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小动物经皮胫骨骨骺骨折修复:技术与17例病例

Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases.

作者信息

von Pfeil Dirsko J F, Glassman Mathieu, Ropski Meaghan

机构信息

Dirsko J. F. von Pfeil, Dr.med.vet, DVM, Diplomate ACVS, Diplomate ECVS, Diplomate ACVSMR, Friendship Surgical Specialists of the Friendship Hospital for Animals, 4105 Brandywine Street NW, Washington, DC 20016, United States, Phone: +1 202 363 7300, Fax: +1 202 363 7126, E-mail:

出版信息

Vet Comp Orthop Traumatol. 2017 Jul 20;30(4):279-287. doi: 10.3415/VCOT-16-07-0102. Epub 2017 Jun 21.

Abstract

OBJECTIVES

To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique ("spiking"), used to treat tibial tuberosity avulsion fractures.

METHODS

Clinical data of 14 dogs and three cats were included. The "spiking" technique was described.

RESULTS

Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures. Surgery times ranged from eight to 54 minutes. The "spiking" technique was successfully applied in six tibial tuberosity avulsion fracture cases. Return to function was at a mean (± standard deviation) of 1.9 (± 1.6) weeks. Long-term (>12 months; n = 17) follow-up was available at a mean of 40.6 (± 13.4) months. Major complications consisted of skin irritation from a pin (distal tibia / fibula physeal fracture case; 8 weeks post-PTPFR), and a bilateral grade II medial patella luxation (tibial tuberosity avulsion fracture case; 1.5 years post-PTPFR). One case developed a mild tibial tuberosity avulsion fracture re-avulsion. All conditions in these three cases were not of clinical concern at follow-up and final outcome was graded as good in these and excellent in the other 14 cases.

CLINICAL SIGNIFICANCE

Percutaneous tibial physeal fracture repair can be considered as a technique to treat tibial physeal fractures. The "spiking" technique was successfully applied in six dogs. A larger, prospective case series is indicated to provide additional clinical information.

摘要

目的

回顾性描述经皮胫骨骨骺骨折修复术(PTPFR)治疗的病例,术中使用术中透视(IFL)或数字X线摄影(DR)。描述一种用于治疗胫骨结节撕脱骨折的技术(“打钉”)。

方法

纳入14只犬和3只猫的临床资料。描述了“打钉”技术。

结果

术中透视(n = 11)和DR(n = 6)成功用于11例胫骨结节撕脱骨折、1例近端骨骺和胫骨结节联合撕脱骨折以及5例胫腓骨远端骨骺骨折。手术时间为8至54分钟。“打钉”技术成功应用于6例胫骨结节撕脱骨折病例。恢复功能的平均时间(±标准差)为1.9(±1.6)周。可获得17例的长期(>12个月)随访,平均随访时间为40.6(±13.4)个月。主要并发症包括一枚钢针引起的皮肤刺激(胫腓骨远端骨骺骨折病例;PTPFR术后8周)和双侧II级内侧髌骨脱位(胫骨结节撕脱骨折病例;PTPFR术后1.5年)。1例发生轻度胫骨结节撕脱骨折再撕脱。这3例中的所有情况在随访时均无临床意义,这3例的最终结局评为良好,其他14例评为优秀。

临床意义

经皮胫骨骨骺骨折修复术可被视为治疗胫骨骨骺骨折的一种技术。“打钉”技术在6只犬中成功应用。需要更大规模的前瞻性病例系列研究以提供更多临床信息。

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