽  
Tibial Tuberosity ◽  
Tibial Tuberosity Fracture ◽  
Long Term Follow Up ◽  
Surgical Group

SummaryTo retrospectively compare two clinical subsets of dogs suffering tibial tuberosity (TT) fracture (incidental finding or sudden onset severe lameness) as a complication of tibial tuberosity advancement (TTA) and to report the surgical management and outcome of TT fracture as a complication of TTA.The medical records of 10 dogs with eleven TT fractures or crest fractures after TTA were reviewed. The outcome and complications were determined from clinical and radiographic follow-up examinations. Limb function was evaluated between six and 12 weeks postoperatively. Owners were contacted by phone for long-term follow-up at least six months after the last examination.Four dogs required surgical stabilization and six dogs had conservative management. In the surgical group, every case experienced a sudden non-weight-bearing lameness after the initial TTA surgery. In three of the four cases an attempt was made to stabilize the TT and crest fracture while maintaining the TT advancement. Postoperative complications were encountered in three of the four surgically treated cases. Functional outcome was considered excellent in seven cases and good in the other three.Tibial tuberosity fracture is a complication of TTA that seems to have a favourable prognosis, although it can result in significant morbidity and in some cases revision surgery may be required.

The use of transarticular external skeletal fixation in the management of failed tibial tuberosity transposition in five dogs

2010 ◽  
Vol 23 (02) ◽  
pp. 109-113 ◽  
Author(s):  
A. Coughlan ◽  
R. Pettitt ◽  
N. MacDonald ◽  
J. Innes ◽  
M. Owen ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Tibial Tuberosity ◽  
Fracture Reduction ◽  
Bone Stock ◽  
Tibial Tuberosity Fracture ◽  
Long Term Follow Up ◽  
Fixation Techniques ◽  
Implant Size

SummaryThe management of tibial tuberosity fracture-avulsion after tibial tuberosity transposition can be challenging. Implants must be able to resist the strong distractive force of the quad-riceps mechanism, yet implant size is limited by the amount of tuberosity bone stock available. Revision fixation is compromised further by fragmentation of the tubercle. Five stifle joints had temporary transarticular external skeletal fixators applied to manage complications of tibial tuberosity transposition. Fracture reduction was confirmed in four out of five tibial tuberosity fractures. Frames were in place for a mean of 44 days. Frame associated complications occurred in four out of five limbs, the most common being pin tract discharge and associated osteolucency. All frame-associated complications resolved. Long-term follow-up information was available for three of the five animals at 13 to 18 months after frame removal. All three owners reported occasional lameness, but this was attributed to concurrent orthopaedic disease. Transarticular external skeleton fixation protects internal fixation techniques, and good limb function was achieved in most cases. Transarticular external skeleton fixation can be successfully used to augment repair of tibial tuberosity fracture after tibial tube-rosity transposition.

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

2021 ◽  
pp. 000348942110155
Author(s):  
Leonard Haller ◽  
Khush Mehul Kharidia ◽  
Caitlin Bertelsen ◽  
Jeffrey Wang ◽  
Karla O’Dell
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Assessment Tool ◽  
Demographic Data ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

scholarly journals Long-term assessment of a modified tibial tuberosity advancement technique in dogs

2018 ◽  
Vol 70 (4) ◽  
pp. 1053-1059 ◽  
Author(s):  
R.M. Medeiros ◽  
M.A.M. Silva ◽  
P.P.M. Teixeira ◽  
D.G. Chung ◽  
M.E.B.A.M. Conceição ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Positive Response ◽  
Tibial Tuberosity ◽  
Compression Tests ◽  
Radiographic Evidence ◽  
Long Term Follow Up

ABSTRACT The purpose of study was to assess long-term clinical and radiographic aspects of dogs’ stifle joints which had undergone a modified tibial tuberosity advancement technique (mTTA). A total of 15 stifles that had undergone mTTA for CCL disease of 11 patients were included in this study. Assessments involved patient’s gait analysis, cranial drawer and tibial compression tests, stifle goniometry range of articular motion, thigh and leg girth and radiographic evidence of progression of osteoarthrosis. Variables were compared between operated and healthy limbs and among moments (M0) on the early postop; (M1) 120 days postop; and (M2) approximately 5 years following surgery. A questionnaire regarding owner’s perceptions after approximately 5 years of surgery was assessed. Most dogs presented positive response to cranial drawer and tibial compression tests on operated knees. There was also decrease on goniometry and thigh girth and increase in leg girth. Radiographic evidence of progression of osteoarthritis was seen especially on the long-term follow-up (M2). On gait analysis, most animals presented some degree of lameness in different conditions, in contrast to owners’ perceptions. Osteoarthritis still develops in dogs following mTTA surgery for CCL disease. However, owners were overall satisfied with their recovery and would be willing to accept indication of mTTA for dogs with ruptured CCL.

scholarly journals Tibial Plateau Leveling Following Tibial Tuberosity Advancement: A Case Series

2022 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Daniele Serrani ◽  
Pierre Paul Picavet ◽  
Juan Marti ◽  
Bernard Bouvy ◽  
Marc Balligand ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Case Series ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Short Term ◽  
Long Term Follow Up ◽  
Persistent Instability

Persistent stifle instability is a recognized complication following tibial tuberosity advancement techniques (TTAT). The aim of this study is to report the feasibility and outcome of tibial plateau leveling techniques (TPLT) to treat dogs with persistent lameness, suspected to be secondary to persistent stifle instability, following (TTAT). Medical records of dogs presented for persistent lameness after TTAT were reviewed. Preoperative data included orthopedic examination, lameness score and radiographs. Inclusion criteria included performance of a surgery to address persistent lameness and suspected instability. Short-term follow up data included orthopedic examination and radiographs of the stifle. Long-term follow up was based on postoperative Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Seven dogs were included in the study. Mean subjective preoperative lameness score was 3 ± 1.53. Mean preoperative patellar ligament angle relative to the tibial plateau (PLATP) was 94° and mean tibial plateau angle (TPA) was 28°. Six dogs had tibial plateau leveling osteotomy and one had modified cranial closing wedge ostectomy. Mean postoperative PLATP was 79° and mean TPA was 5°. Mean subjective lameness score at follow up was 0.57 ± 0.49. Minor complications were present in 2 dogs and major complication in 1 dog. Mean LOAD questionnaire score was 6.6/52. TPLT can be performed after TTAT and may improve clinical function and stability in these cases in which persistent instability is suspected.

Single Transsacral Screw and Nut Stabilization of Bilateral Sacroiliac Luxation in 20 Cats

2018 ◽  
Vol 31 (01) ◽  
pp. 044-052 ◽  
Author(s):  
James Grierson ◽  
Andrew Moores ◽  
Andrea Pratesi
Keyword(s):  
Medical Records ◽  
Normal Activity ◽  
Width Ratio ◽  
Slight Reduction ◽  
Short Term ◽  
Canal Width ◽  
Long Term Follow Up ◽  
Safe Technique

Objective This article aims to describe the use of a single transsacral screw and nut in a cohort of cats with bilateral sacroiliac (SI) luxation and document its radiographic and clinical outcome. Methods Medical records and radiographic studies of cats with bilateral SI luxation managed with a transsacral screw and nut stabilization were reviewed. Short-term follow-up included clinical examination and radiographs. Long-term follow-up was via owner questionnaire. Results Twenty consecutive cats with bilateral SI luxation were included. Six cats (35%) had additional musculoskeletal injuries that required stabilization. Luxations were stabilized with a single 2.7 cortical self-tapping transsacral screw and nylon nut (a metallic nut was used in one case). Postoperative radiographs confirmed SI reduction in all cats and a mean pelvic canal width ratio of 1.21 (a ratio of ≥1.1 was considered optimal). All cats available at follow-up examination were able to walk without signs of discomfort. Evaluation of follow-up radiographs showed maintenance of SI reduction and slight reduction of mean pelvic canal width ratio (1.18). Fourteen owner questionnaires were returned (median follow-up time of 40 months): nine cats were deemed to have normal activity and five cats were reported to have slight to mild reduced ability to jump or run. Clinical Significance The use of transsacral screw and nut stabilization of bilateral SI luxation in cats is a successful, repeatable and safe technique.

scholarly journals Behavioral Problems of Pediatric Recovered Patients Infected with COVID-19 in Wuhan, China

2020 ◽  
Author(s):  
Han Xiao ◽  
Qi Liu ◽  
Hong Mei ◽  
Qi Xue ◽  
Xiaonan Cai ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Medical Records ◽  
Depression Symptoms ◽  
Emotional Symptoms ◽  
Related Information ◽  
Long Term Follow Up ◽  
Strengths And Difficulties ◽  
The Mean

Abstract Background: Coronavirus disease 2019 (COVID-19) is profoundly affecting lives around the globe, and up to now, a large of patients have clinically recovered from their initial illness. As the vulnerable population to adverse events, the effect of the COVID-19 outbreak on pediatric recovered patients are of great concern, but relevant researches are limited. We aimed to investigate the prevalence of behavioral problems among pediatric patients with COVID-19 infection after discharge. Methods: A total of 122 children who were suspected or confirmed COVID-19 cases and hospitalized for treatment were enrolled in the study between April 2020 and May 2020 in Wuhan, China. We collected related information about hospitalization and discharge for the children and emotional symptoms for their parents through electronic medical records and questionnaire. The behavioral problems for children were examined applying the parent-reported the Strengths and Difficulties Questionnaire (SDQ).Results: The participant children were discharged from hospital for about two months. Among them, 76 (62%) were boys, and the mean age were 6.71 years old. The highest prevalence of behavioral problems among pediatric children with COVID-19 was 15% (prosocial behavior), followed by 13% (total difficulties), 11% (emotional symptoms), 10% (hyperactivity), 9% (conduct problems), and 1% (peer problems). With regarding to their parents, 26% of them reported having anxiety symptoms and 23% having depression symptoms. Compared with children without anxious or depressive parents, the scores of SDQ were higher in children whose parents have emotional problems.Conclusions: The long-term follow up studies on the psychological and behavioral problems of children infected with COVID-19 and their parents are warranted.

Cranial tibial plating in the management of failed tibial tuberosity advancement in four large breed dogs

2014 ◽  
Vol 27 (03) ◽  
pp. 236-242 ◽  
Author(s):  
N. D. Lorenz ◽  
R. Pettitt
Keyword(s):  
Avulsion Fracture ◽  
Telephone Interview ◽  
Dynamic Compression ◽  
Tibial Tuberosity ◽  
Bone Stock ◽  
Radiographic Evidence ◽  
Mode Of Failure ◽  
Long Term Follow Up

SummaryThe management of failed surgical procedures involving osteotomy for tibial tuberosity advancement can be demanding due to the limited available bone stock, which must be large enough to counteract the powerful proximal and cranial distractive forces exerted by the quadriceps mechanism. Initial mode of failure may be related to implant failure, fracture of the tibial tuberosity, or a combination of both. The complications and management of the cases reported here were all associated with avulsion fracture of the tibial tuberosity following tibial tuberosity advancement. In all cases, a cranial tibial dynamic compression plate was applied to reduce the fractures and stabilize the osteotomy. No further major complications associated with the implants or fracture occurred. Radiographic evidence of progression of fracture healing was documented in all four cases at the six to eight-week postoperative follow-up. Long-term follow-up information was available for three out of four cases at nine to 23 months after surgery by telephone interview and validated owner questionnaires. Owners reported return to normal exercise with intermittent lameness occurring in two of the three cases. The authors concluded that this technique offers an alternative technique for the management of such fractures, in particular in large breed dogs where sufficient tibial tuberosity bone stock remains.

Prophylactic Gastropexy Incorporating a Gastrotomy Incision in Dogs: A Retrospective Study of 21 Cases (2011–2013)

2016 ◽  
Vol 52 (2) ◽  
pp. 115-118 ◽  
Author(s):  
Sarah Round ◽  
Catherine Popovitch
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Foreign Material ◽  
Long Term Follow Up ◽  
E Mail

The objective of this retrospective study was to report any complications associated with incorporating a gastrotomy incision into a right-sided incisional prophylactic gastropexy. The medical records of dogs that underwent a gastrotomy for the removal of gastric foreign material and had a prophylactic right-sided incisional gastropexy performed at the gastrotomy site between April 2011 and February 2013 were reviewed. Two wk postoperative recheck examination and suture removal reports were reviewed and owners were contacted via phone and e-mail for long-term follow-up. In total, 21 cases were reviewed, 19 with long-term follow-up. No complications of the surgery were reported. We concluded that a prophylactic right-sided incisional gastropexy could successfully be performed incorporating the gastrotomy site without significant complications.

scholarly journals Long-Term Complications after Surgical or Medical Treatment of Predominantly Forefoot Diabetic Foot Osteomyelitis: 1 Year Follow Up

2021 ◽  
Vol 10 (9) ◽  
pp. 1943
Author(s):  
Aroa Tardáguila-García ◽  
Yolanda García-Álvarez ◽  
Esther García-Morales ◽  
Mateo López-Moral ◽  
Irene Sanz-Corbalán ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Diabetic Foot ◽  
Prospective Observational Study ◽  
Group Versus ◽  
Medical Group ◽  
Long Term Follow Up ◽  
Surgical Group ◽  
Diabetic Foot Osteomyelitis

Aim: To compare long-term complications according to the treatment received for management of diabetic foot osteomyelitis (surgical or medical) at 1 year follow up. Design and Participants: A prospective observational study was conducted involving 116 patients with diabetic foot osteomyelitis. The patients received surgical or medical treatment based on the principles described in the literature. To register the development of a complication, both groups of treatments were followed-up 1 year after the ulcer had healed. Results: Ninety-six (82.8%) patients received surgical treatment and 20 (17.2%) medical treatment. No differences were found in the time to healing between both groups of treatment, 15.7 ± 9.2 weeks in the surgical group versus 16.4 ± 12.1 weeks in the medical group; p = 0.103. During follow up, 85 (73.3%) patients developed complications without differences between both groups, 68 (70.8%) in the surgical group versus 17 (85%) in the medical group (p = 0.193). The most common complication in both groups was re-ulceration. We did not observe significant differences comparing complication-free time survival between both treatments (p = 0.665). Conclusion: The onset of complications after healing in patients who suffered from diabetic foot osteomyelitis was not associated with the treatment received. Surgical and medical approaches to the management of diabetic foot osteomyelitis produced similar results in long-term follow up.

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