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通过超声检查和X线摄影评估犬并存的桡骨和尺骨骨折微创钢板接骨术或切开复位内固定术后的骨折愈合情况。

Assessment of fracture healing after minimally invasive plate osteosynthesis or open reduction and internal fixation of coexisting radius and ulna fractures in dogs via ultrasonography and radiography.

作者信息

Pozzi Antonio, Risselada Marije, Winter Matthew D

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.

出版信息

J Am Vet Med Assoc. 2012 Sep 15;241(6):744-53. doi: 10.2460/javma.241.6.744.

DOI:10.2460/javma.241.6.744
PMID:22947157
Abstract

OBJECTIVE

To evaluate fracture healing after minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF) of coexisting radius and ulna fractures in dogs via ultrasonography and radiography.

DESIGN

Prospective cohort study.

ANIMALS

16 dogs with radius-ulna fractures that underwent MIPO (n = 9; 2 dogs were subsequently not included in the analyses because of incomplete follow-up information) or ORIF (7).

PROCEDURES

Dogs in the 2 treatment groups were matched by age, body weight, and configuration of the fractures. Fracture healing was evaluated with ultrasonography, power Doppler ultrasonography, and radiography every 3 to 4 weeks until healing was complete; a semiquantitative score based on the number of Doppler signals was used to characterize neovascularization, and subjective B-mode ultrasonographic and radiographic scores were assigned to classify healing.

RESULTS

Fractures in dogs that underwent MIPO healed in significantly less time than did fractures in dogs that underwent ORIF (mean ± SD; 30 ± 10.5 days and 64 ± 10.1 days, respectively). Radiography revealed that fractures in dogs that underwent MIPO healed with significantly more callus formation than did fractures in dogs that underwent ORIF. Although Doppler ultrasonography revealed abundant vascularization in fractures that were healing following MIPO, no significant difference in neovascularization scores was found between groups.

CONCLUSIONS AND CLINICAL RELEVANCE

For dogs with radius-ulna fractures, data indicated that bridging osteosynthesis combined with a minimally invasive approach contributed to rapid healing after MIPO. The MIPO technique may offer some clinical advantage over ORIF, given that complete radius-ulna fracture healing was achieved in a shorter time with MIPO.

摘要

目的

通过超声检查和X线摄影评估犬同时发生的桡骨和尺骨骨折采用微创钢板接骨术(MIPO)或切开复位内固定术(ORIF)后的骨折愈合情况。

设计

前瞻性队列研究。

动物

16只患有桡骨-尺骨骨折的犬,其中9只接受了MIPO(2只因随访信息不完整随后未纳入分析),7只接受了ORIF。

方法

两个治疗组的犬根据年龄、体重和骨折类型进行匹配。每3至4周通过超声检查、能量多普勒超声检查和X线摄影评估骨折愈合情况,直至愈合完成;基于多普勒信号数量的半定量评分用于表征新生血管形成,并分配主观B型超声和X线摄影评分以对愈合进行分类。

结果

接受MIPO的犬骨折愈合时间明显短于接受ORIF的犬(平均值±标准差;分别为30±10.5天和64±10.1天)。X线摄影显示,接受MIPO的犬骨折愈合时的骨痂形成明显多于接受ORIF的犬。尽管多普勒超声检查显示MIPO后愈合的骨折中有丰富的血管形成,但两组之间的新生血管评分没有显著差异。

结论及临床意义

对于患有桡骨-尺骨骨折的犬,数据表明桥接接骨术结合微创方法有助于MIPO后的快速愈合。鉴于MIPO能在更短时间内实现桡骨-尺骨骨折的完全愈合,MIPO技术可能比ORIF具有一些临床优势。

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