Conkling Amanda L, Fagin Bennett, Daye R Mark
Ohio Veterinary Surgery and Neurology, Metropolitan Veterinary Hospital, Akron, OH 44321, USA.
Vet Surg. 2010 Jun;39(4):475-81. doi: 10.1111/j.1532-950X.2010.00656.x. Epub 2010 Mar 24.
To compare the effects of locking and conventional screws on postoperative tibial plateau angle (TPA), osteotomy healing, and complication rate after tibial plateau leveling osteotomy (TPLO) in dogs treated for naturally occurring cranial cruciate ligament (CCL) rupture.
Prospective clinical study.
Dogs (n=118) with CCL rupture.
Dogs (> or =20 kg) with unilateral CCL rupture and sufficient bone stock for TPLO and use of a 3.5-mm-broad or -narrow TPLO plate were sequentially allocated to have plate fixation with locking or conventional screws. Data analyzed included breed, age, sex, body weight, body condition score, limb operated, implants used, meniscal status, operative time, and days to recheck. Preoperative, immediate postoperative, and 8-week recheck mediolateral radiographs were reviewed, and TPA, complications, and healing status were evaluated.
Stifles in the locking screw group had significantly less change in postoperative TPA than stifles in the conventional screw group. Locking screw fixation also had significantly higher grades of osteotomy healing, assessed on a mediolateral radiographic view.
TPLO plates secured with locking screws are acceptable when compared with those secured with conventional screws; osteotomy healing is improved and TPA better conserved when using locking screws.
Locking screw fixation serves to increase stabilization of TPA during TPLO healing and provides improved radiographic evidence of osteotomy healing.
比较锁定螺钉和传统螺钉对自然发生颅交叉韧带(CCL)断裂的犬进行胫骨平台平整截骨术(TPLO)后胫骨平台角(TPA)、截骨愈合及并发症发生率的影响。
前瞻性临床研究。
CCL断裂的犬(n = 118)。
将单侧CCL断裂且有足够骨量用于TPLO并使用3.5毫米宽或窄TPLO钢板的犬(≥20千克)依次分配为采用锁定螺钉或传统螺钉进行钢板固定。分析的数据包括品种、年龄、性别、体重、身体状况评分、手术肢体、使用的植入物、半月板状态、手术时间及复查天数。回顾术前、术后即刻及8周复查时的内外侧X线片,评估TPA、并发症及愈合情况。
锁定螺钉组的膝关节术后TPA变化显著小于传统螺钉组。在内外侧X线片上评估,锁定螺钉固定的截骨愈合等级也显著更高。
与传统螺钉固定的TPLO钢板相比,锁定螺钉固定的TPLO钢板是可接受的;使用锁定螺钉时截骨愈合得到改善,TPA得到更好的保留。
锁定螺钉固定有助于在TPLO愈合期间增加TPA的稳定性,并提供截骨愈合的更好影像学证据。