Lefebvre Michael D, Broux Olivier R, Barthélémy Nicolas P, Hamon Martin, Moyse Evelyne V, Bouvy Bernard M, Balligand Marc H
Department of Clinical Sciences - Small Animal Surgery, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
Langford Veterinary Services, University of Bristol, Langford, North Somerset, United Kingdom.
Vet Surg. 2018 Jan;47(1):30-35. doi: 10.1111/vsu.12707. Epub 2017 Nov 14.
To identify risk factors for tibial damage associated with the modified Maquet technique (MMT) in dogs with cranial cruciate ligament (CCL) disease.
Retrospective study.
One hundred and seventy-four stifles from 147 client-owned dogs.
Medical records of dogs diagnosed with CCL disease and treated with the current version of MMT were reviewed. Dogs were included if immediate postoperative radiographs were available. Cortical hinge fracture or fissure, tibial tuberosity fracture, and diaphyseal fractures of the tibia were recorded. Age, body weight (BW), thickness of the tibial cortical hinge, and angle of opening of the osteotomy were tested as potential risk factors for tibial damage by univariate logistic regression analysis.
Tibial damage included intraoperative tibial fissures in 37% of MMTs, intraoperative fractures of the cortical hinge in 3.4% of MMTs, postoperative tibial fractures in 14% of MMTs. Risk factors for intraoperative fissure included BW (P = .0153) and thickness of cortical hinge (P = .0006). The angle of opening of the osteotomy was identified as a risk factor for intraoperative cortical hinge fracture (P = .0034), angles below 11° being preventive. No risk factor was identified for postoperative fracture.
Based on these results, preventive measures against tibial damage associated with MMT should include: a thickness of cortical hinge based on the equation related to the BW; a length of osteotomy adjusted to the amount of TTA with an osteotomy angle below 10°; and slow advancement of the tibial tuberosity.
确定患有颅交叉韧带（CCL）疾病的犬采用改良 Maquet 技术（MMT）后胫骨损伤的危险因素。
回顾性研究。
来自 147 只客户拥有犬的 174 个 stifles。
回顾诊断为 CCL 疾病并采用当前版本 MMT 治疗的犬的病历。如果有术后即刻 X 光片，则纳入研究。记录皮质铰链骨折或裂隙、胫骨结节骨折和胫骨干骨折。通过单因素逻辑回归分析，将年龄、体重（BW）、胫骨皮质铰链厚度和截骨开口角度作为胫骨损伤的潜在危险因素进行测试。
胫骨损伤包括 37%的 MMT 术中胫骨裂隙、3.4%的 MMT 术中皮质铰链骨折、14%的 MMT 术后胫骨骨折。术中裂隙的危险因素包括 BW（P = 0.0153）和皮质铰链厚度（P = 0.0006）。截骨开口角度被确定为术中皮质铰链骨折的危险因素（P = 0.0034），角度低于 11°可预防。未确定术后骨折的危险因素。
基于这些结果，针对与 MMT 相关的胫骨损伤的预防措施应包括：根据与 BW 相关的公式确定皮质铰链厚度；根据胫骨结节前移术（TTA）的量调整截骨长度，截骨角度低于 10°；以及缓慢推进胫骨结节。
