Surgical correction of bilateral metacarpophalangeal valgus with curved osteotomies and type II external skeletal fixation in a seven-month-old alpaca

2016 ◽  
Vol 29 (05) ◽  
pp. 444-449
Author(s):  
Chase Whitfield ◽  
Mark Rochat ◽  
Robert Streeter ◽  
Kate Sippel ◽  
Mike Schoonover
Keyword(s):  
Weight Bearing ◽  
Favourable Outcome ◽  
Surgical Correction ◽  
Growth Potential ◽  
Type Ii ◽  
Intact Male ◽  
Limb Deformity ◽  
Axial Alignment ◽  
Metacarpal Bones ◽  
Limb Deformities

SummaryObjective: To report the successful surgical correction of severe bilateral metacarpophalangeal valgus angular limb deformities in a seven-month-old intact male alpaca cria using curved osteotomies stabilized with type II external skeletal fixation.Methods: Using a 21 mm crescentic shaped oscillating saw blade, bilateral osteotomies were performed in the distal metaphyses of the fused third and fourth metacarpal bones to correct valgus angular limb deformity of the metacarpophalangeal joints. Axial alignment of each limb was achieved by medially rotating the distal metacarpus in the frontal plane along the curved osteotomies. The osteotomies were stabilized using type II external skeletal fixators.Results: The alpaca was immediately weight-bearing following the surgical procedure and no to minimal lameness was observed during healing of the osteotomies. Evaluation at five and 10 months following the surgery demonstrated acceptable axial alignment in the left forelimb while moderate to severe varus deformity (overcorrection) was observed in the right.Clinical significance: Curved osteotomy of the distal metacarpus stabilized with type II external skeletal fixation can provide a favourable outcome in older alpaca crias affected with metacarpophalangeal angular limb deformities. Placement of the distal transfixation pins relative to the metacarpal physes should be carefully evaluated as over-correction is possible, especially if growth -potential remains in only one physis of the fused third and fourth metacarpal bones.

scholarly journals Report of an equine forelimb varus case

2017 ◽  
Vol 58 (2) ◽  
pp. 137
Author(s):  
N. DIAKAKIS (Ν.ΔΙΑΚΑΚΗΣ) ◽  
A. DESIRIS (Α. ΔΕΣΙΡΗΣ)
Keyword(s):  
Endochondral Ossification ◽  
Weight Bearing ◽  
Carpal Bones ◽  
Congenital Deformity ◽  
Limb Deformity ◽  
Contralateral Limb ◽  
Recommended Treatment ◽  
Metacarpal Bones ◽  
Limb Deformities ◽  
Growth Plate Injury

Angular limb deformities could be congenital oracquired and could result from: a) asymmetrical growth from the distal radial epiphysis, b) incomplete growth of the carpal bones, the second and fourth metacarpal bones and c) laxity of the carpal joints. The causes of these conditions are numerous. As far as congenital angular deformities are concerned, the cause may be due to intrauterine malposition, overnutrition of the mare in the latter half of pregnancy, joint laxity, twin pregnancy, short gestation period, defective endochondral ossification of the carpal bones or maldevelopment of the second and fourth metacarpal bones. Specifically for the defective endochondral ossification of the carpal bones, the condition is put down to placentitis or reduced uterine blood supply, which prohibits the development of the placenta. Moreover, others claim that toxic and hormonal factors pray a role in the aetiopathogenesis of the disease. As far as the acquired angular limb deformity is concerned, it can be due to growth plate injury, deterioration of an existing subtle congenital deformity, excessive contralateral limb weight bearing, over nutrition, improper trimming, excessive exercise or bad training and poor limb conformation. This report describes the case of a 15-month-old foal, which was admitted to the Veterinary Teaching Hospital, Faculty of Veterinary Medicine, A.U.Th. with bilateral forelimb varus, which was due to overfeeding of the animal. Based on the radiological findings and the age of the animal, the transection of the periosteum (periosteal stripping) from the concave side was the recommended treatment of choice. On re-examination, 4months post-operatively, carpal varus had resolved completely in both forelimbs.

Salter-Harris type II metacarpal and metatarsal fracture in three foals

2016 ◽  
Vol 29 (03) ◽  
pp. 239-245 ◽  
Author(s):  
Anton Fürst ◽  
Patrick Kircher ◽  
Katharina Kluge ◽  
Martin Kummer ◽  
Micaël Klopfenstein Bregger
Keyword(s):  
Bone Fractures ◽  
Metatarsal Bone ◽  
Growth Potential ◽  
Type Ii ◽  
Limb Deformity ◽  
Fluoroscopic Control ◽  
Metatarsal Fracture ◽  
Metatarsal Fractures ◽  
Salter Harris ◽  
Fracture Surgery

Summary Objectives: To describe minimally-invasive lag screw osteosynthesis combined with external coaptation for the treatment of Salter-Harris type II third metacarpal and third metatarsal bone fractures. Methods: Three foals aged two weeks to four months with a Salter-Harris type II third metacarpal or third metatarsal fracture. Surgery was carried out under general anaesthesia in lateral recumbency. After fracture reduction, the metaphyseal fragment was stabilized with two cortical screws placed in lag fashion under fluoroscopic control. A cast was applied for at least two weeks. Results: All foals had a good outcome with complete fracture healing and return to complete soundness without any angular limb deformity. All foals had moderate transient digital hyperextension after cast removal. Clinical significance: Internal fixation of Salter-Harris type II third metacarpal or third metatarsal fractures with two cortical screws in lag fashion, combined with external coaptation provided good stabilization and preserved the longitudinal growth potential of the injured physis.

scholarly journals Radiographic Recurrence of Hallux Valgus Based on Osteotomy Location

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Andrew Federer ◽  
Travis Dekker ◽  
David Tainter ◽  
Jordan Liles ◽  
Mark Easley ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Surgical Correction ◽  
P Value ◽  
Single Individual ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference

Category: Bunion Introduction/Purpose: Hallux valgus (HV) is one of the most common deformities of the foot resulting in pain and lifestyle modification of the patient. Recurrence rates of 10-47% have been documented in single individual osteotomy series. Unfortunately, surgical correction and recurrence are often defined as changes related to normal radiographs and not actually as the magnitude of correction lost with follow-up. Currently there have not been studies evaluating the percentage of recurrence of intermetatarsal angle (IMA) and hallux valgus angle (HVA). As there is substantial difference in starting IMA and HVA, as well as amount of surgical correction, our goal was to evaluate the percentage loss of correction over time comparing preoperative, initial postoperative and minimum of 2-year follow up radiographs among three different surgical correction techniques. Methods: This is a retrospective chart review study that examines the weight-bearing radiographic measurements of patients undergoing hallux valgus corrective surgery at a single institution over 5 years. Fifty-three patients were divided into first tarsometatarsal arthrodesis (i.e. Lapidus), mid-diaphyseal osteotomies (i.e. scarf), and distal metatarsal osteotomies (i.e. chevron). The preoperative, initial postoperative, and final follow up weight-bearing radiographs were measured for intermetatarsal angle (IMA) and hallux valgus angle (HVA). Primary outcome was percentage of recurrence of IMA and HVA, with the difference in angles between preoperative and initial postoperative weight-bearing films being considered 100% correction. The percentage of recurrence between initial postoperative and most recent follow up was then calculated (Figure 1A). A one-way analysis of variance (ANOVA) test and post-hoc Tukey-Kramer tests were used to compare preoperative IMA and HVA and percentage recurrence of IMA and HVA at most recent follow up. Results: There was no significant difference between Lapidus (14.3deg) and mid-diaphyseal osteotomies (12.7deg) in preoperative IMA (p-value=0.26). There was a significant difference between Lapidus (-0.3deg) and mid-diaphyseal (2.8deg) osteotomies for degree of hallux valgus recurrence as measured by IMA between initial postoperative films and final 2-year follow up (p-value=0.009). Lapidus procedure showed a greater magnitude decrease in IMA degrees from preoperation to final follow up compared to distal osteotomy (p-value=0.037) and trended toward significance compared to mid-diaphyseal (p-value=0.056). Mid-diaphyseal osteotomies (30%) showed a statistically significant higher percentage of IMA recurrence compared to Lapidus (-11%) (p-value=0.0014) (Figure 1B). When comparing percentage recurrence of HVA, distal osteotomies had a significantly smaller rate of recurrence when compared to the diaphyseal osteotomies (p-value=0.030). Conclusion: Though Lapidus and mid-diaphyseal osteotomies were performed for patients with a similar preoperative IMA, mid-diaphyseal osteotomies had a significantly higher percentage of recurrence at 2-year follow up compared to Lapidus procedures. Moreover, Lapidus procedures trended toward greater overall of IMA correction compared to mid-diaphyseal osteotomies. When either a Lapidus or mid-diaphyseal osteotomy is indicated, a Lapidus procedure may result in decreased rate of radiographic recurrence of hallux valgus at 2 years.

The responses of growing pigs, of different sex and genotype, to dietary energy and protein

1995 ◽  
Vol 60 (2) ◽  
pp. 291-298 ◽  
Author(s):  
M. F. Fuller ◽  
M. F. Franklin ◽  
R. McWilliam ◽  
K. Pennie
Keyword(s):  
Growing Pigs ◽  
Carcass Composition ◽  
Growth Potential ◽  
The Other ◽  
Daily Weight Gain ◽  
Dietary Energy ◽  
Intact Male ◽  
Body Protein ◽  
Low Protein ◽  
Lean Growth

AbstractIntact male pigs from two nucleus breeding herds (one predominantly Duroc, DM; the other purebred Large Wliite, LM) together with intact male (RM), castrated male (RC) and female (RF) commercial hybrid pigs were given one of two diets, with the same balanced protein (180 or 240 g/kg) at three daily rates, the highest being ‘to appetite‘. Six replicates of 30 pigs were allocated to these regimes at 40 kg: one replicate was slaughtered immediately to determine initial carcass composition; the remaining pigs were slaughtered at 85 kg when carcass fat and specific gravity (SG) were measured. For two replicates this was followed by dissection and chemical analysis: daily gains of carcass lipid and protein were estimated directly for these two replicates and predicted from carcass weight and SG for the other three. Fed ‘to appetite’, castrated males and females ate more than males; LM pigs ate least. All males grew faster than females or castrated males, the DM pigs the fastest, these rankings being relatively insensitive to feeding level. However, both in daily weight gain and daily protein accretion only the males responded to additional dietary protein. Daily body protein accretion of DM pigs increased linearly with intake on both diets whereas LM pigs showed little response to the highest level of feeding. At the same daily protein intake all pigs had higher rates of body protein accretion on the low protein diet, showing that they were sensitive to additional dietary energy. Results indicate that an animal's superiority may result from a greater efficiency of protein utilization or a higher lean growth potential but that these two characteristics are not simply related.

A modified Bell-Tawse Proceduter for surgical correction of congenital elbow luxation in a Dalmatian puppy

2001 ◽  
Vol 14 (04) ◽  
pp. 210-213 ◽  
Author(s):  
N. Romagnoli ◽  
A. Venturini ◽  
A. Spadari
Keyword(s):  
Contact Surface ◽  
Radial Head ◽  
Ligament Reconstruction ◽  
Weight Bearing ◽  
Surgical Correction ◽  
Annular Ligament ◽  
Orthopaedic Procedure ◽  
Elbow Luxation ◽  
Annular Ligament Reconstruction ◽  
The Right

SummaryA four month old Dalmatian puppy affected by congenital luxation of the radial head was very lame on the right front limb and was not weight bearing after little exercise. The radiological examination revealed humero-radial articular incongruity, excessive humeral trochlea development, trochlear notch deformation, and medial deviation of the olecranon. The surgery performed was derived from a modification of a human orthopaedic procedure, the Bell-Tawse technique. It was intended to increase the articular contact surface between the humerus and radius, with ostectomy, rotation, and osteosynthesis of the radius; to treat the luxation, by reduction and elbow annular ligament reconstruction; to prevent its recurrence, by means of a Kirschner pin inserted through the lateral humeral epicondyle to the radial head. Over six months the patient completely recovered.A congenital luxation of the radial head in a puppy was treated successfully employing a technique reported in human orthopaedics.

Bilateral tibial agenesis and syndactyly in a cat

2016 ◽  
Vol 29 (04) ◽  
pp. 277-282
Author(s):  
Carla Murino ◽  
Giovanni Della Valle ◽  
Gerardo Fatone ◽  
Francesco Di Dona
Keyword(s):  
Congenital Anomaly ◽  
Clinical Findings ◽  
Abnormal Development ◽  
Case Description ◽  
Limb Deformity ◽  
Radiographic Findings ◽  
Limb Deformities ◽  
Congenital Limb ◽  
Pelvic Limb ◽  
Congenital Limb Deformities

SummaryCase description: A three-year-old cat was referred to the Veterinary Teaching Hospital, University of Naples, Italy. The cat had severe pelvic limb deformity, and abnormal development of all four paws.Clinical findings: Radiographs revealed bilateral tibial agenesis, syndactyly, and digital hypoplasia.Treatment and outcome: No treatment was instituted because of the severity of the injury, the adaptation of the cat to the abnormal condition, and the owner's refusal to permit any treatment.Clinical relevance: Congenital limb deformities are rarely reported in the cat and tibial agenesis is considered a very rare disease. This congenital anomaly is well documented and classified in man, and it has been associated with other abnormalities in more complex syndromes. This paper reports clinical and radiographic findings in a cat affected by bilateral complete tibial agenesis associated with other congenital anomalies.

Surgical correction of a congenital preputial and penile deformity in a dog

2001 ◽  
Vol 37 (2) ◽  
pp. 187-192 ◽  
Author(s):  
D Olsen ◽  
R Salwei
Keyword(s):  
Surgical Correction ◽  
Intact Male ◽  
Dorsal Wall ◽  
Surgical Exploration ◽  
Initial Surgery

An 11-month-old, intact male Great Pyrenees was presented for recurrent, nonpainful accumulation of suppurative fluid within the prepuce. Surgical exploration revealed a continuation of the urethral mucosa with the cutaneous epidermis of the prepuce, thus creating a closed preputial cavity surrounding the penis where fluid could accumulate. A persistent frenulum and a previously undescribed tissue remnant connecting the dorsal and distal aspects of the penis to the dorsal wall of the prepuce were also present. Surgical correction of the preputial and penile deformity, along with correction of the resulting paraphimosis and pendulous prepuce that became apparent following the initial surgery, are discussed.

scholarly journals The analysis report of surgical treatment of limb deformity and disability: 35,075 cases

2021 ◽  
Vol 27 (3) ◽  
pp. 331-336
Author(s):  
J. Zang ◽  
◽  
S. Qin ◽  
◽  
◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Central Government ◽  
Regional Distribution ◽  
Population Characteristics ◽  
Congenital Talipes Equinovarus ◽  
Limb Deformity ◽  
Tendon Lengthening ◽  
Surgical Methods ◽  
Talipes Equinovarus ◽  
Limb Deformities

Objective To investigate the incidence characteristics and corrective strategies of various limb deformities treated by Qinsihe orthopaedic team in the past 40 years, so as to provide a large sample for understanding the causes, types and treatment methods of limb deformity and disability in China. Method A total of 35,075 cases were treated by Qinsihe orthopaedic team from May 1978 to December 2018. The age, gender, deformity characteristics, etiological and pathological composition, regional distribution and surgical methods of the patients were statistically analyzed. Results There were 20,458 males and 14,617 females. The age was 1 year to 82 years old, average 20.5 years. The majority of subjects were from 11 to 25 years old or 19,363 cases (63 %). There were 33,259 cases (94.82 %) of interventions on lower extremity. The geographical distribution of patients covers all the provinces, municipalities directly under the central government, autonomous regions in China and 12 foreign countries. There were 202 etiologies involving neurological, heredity, metabolism, traumatic sequelae, congenital, vascular, lymphoid, skin, endocrine, iatrogenic and so on. The top six deformities were due to poliomyelitis sequelae, cerebral palsy, traumatic sequelae, spondylolysis sequelae, genu varus&valgus, congenital talipes equinovarus. There were 280 kinds of surgical methods, the majority of which were Achilles tendon lengthening, supracondylar osteotomy, subtalar joint arthrodesis, tibiofibular osteotomy, metatarsal aponeurosis and Achilles tendon replacement of peroneal longus muscle, etc. 8,702 cases were treated by orthopedic surgery combined with external fixation, including the Ilizarov fixator in 3,696 cases and hybrid fixator in 5,006 cases. Conclusion Qinsihe orthopaedic database with a history of 40 years is the largest one of limb deformity and disability in China. It reflects the etiology, type, population characteristics, surgical methods and strategy of limb disability and deformity, which can be treated by orthopaedic surgery. The data is a great treasure for orthopaedics and disability medicine in China and worldwide, and its important academic value and historical significance need to be further excavated and deep studied in future.

scholarly journals "MORIEF Technique" for Schatzker Type II–III Tibial Plateau Fractures with Tension Blisters: A Retrospective Study of Seven Patients

2021 ◽  
Author(s):  
Xin Qi ◽  
Yong-Qing Xu ◽  
Hong-Bo Tan ◽  
Shen Xia ◽  
Xiao-Yan Xu ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Weight Bearing ◽  
Clinical Score ◽  
Tibial Plateau Fractures ◽  
Functional Score ◽  
Type Ii ◽  
Joint Function ◽  
Schatzker Type ◽  
Needle Tract

Abstract Background: When tibial plateau fractures are combined with tension blisters, internal fixation surgery must be delayed. However, a prolonged delay may cause complications during fracture treatment. To combat this challenge, we innovatively proposed a minimally open reduction and Ilizarov external fixation (MORIEF) technology. Therefore, the present study aimed to explore the treatment, safety, and efficacy of the MORIEF technique in Schatzker type II–III tibial plateau fractures with tension blisters.Methods: We retrospectively analyzed data of seven patients with Schatzker type II–III tibial plateau fractures with tension blisters treated at our hospital from September 2013 to March 2017. All patients (five males, two females; mean age: 38.1±8.2 [range: 28–50] years) underwent the MORIEF technique. The Knee Society Score (KSS) and assessment of bone status according to the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system were used to evaluate the knee joint function and bone healing condition.Results: The operative time was 108.6±14.6 (range: 90–135) min, blood loss was 104.3±50.4 (range: 50–200) ml, time from operation to discharge was 2.6±0.7 (range: 2–4) days, and the follow-up period was 20.6±1.8 (range: 18–22) weeks. The fractures healed in all patients at 11.9±1.1 (range: 10–14) weeks. Except for one case of needle tract infection, no other complications occurred. At the last follow-up, the KSS presented a clinical score of 80–95 (mean: 86.4±4.4) points and a functional score of 85–95 (mean: 87.9±3.6) points. According to ASAMI, four cases were classified as excellent, two as good, one as fair, and none as poor.Conclusions: The use of the MORIEF technology for the treatment of Schatzker type II–III tibial plateau fractures with tension blisters showed that the resulting incidence of infection is low, weight-bearing and walking can be resumed immediately, hospitalization time is shortened, economic burden of patients is reduced, and fracture healing and joint function recovery are not affected postoperatively. Therefore, this technique was shown to be a relatively safe and effective treatment method for the condition.

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