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两只工作农场犬股骨远端内侧髁骨折手术修复后成功重返工作岗位。

Successful return to work after surgical repair of fracture of the medial condyle of the distal femur in two working farm dogs.

作者信息

Davis S, Worth A J

机构信息

Centre for Service and Working Dog Health and Research, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.

出版信息

N Z Vet J. 2009 Feb;57(1):58-62. doi: 10.1080/00480169.2009.36870.

Abstract

CASE HISTORY

A 5-year-old male Heading dog (working Collie) and a 2-year-old female Huntaway each presented with non-weight-bearing lameness of a hindlimb after jumping or falling with the leg trapped in a gate or motorbike carrier.

CLINICAL FINDINGS

Pain and swelling were localised to the stifle, and radiographs revealed a fracture of the medial condyle of the distal femur in each case.

DIAGNOSIS

Medial unicondylar, intra-articular fractures of the distal femur.

CLINICAL RELEVANCE

Open reduction and internal fixation provided an excellent outcome in each case. Open reduction was achieved after elevation of the insertion of the medial collateral ligament from the proximal tibia. Both cases had severe tears to the caudal pole of the medial meniscus, requiring partial meniscectomy. Internal fixation was applied using either divergent K-wires and a biodegradable pin, or a lag-screw technique. The medial collateral ligament was reattached using a 3.5-mm cancellous screw and spiked washer. The therapeutic outcome, i.e. clinical result and return to work, was determined by gait assessment, physical examination, radiography, and an owner's questionnaire. Both working dogs became sound and successfully returned to full work within 6 months of surgery. One dog was subject to euthanasia due to unrelated disease one year after surgery, but the other dog was working fully at 2 years post-operatively; radiography showed osteoarthrosis (OA) but manipulation revealed near-normal range of motion and no loss of muscling.

摘要

病例史

一只5岁雄性赫德牧羊犬(工作用柯利犬)和一只2岁雌性汉塔威犬,均在跳跃或摔倒后腿被困在门或摩托车行李架后出现后肢非负重性跛行。

临床检查结果

疼痛和肿胀局限于膝关节,X线片显示两例均为股骨远端内侧髁骨折。

诊断

股骨远端内侧单髁关节内骨折。

临床意义

两例均采用切开复位内固定术,效果良好。从胫骨近端抬起内侧副韧带附着点后进行切开复位。两例内侧半月板后极均有严重撕裂,需要部分半月板切除术。内固定采用交叉克氏针和可生物降解针或拉力螺钉技术。内侧副韧带用3.5毫米的松质骨螺钉和带尖垫圈重新附着。治疗结果,即临床效果和恢复工作情况,通过步态评估、体格检查、X线检查和主人问卷来确定。两只工作犬术后6个月内均恢复正常,并成功恢复全职工作。其中一只犬在术后一年因 unrelated disease实施安乐死,但另一只犬在术后两年仍能完全工作;X线检查显示有骨关节炎(OA),但手法检查显示活动范围接近正常,肌肉无萎缩。

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