Kornmayer Matthias, Matis Ulrike
Dr. Matthias Kornmayer, Chirurgische und Gynäkologische Kleintierklinik, Zentrum für Klinische Tiermedizin, Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2017 Jun 20;45(3):154-162. doi: 10.15654/TPK-160948. Epub 2017 May 16.
To evaluate a dowel pinning technique for metacarpal and metatarsal fractures in dogs.
Medical records of 13 dogs with complete clinical and radiographic follow-up examinations after a median observation time of 5 months were evaluated retrospectively. Assessment included fracture data, number of stabilized bones versus number of fractured bones and parameters of internal fixation including postoperative axial alignment and position of implants assessed on serial radiographs. Complications during the healing period and the final radiographic and functional outcome were analysed in relation to the details of fracture fixation.
Most dogs in this study (mean age: 2.9 years, mean weight: 9.9 kg) had fractures of three or four bones, and fractures were closed in all but one dog. All fractures involved the metacarpal/metatarsal body, and all but five were transverse. The size of Kirschner wires used for dowel pinning ranged from 0.8 to 2.0 mm, and the length in relation to bone length ranged from 39 to 91%. Axial alignment of internal fixation was and remained anatomically correct and the dowel pins remained in place in all but one dog. This dog had open metatarsal fractures and dowel pinning was contraindicated. Additionally, the Kirschner wires perforated the cortex of the proximal segments, which resulted in implant migration, malunion and residual lameness. The other dogs achieved complete functional union even though seven of 13 dogs developed radiographic signs of synostosis.
Although the number of dogs in this study was small, dowel pinning was shown to be technically straightforward, inexpensive and effective for surgical repair of canine metacarpal and metatarsal bone fractures. Further studies should focus on the need for and duration of additional external coaptation.
评估一种用于犬掌骨和跖骨骨折的销钉固定技术。
回顾性评估13只犬的病历，这些犬在中位观察时间5个月后进行了完整的临床和放射学随访检查。评估内容包括骨折数据、稳定骨骼数量与骨折骨骼数量，以及内固定参数，包括通过系列X光片评估的术后轴向对线和植入物位置。分析愈合期的并发症以及最终的放射学和功能结果与骨折固定细节的关系。
本研究中的大多数犬（平均年龄：2.9岁，平均体重：9.9千克）有三或四处骨折，除一只犬外所有骨折均为闭合性骨折。所有骨折均累及掌骨/跖骨体，除五处外均为横行骨折。用于销钉固定的克氏针尺寸范围为0.8至2.0毫米，其长度与骨长度的比例范围为39%至91%。内固定的轴向对线在解剖学上是正确的且一直保持，除一只犬外所有犬的销钉均保持在位。这只犬有开放性跖骨骨折，销钉固定为禁忌。此外，克氏针穿透了近端节段的皮质，导致植入物移位、畸形愈合和残留跛行。其他犬实现了完全功能愈合，尽管13只犬中有7只出现了影像学上的骨桥形成迹象。
尽管本研究中的犬数量较少，但销钉固定技术显示在技术上简单、成本低廉且对犬掌骨和跖骨骨折的手术修复有效。进一步的研究应聚焦于额外外部固定的必要性和持续时间。
