DeTora Michael D, Boudrieau Randy J
Randy J. Boudrieau, DVM, Diplomate ACVS & ECVS, Cummings School of Veterinary Medicine at Tufts University, Department of Clinical Sciences, 200 Westboro Road, N. Grafton, MA 01536, United States, E-mail:
Vet Comp Orthop Traumatol. 2016 Sep 20;29(5):416-25. doi: 10.3415/VCOT-15-08-0145. Epub 2016 Jul 21.
To describe the surgical technique of complex distal femoral deformity correction with the aid of stereolithography apparatus (SLA) biomodels, stabilized with locking plate fixation.
Full-size replica epoxy bone biomodels of the affected femurs (4 dogs/ 5 limbs) were used as templates for surgical planning. A rehearsal procedure was performed on the biomodels aided by a guide wire technique and stabilized with locking plate fixation. Surgery performed in all dogs was guided by the rehearsal procedure. All pre-contoured implants were subsequently used in the definitive surgical procedure with minimal modification.
All dogs had markedly improved, with near normal functional outcomes; all but one had a mild persistent lameness at the final in-hospital follow-up examination (mean: 54.4 weeks; range: 24-113 weeks after surgery). All femurs healed without complications (mean: 34 weeks, median: 12 weeks; range: 8-12 weeks for closing osteotomies, and 26-113 weeks for opening wedge osteotomies). Long-term follow-up examination (mean: 28.6 months; range: 5-42 months) revealed all but one owner to be highly satisfied with the outcome. Complications were observed in two dogs: prolonged tibiotarsal joint decreased flexion that resolved with physical therapy. In one of these dogs, iatrogenic transection of the long digital extensor tendon was repaired, and the other had a peroneal nerve neurapraxia.
Stereolithography apparatus biomodels and rehearsal surgery simplified the definitive surgical corrections of complex femoral malunions and resulted in good functional outcomes.
描述借助立体光刻设备（SLA）生物模型进行复杂股骨远端畸形矫正并采用锁定钢板固定的手术技术。
将患侧股骨的全尺寸复制环氧树脂骨生物模型（4只犬/5条肢体）用作手术规划模板。在导丝技术辅助下对生物模型进行预演手术，并用锁定钢板固定。所有犬只的手术均按照预演手术进行指导。随后，所有预塑形植入物在最终手术中只需进行最小程度的修改即可使用。
所有犬只均有明显改善，功能结局接近正常；除1只犬外，所有犬在最终的院内随访检查时均有轻度持续性跛行（平均：54.4周；范围：术后24 - 113周）。所有股骨均愈合且无并发症（平均：34周，中位数：12周；闭合截骨术范围：8 - 12周，开放楔形截骨术范围：26 - 113周）。长期随访检查（平均：28.6个月；范围：5 - 42个月）显示，除1位主人外，其他主人对结果均高度满意。2只犬出现并发症：胫跗关节屈曲时间延长，经物理治疗后缓解。其中1只犬医源性切断的长趾伸肌腱得到修复，另1只犬出现腓总神经失用。
立体光刻设备生物模型和预演手术简化了复杂股骨畸形愈合的最终手术矫正，并产生了良好的功能结局。
