Coggeshall J D, Reese D J, Kim S E, Pozzi A
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610, USA.
J Small Anim Pract. 2014 Jan;55(1):46-51. doi: 10.1111/jsap.12126. Epub 2013 Aug 23.
Four skeletally immature, small breed dogs (five elbows) with elbow incongruency were evaluated for forelimb lameness. Findings on clinical examination included pain, effusion and decreased range of motion of the affected elbow. Radiography, computed tomography and arthroscopy demonstrated elbow incongruency in all dogs. Fragmented medial coronoid process was diagnosed arthroscopically in three dogs (four elbows). Arthroscopic subtotal coronoidectomy was performed in all cases of fragmented medial coronoid process. Incongruency was corrected with acute ulnar lengthening under arthroscopic visualisation. The ulna was stabilised with a plate following correction. In two elbows an ostectomy of the anconeal process was performed to prevent impingement against the olecranon fossa. All dogs demonstrated improvement in lameness scores and client-scored visual analogue scale scores. Postoperative computed tomography showed significant improvement in elbow incongruency in all dogs. Arthroscopic-guided ulnar lengthening may be considered as a valid treatment in severe cases of elbow incongruency.
对四只骨骼未成熟的小型犬(五只肘部)的肘部不协调进行了前肢跛行评估。临床检查结果包括疼痛、积液以及患侧肘部活动范围减小。X线摄影、计算机断层扫描和关节镜检查显示所有犬均存在肘部不协调。关节镜检查诊断出三只犬(四只肘部)存在内侧冠状突碎片。对所有内侧冠状突碎片病例均进行了关节镜下冠状突次全切除术。在关节镜直视下通过急性尺骨延长矫正不协调。矫正后用钢板固定尺骨。在两个肘部进行了肘肌突切除术以防止撞击鹰嘴窝。所有犬的跛行评分和主人评分的视觉模拟量表评分均有改善。术后计算机断层扫描显示所有犬的肘部不协调均有显著改善。关节镜引导下尺骨延长可被视为严重肘部不协调病例的一种有效治疗方法。