Samoy Y C A, de Bakker E, Van Vynckt D, Coppieters E, van Bree H, Van Ryssen B
University Ghent, Department of Medical Imaging and Orthopedics, Merelbeke, Belgium.
Vet Comp Orthop Traumatol. 2013;26(1):27-33. doi: 10.3415/VCOT-11-06-0087. Epub 2012 Nov 14.
The purpose of this study was to investigate the long-term treatment results of fragmented coronoid process (FCP) in joints with a radio-ulnar step greater than 3 mm. Treatment of these patients only consisted of fragment removal, without correction of the incongruity. The eight Bernese Mountain Dogs (11 joints) included in this study showed obvious clinical signs of elbow disease and were diagnosed with severe elbow incongruity and concomitant FCP in the time period from 1999-2003. At that time, elbow radiography, computed tomography, and arthroscopy were performed. The mean follow-up period was 5.6 years. The follow-up consisted of a telephone questionnaire combined with a clinical and radiographic re-evaluation at our clinic. The questionnaire revealed that all dogs were either free of lameness or only lame following heavy exercise. One dog sporadically required medication after heavy exercise. The owner satisfaction rate was 100%. The clinical re-evaluation did not reveal any signs of pain or lameness in all cases. Range-of- motion was decreased in nine of the 11 elbows. Radiographs revealed an increase in severity of osteoarthritis in every case.In this case series, arthroscopic fragment removal without treatment of incongruity was demonstrated to be a valuable treatment option and may provide a satisfactory long-term outcome.
本研究的目的是调查尺桡骨台阶大于3 mm的关节中冠状突骨折(FCP)的长期治疗结果。这些患者的治疗仅包括碎片清除,未对关节不匹配进行矫正。本研究纳入的8只伯恩山犬(11个关节)在1999年至2003年期间表现出明显的肘部疾病临床症状,被诊断为严重肘部关节不匹配并伴有冠状突骨折。当时,进行了肘部X线摄影、计算机断层扫描和关节镜检查。平均随访期为5.6年。随访包括电话问卷调查以及在我们诊所进行的临床和影像学重新评估。问卷调查显示,所有犬只要么没有跛行,要么仅在剧烈运动后跛行。一只犬在剧烈运动后偶尔需要用药。主人满意度为100%。临床重新评估在所有病例中均未发现任何疼痛或跛行迹象。11个肘部中有9个的活动范围减小。X线片显示每个病例的骨关节炎严重程度均增加。在这个病例系列中,关节镜下碎片清除而不对关节不匹配进行治疗被证明是一种有价值的治疗选择,并且可能提供令人满意的长期结果。