The Minimally Invasive Reduction Instrumentation System (MIRIS) was utilized to facilitate minima... more The Minimally Invasive Reduction Instrumentation System (MIRIS) was utilized to facilitate minimally invasive plate osteosynthesis (MIPO) of distal limb diaphyseal comminuted fractures (2 crural, 1 antebrachial) in three dogs. The MIRIS facilitated efficient MIPO in all three fractures. Radial and tibial lengths were restored within 2% of the length of the intact bone and postoperative frontal and sagittal plane angulation were within 3° of the normal contralateral limb for each of the fractures. Fixation failed in one of the tibial fractures when the plates bent a week following surgery. The implants were removed and the fracture was restabilized via MIPO facilitated by the MIRIS. Inappropriate implant selection was considered the primary reason for implant failure. All three fractures achieved union by 10 weeks following surgery. The dog that underwent revision surgery developed a surgical site infection 5 months following revision surgery, which necessitated implant removal. All ...
Olecranon fractures in dogs are often both comminuted and intra-articular. Anatomic reduction and... more Olecranon fractures in dogs are often both comminuted and intra-articular. Anatomic reduction and stable internal fixation are thus paramount to achieving primary bone healing and mitigating the development of posttraumatic osteoarthritis. Intraoperative fluoroscopy can be useful to confirm accurate fracture reduction and facilitate precise implant placement, potentially reducing the surgical exposure required and additional trauma. Despite widespread use in human surgery, reports of fluoroscopic-assisted fracture repair in dogs are limited. Presented here are three dogs in which intraoperative fluoroscopy was used to facilitate accurate olecranon fracture reduction and implant positioning. The olecranon fractures appeared to heal by primary bone union, although the anconeal process failed to obtain osseous union in one dog. Despite the development of mild-to-moderate osteoarthritis in all three dogs, and the nonunion of the anconeal process in one dog, the clinical outcome was cons...
The Canadian veterinary journal = La revue veterinaire canadienne, 2017
Two dogs with spontaneous luxation of the long digital extensor tendon of origin were managed by ... more Two dogs with spontaneous luxation of the long digital extensor tendon of origin were managed by performing a sulcoplasty and applying a plate bridging the extensor sulcus. Lameness resolved and neither dog had recurrence of lameness 59 and 15 months following surgery.
To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2... more To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2.7 mm reconstruction plate as adjunctive epicondylar stabilization in simulated comminuted lateral unicondylar humeral fractures stabilized with a transcondylar 4.5 mm cortical screw. Cadaveric biomechanical assessment. Paired humeri harvested from 9 young, skeletally mature dogs. Simulated comminuted lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a 1.6 mm Kirschner wire on one side, and a 2.7 mm reconstruction plate on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and load to failure were obtained from the load-deformation curves. Stiffness (mean ± SD: 577 ± 245 vs 310 ± 71 N/mm; P = .01), yield load (mean ± SD: 2389 ± 572 vs 1017 N ± 292; P = .0002), and load at failure (mean ± SD: 3351 ±...
Background: Fractures of the distal femoral physis are the most common physeal fracture sustained... more Background: Fractures of the distal femoral physis are the most common physeal fracture sustained by skeletally immature dogs. Reduction and stabilization of these fractures can sometimes be achieved through closed reduction, primarily in fractures that are nominally displaced. Circular external fixator constructs have been used to assist in indirect, closed reduction of fractures at other anatomic locations in dogs and this report describes application of this method to reduce a displaced Salter-Harris type II fracture of the distal femur in a 1-year-old dog. Case Description: A 1-year-old female spayed Akita was referred for treatment of a Salter-Harris type II fracture of the right distal femur. The epiphyseal segment was laterally and slightly caudally displaced. Multiple attempts to manually reduce the fracture during surgery were unsuccessful, so a two-ring circular external fixator construct was applied to facilitate distraction and reduction. The construct was applied by pla...
Background: Cranial luxation of the scapulohumeral has been rarely reported in dogs and there is ... more Background: Cranial luxation of the scapulohumeral has been rarely reported in dogs and there is limited information available regarding surgical management of this condition, particularly with respect to long-term functional outcomes. Case Description: This report describes the successful resolution of a chronic traumatic cranial scapulohumeral joint luxation in a dog that was stabilized by cranial transposition of the biceps brachii tendon of origin. At surgery, an osteotomy of the greater tubercle was performed and a trough was made in the exposed bed of the osteotomy. The transverse humeral ligament was incised, and the bicipital tendon was levered into the trough and secured in that location by reattachment of the greater tubercle using multiple Kirschner wires and a figure-of-eight tension band wire. Postoperatively, the dog was maintained in a Spica splint for 2 weeks. Although surgical reduction was performed 4 months after the original injury, the luxation did not recur and...
OBJECTIVE:This study evaluated the proficiency in executing closed, fluoroscopic-assisted reducti... more OBJECTIVE:This study evaluated the proficiency in executing closed, fluoroscopic-assisted reduction of unicondylar humeral fractures. The following were hypothesised: experienced surgeons would be highly successful in performing closed reduction; body weight, time to surgery and surgeon experience would influence the reduction method; and the reduction method would not affect technical aspects of the repair. METHODS: All unicondylar humeral fractures stabilised between January 2007 and January 2017 were reviewed. Signalment and time to surgery, experience of the attending surgeon, and the initial and definitive reduction methods were recorded. Initial and subsequent postoperative radiographs were used to assess fracture reduction, implant placement and complications. Univariate polychotomous logistic regressions, Fisher's exact test, Kruskal-Wallis rank sums non-parametric test or equivalence tests were used to compare parameters evaluated based on the approach employed (P < 0.05 significant). RESULTS:A total of 36 dogs with 37 fractures were identified (median weight: 5.4 kg; median time to surgery: 3 days). Of these, 11 of 15 attempted closed reductions were successful. Successful closed reductions had shorter times to surgery than limited open or open reductions (P = 0.009). Age, weight and surgeon experience did not influence the definitive reduction method. Technical aspects of reduction and stabilisation were similar among the reduction methods. Surgery times were shorter for closed reductions (P = 0.034). Of the fractures, 75% healed without complications and 85% had excellent long-term function. CONCLUSION: The results suggested that closed, fluoroscopic-assisted reduction is a proficient (73% successful) and efficient (shorter surgery times with comparable technical results compared with other limited open and open reduction) means of stabilising acute unicondylar humeral fractures.
A three-and-a-half-year-old neutered male Standard Schnauzer presented with a 5-week history of i... more A three-and-a-half-year-old neutered male Standard Schnauzer presented with a 5-week history of inability to bear full weight on the right pelvic limb following a traumatic injury to the right stifle. Clinical, radiographic, and ultrasound findings were consistent with a proximal patellar tendon rupture with a distal patellar avulsion fragment. A proprietary Achilles repair jig system was used to reattach the patellar tendon to the patella, allowing for direct approximation of the tissues. The primary repair was supported with a protective patella-to-tibia suture, and the dog was fitted with an orthosis to restrict range of motion of the stifle. Primary tendon repair using alternative suture materials and suture placement, in conjunction with a protective suture loop and transient stifle immobilization, allowed for a successful outcome without appreciable lameness at a final evaluation 3.6 years after presentation. The dog in this report was successfully treated with a modified prop...
Bone healing and assessment of the state of bone bridging is an important part of clinical orthop... more Bone healing and assessment of the state of bone bridging is an important part of clinical orthopedics, whether for fracture healing or for follow up of osteotomy procedures. Tibial tuberosity advancement (TTA) is designed to restore stability in cruciate deficient stifle joints by advancing the tuberosity while creating an osteotomy gap. The current study aims to: 1) compare three different imaging modalities to assess bone healing: ultrasound, radiographs and computed tomography (CT) and, to 2) compare the effect of a gelatinous matrix (GM) versus a demineralized bone matrix mix (DBM mix) on bone healing and bridging of this osteotomy gap in 10 otherwise healthy client-owned dogs with cranial cruciate ligament insufficiency. Osseous union of the osteotomy gap was evaluated with ultrasound, radiographs and CT at one, two, and 3 months postoperatively. Dogs were randomly selected to receive GM or DBM mix to fill the osteotomy gap created during the TTA procedure. Bone healing was as...
Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause... more Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause of pelvic limb lameness and osteoarthritis in dogs. Surgical therapies developed to treat dogs with naturally occurring CrCL insufficiency aim to address the resultant instability, but the in-vivo alterations in stifle kinematics associated with CrCL insufficiency have not been accurately defined. The objective of this study was to quantify the 3-dimensional femorotibial joint kinematics of dogs with naturally occurring cranial cruciate ligament (CrCL) insufficiency during ambulation. Eighteen client-owned dogs (20-40 kg) with natural unilateral complete CrCL rupture were included. Computed tomographic scans were used to create digital 3-dimensional models of the femur and tibia bilaterally for each dog. Lateral fluoroscopic images were obtained during treadmill walking and 3 complete gait cycles were analyzed. Stifle flexion/extension angle, craniocaudal translation, and internal/exter...
Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause... more Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause of pelvic limb lameness and osteoarthritis in dogs. Surgical therapies developed to treat dogs with naturally occurring CrCL insufficiency aim to address the resultant instability, but the in-vivo alterations in stifle kinematics associated with CrCL insufficiency have not been accurately defined. The objective of this study was to quantify the 3-dimensional femorotibial joint kinematics of dogs with naturally occurring cranial cruciate ligament (CrCL) insufficiency during ambulation. Eighteen client-owned dogs (20-40 kg) with natural unilateral complete CrCL rupture were included. Computed tomographic scans were used to create digital 3-dimensional models of the femur and tibia bilaterally for each dog. Lateral fluoroscopic images were obtained during treadmill walking and 3 complete gait cycles were analyzed. Stifle flexion/extension angle, craniocaudal translation, and internal/exter...
To determine how American College of Veterinary Surgeons (ACVS) small animal surgery residency pr... more To determine how American College of Veterinary Surgeons (ACVS) small animal surgery residency programs are teaching and assessing technical skills, and ascertain the perceived value of those methods. Internet-based survey. Residents and Diplomate supervisors of ACVS small animal residency programs. Residents and supervisors were surveyed on their experience of surgery instruction, use of different resources for teaching, type and frequency of feedback, and perceived effectiveness of their programs in imparting technical proficiency. A total of 130 residents (62%) and 119 supervisors (44%) participated. Both residents and supervisors estimated the resident was the primary surgeon for a mean of 64% of cases, although this proportion varied widely between participants. The majority of residents and supervisors considered that direct intraoperative guidance was the most effective way for residents to develop technical skills. Verbal interactions between supervisor and resident occurred...
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, Jan 18, 2015
The canine knee is morphologically similar to the human knee and thus dogs have been used in expe... more The canine knee is morphologically similar to the human knee and thus dogs have been used in experimental models to study human knee pathology. To date, there is limited data of normal canine 3D knee kinematics during daily activities. The objective of this study was to characterize 3D in-vivo femorotibial kinematics in normal dogs during commonly performed daily activities. Using single-plane fluoroscopy, six normal dogs were imaged performing walk, trot, sit, and stair ascent activities. CT-generated bone models were used for kinematic measurement using a 3D-to-2D model registration technique. Increasing knee flexion angle was typically associated with increasing tibial internal rotation, abduction and anterior translation during all four activities. The precise relationship between flexion angle and these movements varied both within and between activities. Significant differences in axial rotation and coronal angulation were found at the same flexion angle during different phase...
Twenty-four dogs underwent unilateral excision of the femoral head and neck. An adjunctive biceps... more Twenty-four dogs underwent unilateral excision of the femoral head and neck. An adjunctive biceps femoris muscle sling procedure was done in 16 dogs. In eight dogs (controls), the flap was dissected and returned to its original position. Four dogs with muscle slings were euthanatized on days 2,5,30, and 60, respectively. Four control dogs were euthanatized on day 2 and four dogs on day 5. Limb function did not differ consistently between dogs with muscle slings and control dogs. There was marked swelling and edema of the affected limb in half the dogs with muscle slings but not in the controls. Postoperative temperature elevations were significantly higher in dogs with muscle slings on days 1 and 2 (p < 0.05). Infection was documented in four dogs with mugcle slings. Flaps from control dogs had only minor gross and histologic abnormalities. On days 2 and 5, flaps from dogs with muscle slings appeared congested and swollen beneath and distal to the ostectomy site, with infarction involving 50 to 90% of the muscle mass. On days 30 and 60, the muscle slings were atrophic and fibrous, and by day 60 a synovial membrane covered the surfaces of all slings within the pseudarthrosis. Muscle fiber loss was attributed to infarction, necrosis, and disuse atrophy. XCISION OF THE FEMORAL head and neck is COmE monly used in small animals to relieve pain and salvage limb function when there is irreparable damage to the coxofemoral joint.' The clinical results are reported to be good to excellent in animals weighing less than 20 kg; however, results are less consistent in larger dog^.^-^ Decreased efficacy has been attributed to a greater body mass driving the femoral shaft into the acetabular rim.7 The biceps femoris muscle sling was developed to improve limb function after excision arthroplasty by preventing pain caused by bone-to-bone ont tact.^ In this
To determine effects of increased dietary protein and decreased dietary carbohydrate on hematolog... more To determine effects of increased dietary protein and decreased dietary carbohydrate on hematologic variables, body composition, and racing performance in Greyhounds. 8 adult Greyhounds. Dogs were fed a high-protein (HP; 37% metabolizable-energy [ME] protein, 33% ME fat, 30% ME carbohydrate) or moderate-protein (MP; 24% ME protein, 33% ME fat, 43% ME carbohydrate) extruded diet for 11 weeks. Dogs subsequently were fed the other diet for 11 weeks (crossover design). Dogs raced a distance of 500 m twice weekly. Rectal temperature, hematologic variables before and after racing, plasma volume, total body water, body weight, average weekly food intake, and race times were measured at the end of each diet period. When dogs were fed the MP diet, compared with the HP diet, values (mean +/- SD) differed significantly for race time (32.43 +/- 0.48 vs 32.61 +/- 0.50 seconds), body weight (32.8 +/- 2.5 vs 32.2 +/- 2.9 kg), Hct before (56 +/- 4 vs 54 +/- 6%) and after (67 +/- 3 vs 64 +/- 8%) racing, and glucose (131 +/- 16 vs 151 +/- 27 mg/dl) and triglyceride (128 +/- 17 vs 104 +/- 28 mg/dl) concentrations after racing. Greyhounds were 0.18 seconds slower (equivalent to 0.08 m/s or 2.6 m) over a distance of 500 m when fed a diet with increased protein and decreased carbohydrate. Improved performance attributed to feeding meat to racing Greyhounds apparently is not attributable to increased dietary protein and decreased dietary carbohydrate.
T he thyroid hormones thyroxine (T 4), triiodothyronine (T 3), and thyroid stimulating hormone (T... more T he thyroid hormones thyroxine (T 4), triiodothyronine (T 3), and thyroid stimulating hormone (TSH) regulate and are regulated by metabolic rate. Exercise alters metabolic rate. The effect of exercise and training on serum concentrations of thyroid hormones has, therefore, been investigated in many species including humans, rodents, dogs, and horses. However, results from these studies have varied with the intensity and duration of exercise, 1,2 the amount of training, 3,4 the adequacy of energy intake, 4,5 and the time when blood was sampled. 6,7 Results from studies in which the effect of training on thyroid hormones was examined were also varied; some revealed that thyroid hormone concentrations change with training, 3 whereas others have not. 8,9 In sled dogs that underwent severe endurance exercise during an Iditerod race, there was no change in total or free T 4 and total or free T 3 concentrations before or after the race. 10 In 1 study, resting total T 4 concentrations were slightly (13%) lower in Beagles undergoing long-distance aerobic exercise on a treadmill, compared with sedentary dogs, but there was no change in free T 4 or total T 3 concentrations. 11 To date, however, the authors are unaware of any studies of the effect of racing on thyroid hormones in Greyhounds. Resting serum T 4 concentrations appear to be lower in Greyhounds than in other breeds of dogs, 12,a and it is possible that thyroid hormone concentrations may be affected differently after a short sprint race than after endurance exercise. Therefore, the purpose of the study reported here was to measure the effect of racing and training on thyroid hormone and TSH concentrations in racing Greyhounds. Materials and Methods Dogs-Nine Greyhounds (5 females, 4 males) 2.6 to 4.6 years of age and weighing 26 to 35 kg were used for this study. These dogs had been trained to chase a lure on a racetrack and were donated by Greyhound breeding kennels. All dogs were considered to be in good health on the basis of results of physical examination, CBC, serum biochemical analysis, and urinalysis. Dogs were cared for as previously described 13 and according to the principles outlined in the NIH guide for the care of laboratory animals 14 ; the study protocol was approved by the Institutional Animal Care and Use Committee at the University of Florida. All dogs were housed in 1.4 X 1.9-m cages in a room with a 12-hour light:dark cycle, a constant temperature of 24 C, and 13 to 18 air changes/h. All dogs were exercised for 15 minutes twice daily in a 30 X 30-m grass paddock and raced in pairs up to twice a week at this facility for 6 months prior to this experiment. Each race was 500 m (five-sixteenths of a mile) in length and was performed on a 400-m (quarter mile) oval soft sand-clay track with 10 o banking on the corners. Dogs chased a mechanical lure maintained 10 to 20 m in front of the lead dog. Dogs were randomly assigned to race and starting position. Dogs were fed an extruded dry com
An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III... more An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of the caudal aspect of the proximal tibial physis, secondary to the proximal physeal fracture, resulted in an excessively high tibial plateau angle (TPA) of 50° with a limb length discrepancy of 13% by 24 weeks of age. The deformity was addressed by performing a proximal tibial osteotomy and subsequent distraction osteogenesis to reduce the TPA while concurrently lengthening the crus. A radial osteotomy was performed in the proximal metaphyseal region and the hinged fixator was applied. Distraction was initiated the day following surgery at a rate of 1 mm per day as measured along the caudal cortex of the tibia with a rhythm of three distractions daily. Distraction was terminated 19 days po...
Vacuum-assisted closure (VAC) is a wound management therapy that creates local negative pressure ... more Vacuum-assisted closure (VAC) is a wound management therapy that creates local negative pressure over a wound bed to promote healing. Benefits of VAC therapy include removal of fluid from the extravascular space, improved circulation, enhanced granulation tissue formation, increased bacterial clearance, and hastening of wound closure. This article describes the mechanism of action of VAC therapy, reviews application techniques, and lists potential complications and contraindications.
The Minimally Invasive Reduction Instrumentation System (MIRIS) was utilized to facilitate minima... more The Minimally Invasive Reduction Instrumentation System (MIRIS) was utilized to facilitate minimally invasive plate osteosynthesis (MIPO) of distal limb diaphyseal comminuted fractures (2 crural, 1 antebrachial) in three dogs. The MIRIS facilitated efficient MIPO in all three fractures. Radial and tibial lengths were restored within 2% of the length of the intact bone and postoperative frontal and sagittal plane angulation were within 3° of the normal contralateral limb for each of the fractures. Fixation failed in one of the tibial fractures when the plates bent a week following surgery. The implants were removed and the fracture was restabilized via MIPO facilitated by the MIRIS. Inappropriate implant selection was considered the primary reason for implant failure. All three fractures achieved union by 10 weeks following surgery. The dog that underwent revision surgery developed a surgical site infection 5 months following revision surgery, which necessitated implant removal. All ...
Olecranon fractures in dogs are often both comminuted and intra-articular. Anatomic reduction and... more Olecranon fractures in dogs are often both comminuted and intra-articular. Anatomic reduction and stable internal fixation are thus paramount to achieving primary bone healing and mitigating the development of posttraumatic osteoarthritis. Intraoperative fluoroscopy can be useful to confirm accurate fracture reduction and facilitate precise implant placement, potentially reducing the surgical exposure required and additional trauma. Despite widespread use in human surgery, reports of fluoroscopic-assisted fracture repair in dogs are limited. Presented here are three dogs in which intraoperative fluoroscopy was used to facilitate accurate olecranon fracture reduction and implant positioning. The olecranon fractures appeared to heal by primary bone union, although the anconeal process failed to obtain osseous union in one dog. Despite the development of mild-to-moderate osteoarthritis in all three dogs, and the nonunion of the anconeal process in one dog, the clinical outcome was cons...
The Canadian veterinary journal = La revue veterinaire canadienne, 2017
Two dogs with spontaneous luxation of the long digital extensor tendon of origin were managed by ... more Two dogs with spontaneous luxation of the long digital extensor tendon of origin were managed by performing a sulcoplasty and applying a plate bridging the extensor sulcus. Lameness resolved and neither dog had recurrence of lameness 59 and 15 months following surgery.
To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2... more To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2.7 mm reconstruction plate as adjunctive epicondylar stabilization in simulated comminuted lateral unicondylar humeral fractures stabilized with a transcondylar 4.5 mm cortical screw. Cadaveric biomechanical assessment. Paired humeri harvested from 9 young, skeletally mature dogs. Simulated comminuted lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a 1.6 mm Kirschner wire on one side, and a 2.7 mm reconstruction plate on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and load to failure were obtained from the load-deformation curves. Stiffness (mean ± SD: 577 ± 245 vs 310 ± 71 N/mm; P = .01), yield load (mean ± SD: 2389 ± 572 vs 1017 N ± 292; P = .0002), and load at failure (mean ± SD: 3351 ±...
Background: Fractures of the distal femoral physis are the most common physeal fracture sustained... more Background: Fractures of the distal femoral physis are the most common physeal fracture sustained by skeletally immature dogs. Reduction and stabilization of these fractures can sometimes be achieved through closed reduction, primarily in fractures that are nominally displaced. Circular external fixator constructs have been used to assist in indirect, closed reduction of fractures at other anatomic locations in dogs and this report describes application of this method to reduce a displaced Salter-Harris type II fracture of the distal femur in a 1-year-old dog. Case Description: A 1-year-old female spayed Akita was referred for treatment of a Salter-Harris type II fracture of the right distal femur. The epiphyseal segment was laterally and slightly caudally displaced. Multiple attempts to manually reduce the fracture during surgery were unsuccessful, so a two-ring circular external fixator construct was applied to facilitate distraction and reduction. The construct was applied by pla...
Background: Cranial luxation of the scapulohumeral has been rarely reported in dogs and there is ... more Background: Cranial luxation of the scapulohumeral has been rarely reported in dogs and there is limited information available regarding surgical management of this condition, particularly with respect to long-term functional outcomes. Case Description: This report describes the successful resolution of a chronic traumatic cranial scapulohumeral joint luxation in a dog that was stabilized by cranial transposition of the biceps brachii tendon of origin. At surgery, an osteotomy of the greater tubercle was performed and a trough was made in the exposed bed of the osteotomy. The transverse humeral ligament was incised, and the bicipital tendon was levered into the trough and secured in that location by reattachment of the greater tubercle using multiple Kirschner wires and a figure-of-eight tension band wire. Postoperatively, the dog was maintained in a Spica splint for 2 weeks. Although surgical reduction was performed 4 months after the original injury, the luxation did not recur and...
OBJECTIVE:This study evaluated the proficiency in executing closed, fluoroscopic-assisted reducti... more OBJECTIVE:This study evaluated the proficiency in executing closed, fluoroscopic-assisted reduction of unicondylar humeral fractures. The following were hypothesised: experienced surgeons would be highly successful in performing closed reduction; body weight, time to surgery and surgeon experience would influence the reduction method; and the reduction method would not affect technical aspects of the repair. METHODS: All unicondylar humeral fractures stabilised between January 2007 and January 2017 were reviewed. Signalment and time to surgery, experience of the attending surgeon, and the initial and definitive reduction methods were recorded. Initial and subsequent postoperative radiographs were used to assess fracture reduction, implant placement and complications. Univariate polychotomous logistic regressions, Fisher's exact test, Kruskal-Wallis rank sums non-parametric test or equivalence tests were used to compare parameters evaluated based on the approach employed (P < 0.05 significant). RESULTS:A total of 36 dogs with 37 fractures were identified (median weight: 5.4 kg; median time to surgery: 3 days). Of these, 11 of 15 attempted closed reductions were successful. Successful closed reductions had shorter times to surgery than limited open or open reductions (P = 0.009). Age, weight and surgeon experience did not influence the definitive reduction method. Technical aspects of reduction and stabilisation were similar among the reduction methods. Surgery times were shorter for closed reductions (P = 0.034). Of the fractures, 75% healed without complications and 85% had excellent long-term function. CONCLUSION: The results suggested that closed, fluoroscopic-assisted reduction is a proficient (73% successful) and efficient (shorter surgery times with comparable technical results compared with other limited open and open reduction) means of stabilising acute unicondylar humeral fractures.
A three-and-a-half-year-old neutered male Standard Schnauzer presented with a 5-week history of i... more A three-and-a-half-year-old neutered male Standard Schnauzer presented with a 5-week history of inability to bear full weight on the right pelvic limb following a traumatic injury to the right stifle. Clinical, radiographic, and ultrasound findings were consistent with a proximal patellar tendon rupture with a distal patellar avulsion fragment. A proprietary Achilles repair jig system was used to reattach the patellar tendon to the patella, allowing for direct approximation of the tissues. The primary repair was supported with a protective patella-to-tibia suture, and the dog was fitted with an orthosis to restrict range of motion of the stifle. Primary tendon repair using alternative suture materials and suture placement, in conjunction with a protective suture loop and transient stifle immobilization, allowed for a successful outcome without appreciable lameness at a final evaluation 3.6 years after presentation. The dog in this report was successfully treated with a modified prop...
Bone healing and assessment of the state of bone bridging is an important part of clinical orthop... more Bone healing and assessment of the state of bone bridging is an important part of clinical orthopedics, whether for fracture healing or for follow up of osteotomy procedures. Tibial tuberosity advancement (TTA) is designed to restore stability in cruciate deficient stifle joints by advancing the tuberosity while creating an osteotomy gap. The current study aims to: 1) compare three different imaging modalities to assess bone healing: ultrasound, radiographs and computed tomography (CT) and, to 2) compare the effect of a gelatinous matrix (GM) versus a demineralized bone matrix mix (DBM mix) on bone healing and bridging of this osteotomy gap in 10 otherwise healthy client-owned dogs with cranial cruciate ligament insufficiency. Osseous union of the osteotomy gap was evaluated with ultrasound, radiographs and CT at one, two, and 3 months postoperatively. Dogs were randomly selected to receive GM or DBM mix to fill the osteotomy gap created during the TTA procedure. Bone healing was as...
Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause... more Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause of pelvic limb lameness and osteoarthritis in dogs. Surgical therapies developed to treat dogs with naturally occurring CrCL insufficiency aim to address the resultant instability, but the in-vivo alterations in stifle kinematics associated with CrCL insufficiency have not been accurately defined. The objective of this study was to quantify the 3-dimensional femorotibial joint kinematics of dogs with naturally occurring cranial cruciate ligament (CrCL) insufficiency during ambulation. Eighteen client-owned dogs (20-40 kg) with natural unilateral complete CrCL rupture were included. Computed tomographic scans were used to create digital 3-dimensional models of the femur and tibia bilaterally for each dog. Lateral fluoroscopic images were obtained during treadmill walking and 3 complete gait cycles were analyzed. Stifle flexion/extension angle, craniocaudal translation, and internal/exter...
Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause... more Cranial cruciate ligament (CrCL) insufficiency is a degenerative condition that is a common cause of pelvic limb lameness and osteoarthritis in dogs. Surgical therapies developed to treat dogs with naturally occurring CrCL insufficiency aim to address the resultant instability, but the in-vivo alterations in stifle kinematics associated with CrCL insufficiency have not been accurately defined. The objective of this study was to quantify the 3-dimensional femorotibial joint kinematics of dogs with naturally occurring cranial cruciate ligament (CrCL) insufficiency during ambulation. Eighteen client-owned dogs (20-40 kg) with natural unilateral complete CrCL rupture were included. Computed tomographic scans were used to create digital 3-dimensional models of the femur and tibia bilaterally for each dog. Lateral fluoroscopic images were obtained during treadmill walking and 3 complete gait cycles were analyzed. Stifle flexion/extension angle, craniocaudal translation, and internal/exter...
To determine how American College of Veterinary Surgeons (ACVS) small animal surgery residency pr... more To determine how American College of Veterinary Surgeons (ACVS) small animal surgery residency programs are teaching and assessing technical skills, and ascertain the perceived value of those methods. Internet-based survey. Residents and Diplomate supervisors of ACVS small animal residency programs. Residents and supervisors were surveyed on their experience of surgery instruction, use of different resources for teaching, type and frequency of feedback, and perceived effectiveness of their programs in imparting technical proficiency. A total of 130 residents (62%) and 119 supervisors (44%) participated. Both residents and supervisors estimated the resident was the primary surgeon for a mean of 64% of cases, although this proportion varied widely between participants. The majority of residents and supervisors considered that direct intraoperative guidance was the most effective way for residents to develop technical skills. Verbal interactions between supervisor and resident occurred...
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, Jan 18, 2015
The canine knee is morphologically similar to the human knee and thus dogs have been used in expe... more The canine knee is morphologically similar to the human knee and thus dogs have been used in experimental models to study human knee pathology. To date, there is limited data of normal canine 3D knee kinematics during daily activities. The objective of this study was to characterize 3D in-vivo femorotibial kinematics in normal dogs during commonly performed daily activities. Using single-plane fluoroscopy, six normal dogs were imaged performing walk, trot, sit, and stair ascent activities. CT-generated bone models were used for kinematic measurement using a 3D-to-2D model registration technique. Increasing knee flexion angle was typically associated with increasing tibial internal rotation, abduction and anterior translation during all four activities. The precise relationship between flexion angle and these movements varied both within and between activities. Significant differences in axial rotation and coronal angulation were found at the same flexion angle during different phase...
Twenty-four dogs underwent unilateral excision of the femoral head and neck. An adjunctive biceps... more Twenty-four dogs underwent unilateral excision of the femoral head and neck. An adjunctive biceps femoris muscle sling procedure was done in 16 dogs. In eight dogs (controls), the flap was dissected and returned to its original position. Four dogs with muscle slings were euthanatized on days 2,5,30, and 60, respectively. Four control dogs were euthanatized on day 2 and four dogs on day 5. Limb function did not differ consistently between dogs with muscle slings and control dogs. There was marked swelling and edema of the affected limb in half the dogs with muscle slings but not in the controls. Postoperative temperature elevations were significantly higher in dogs with muscle slings on days 1 and 2 (p < 0.05). Infection was documented in four dogs with mugcle slings. Flaps from control dogs had only minor gross and histologic abnormalities. On days 2 and 5, flaps from dogs with muscle slings appeared congested and swollen beneath and distal to the ostectomy site, with infarction involving 50 to 90% of the muscle mass. On days 30 and 60, the muscle slings were atrophic and fibrous, and by day 60 a synovial membrane covered the surfaces of all slings within the pseudarthrosis. Muscle fiber loss was attributed to infarction, necrosis, and disuse atrophy. XCISION OF THE FEMORAL head and neck is COmE monly used in small animals to relieve pain and salvage limb function when there is irreparable damage to the coxofemoral joint.' The clinical results are reported to be good to excellent in animals weighing less than 20 kg; however, results are less consistent in larger dog^.^-^ Decreased efficacy has been attributed to a greater body mass driving the femoral shaft into the acetabular rim.7 The biceps femoris muscle sling was developed to improve limb function after excision arthroplasty by preventing pain caused by bone-to-bone ont tact.^ In this
To determine effects of increased dietary protein and decreased dietary carbohydrate on hematolog... more To determine effects of increased dietary protein and decreased dietary carbohydrate on hematologic variables, body composition, and racing performance in Greyhounds. 8 adult Greyhounds. Dogs were fed a high-protein (HP; 37% metabolizable-energy [ME] protein, 33% ME fat, 30% ME carbohydrate) or moderate-protein (MP; 24% ME protein, 33% ME fat, 43% ME carbohydrate) extruded diet for 11 weeks. Dogs subsequently were fed the other diet for 11 weeks (crossover design). Dogs raced a distance of 500 m twice weekly. Rectal temperature, hematologic variables before and after racing, plasma volume, total body water, body weight, average weekly food intake, and race times were measured at the end of each diet period. When dogs were fed the MP diet, compared with the HP diet, values (mean +/- SD) differed significantly for race time (32.43 +/- 0.48 vs 32.61 +/- 0.50 seconds), body weight (32.8 +/- 2.5 vs 32.2 +/- 2.9 kg), Hct before (56 +/- 4 vs 54 +/- 6%) and after (67 +/- 3 vs 64 +/- 8%) racing, and glucose (131 +/- 16 vs 151 +/- 27 mg/dl) and triglyceride (128 +/- 17 vs 104 +/- 28 mg/dl) concentrations after racing. Greyhounds were 0.18 seconds slower (equivalent to 0.08 m/s or 2.6 m) over a distance of 500 m when fed a diet with increased protein and decreased carbohydrate. Improved performance attributed to feeding meat to racing Greyhounds apparently is not attributable to increased dietary protein and decreased dietary carbohydrate.
T he thyroid hormones thyroxine (T 4), triiodothyronine (T 3), and thyroid stimulating hormone (T... more T he thyroid hormones thyroxine (T 4), triiodothyronine (T 3), and thyroid stimulating hormone (TSH) regulate and are regulated by metabolic rate. Exercise alters metabolic rate. The effect of exercise and training on serum concentrations of thyroid hormones has, therefore, been investigated in many species including humans, rodents, dogs, and horses. However, results from these studies have varied with the intensity and duration of exercise, 1,2 the amount of training, 3,4 the adequacy of energy intake, 4,5 and the time when blood was sampled. 6,7 Results from studies in which the effect of training on thyroid hormones was examined were also varied; some revealed that thyroid hormone concentrations change with training, 3 whereas others have not. 8,9 In sled dogs that underwent severe endurance exercise during an Iditerod race, there was no change in total or free T 4 and total or free T 3 concentrations before or after the race. 10 In 1 study, resting total T 4 concentrations were slightly (13%) lower in Beagles undergoing long-distance aerobic exercise on a treadmill, compared with sedentary dogs, but there was no change in free T 4 or total T 3 concentrations. 11 To date, however, the authors are unaware of any studies of the effect of racing on thyroid hormones in Greyhounds. Resting serum T 4 concentrations appear to be lower in Greyhounds than in other breeds of dogs, 12,a and it is possible that thyroid hormone concentrations may be affected differently after a short sprint race than after endurance exercise. Therefore, the purpose of the study reported here was to measure the effect of racing and training on thyroid hormone and TSH concentrations in racing Greyhounds. Materials and Methods Dogs-Nine Greyhounds (5 females, 4 males) 2.6 to 4.6 years of age and weighing 26 to 35 kg were used for this study. These dogs had been trained to chase a lure on a racetrack and were donated by Greyhound breeding kennels. All dogs were considered to be in good health on the basis of results of physical examination, CBC, serum biochemical analysis, and urinalysis. Dogs were cared for as previously described 13 and according to the principles outlined in the NIH guide for the care of laboratory animals 14 ; the study protocol was approved by the Institutional Animal Care and Use Committee at the University of Florida. All dogs were housed in 1.4 X 1.9-m cages in a room with a 12-hour light:dark cycle, a constant temperature of 24 C, and 13 to 18 air changes/h. All dogs were exercised for 15 minutes twice daily in a 30 X 30-m grass paddock and raced in pairs up to twice a week at this facility for 6 months prior to this experiment. Each race was 500 m (five-sixteenths of a mile) in length and was performed on a 400-m (quarter mile) oval soft sand-clay track with 10 o banking on the corners. Dogs chased a mechanical lure maintained 10 to 20 m in front of the lead dog. Dogs were randomly assigned to race and starting position. Dogs were fed an extruded dry com
An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III... more An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of the caudal aspect of the proximal tibial physis, secondary to the proximal physeal fracture, resulted in an excessively high tibial plateau angle (TPA) of 50° with a limb length discrepancy of 13% by 24 weeks of age. The deformity was addressed by performing a proximal tibial osteotomy and subsequent distraction osteogenesis to reduce the TPA while concurrently lengthening the crus. A radial osteotomy was performed in the proximal metaphyseal region and the hinged fixator was applied. Distraction was initiated the day following surgery at a rate of 1 mm per day as measured along the caudal cortex of the tibia with a rhythm of three distractions daily. Distraction was terminated 19 days po...
Vacuum-assisted closure (VAC) is a wound management therapy that creates local negative pressure ... more Vacuum-assisted closure (VAC) is a wound management therapy that creates local negative pressure over a wound bed to promote healing. Benefits of VAC therapy include removal of fluid from the extravascular space, improved circulation, enhanced granulation tissue formation, increased bacterial clearance, and hastening of wound closure. This article describes the mechanism of action of VAC therapy, reviews application techniques, and lists potential complications and contraindications.
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