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幼年耻骨联合固定术及与耻骨肌切断术相关的幼年耻骨联合固定术:56只发育不良幼犬的短期结果

Juvenile pubic symphysiodesis and juvenile pubic symphysiodesis associated with pectineus myotomy: short-term outcome in 56 dysplastic puppies.

作者信息

Bernardé Antoine

机构信息

Clinique Vétérinaire des Quais, Blois, France.

出版信息

Vet Surg. 2010 Feb;39(2):158-64. doi: 10.1111/j.1532-950X.2010.00644.x.

Abstract

OBJECTIVES

(1) To compare short-term outcome of juvenile pubic symphysiodesis (JPS) in puppies aged 12-17 weeks with lax hips (group JPS1), in puppies aged 18-22 weeks (group JPS2), and control (group C) puppies; and (2) to document outcome of bilateral pectineus myotomy (PM) associated with JPS in 18-22-week-old puppies (group JPS-PM).

STUDY DESIGN

Prospective study.

METHODS

Puppies (12-22 weeks) from large and giant breed dogs with a combination of a positive Ortolani sign, poor acetabular coverage (Norberg angle [NA]<or=100 degrees ), and a subluxation index (SI) >0.5 for one or both hips were selected. Puppies aged <18 weeks were randomly assigned to group JPS1 or C. Puppies aged 18-22 weeks were randomly assigned to group JPS2, JPS-PM, or C. Three to 4 months later, surgery was considered successful in pain-free dogs with negative Ortolani sign, normalized acetabular coverage (NA>or=105 degrees ), and SI>0.5. Success rates were compared using Fisher's exact tests: JPS1 versus JPS2 versus C; JPS2 versus JPS-PM. Significance was set at P<.05.

RESULTS

All dysplastic hips from nonoperated (C) groups were dysplastic at follow-up, meaning that our criteria for case selection were accurate. JPS1 had significantly better success rate than JPS2 (85 versus 17.8%, respectively). JPS-PM dysplastic hips failed to demonstrate a better outcome than JPS2 hips.

CLINICAL RELEVANCE

This study confirms, on a large series of dysplastic hips, the age-dependent effects of JPS, with better results if performed before 18 weeks of age. There is no benefit of adding PM to the procedure in candidates >18 weeks at surgery.

摘要

目的

(1)比较12 - 17周龄髋关节松弛幼犬(JPS1组)、18 - 22周龄幼犬(JPS2组)和对照(C组)幼犬行青少年耻骨联合固定术(JPS)的短期疗效;(2)记录18 - 22周龄幼犬(JPS - PM组)行JPS联合双侧耻骨肌切断术(PM)的疗效。

研究设计

前瞻性研究。

方法

选取大型和巨型犬种12 - 22周龄幼犬,其具备以下特征:Ortolani征阳性、髋臼覆盖不良(诺伯格角[NA]≤100度)且一侧或双侧髋关节半脱位指数(SI)>0.5。18周龄以下幼犬随机分为JPS1组或C组。18 - 22周龄幼犬随机分为JPS2组、JPS - PM组或C组。3至4个月后,对于无疼痛、Ortolani征阴性、髋臼覆盖正常化(NA≥105度)且SI>0.5的犬只,手术被认为成功。使用Fisher精确检验比较成功率:JPS1组与JPS2组与C组;JPS2组与JPS - PM组。显著性设定为P<0.05。

结果

未手术(C)组所有发育不良的髋关节在随访时仍发育不良,这意味着我们的病例选择标准是准确的。JPS1组的成功率显著高于JPS2组(分别为85%和17.8%)。JPS - PM组发育不良的髋关节未显示出比JPS2组髋关节更好的疗效。

临床意义

本研究在大量发育不良髋关节病例中证实了JPS的年龄依赖性效应,18周龄前进行手术效果更佳。对于手术时年龄>18周的犬只进行该手术时,添加PM并无益处。

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