Armstrong Andrew J, Bruce Mieghan, Adams Robert, Kulendra Elvin, Pease Tony, Perry Karen L
Veterinary Medical Center, Michigan State University, East Lansing, Michigan.
School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia.
Vet Surg. 2019 May;48(4):524-536. doi: 10.1111/vsu.13187. Epub 2019 Feb 28.
To describe traumatic injuries involving the central tarsal bone (Tc) in nonracing dogs.
Retrospective multicenter study.
Thirty-two client-owned dogs.
Medical records from January 2010 to December 2016 were searched for dogs with Tc injury. Fracture classification, concurrent tarsal fractures, treatment, and perioperative management were tested for association with postoperative complications and short-term outcome. Outcome measures consisted of the latest lameness score reported in the record.
The most common injuries consisted of type V fractures (22) and luxation of the Tc (8). Other injuries included 1 case each of type III and type IV fractures. Twenty-two concurrent fractures involved other tarsal bones. Complications were diagnosed in 18 (62.1%) dogs, consisting of 13 minor, 4 major, and 1 catastrophic complication. Lameness at final follow-up (median 7 weeks) in 28 dogs was scored as 0 of 5 in 14 (50.0%) dogs, 1 of 5 in 7 (25.0%) dogs, 2 of 5 in 4 (14.3%) dogs, 4 of 5 in 1 (3.5%) dogs, and 5 of 5 in 2 (7.1%) dogs. Major complications were associated with the presence of multiple tarsal fractures (risk ratio [RR] 3.94, 95% CI 0.80-19.37, P = .13), specifically when the calcaneus was involved (RR 5.78, 95% CI 1.53-21.88, P = .05).
The most common diagnosis in this population of nonracing dogs consisted of type V Tc fractures. Fractures affecting other tarsal bones were common and were associated with a higher risk of major complications, especially those affecting the calcaneus.
Short-term outcomes seem favorable in nonracing dogs with isolated Tc fractures, but dogs with concomitant tarsal fractures are predisposed to major complications.
描述非赛犬中涉及中央跗骨(Tc)的创伤性损伤。
回顾性多中心研究。
32只客户拥有的犬。
检索2010年1月至2016年12月的医疗记录,查找患有Tc损伤的犬。对骨折分类、并发跗骨骨折、治疗及围手术期管理与术后并发症和短期预后的相关性进行检验。预后指标包括记录中报告的最新跛行评分。
最常见的损伤包括V型骨折(22例)和Tc脱位(8例)。其他损伤包括III型和IV型骨折各1例。22例并发骨折累及其他跗骨。18只(62.1%)犬被诊断有并发症,包括13例轻度、4例重度和1例灾难性并发症。28只犬最后一次随访(中位时间7周)时的跛行评分,14只(50.0%)犬为5分制中的0分,7只(25.0%)犬为1分,4只(14.3%)犬为2分,1只(3.5%)犬为4分,2只(7.1%)犬为5分。重度并发症与多发跗骨骨折有关(风险比[RR]3.94,95%可信区间0.80 - 19.37,P = 0.13),特别是当跟骨受累时(RR 5.78,95%可信区间1.53 - 21.88,P = 0.05)。
这群非赛犬中最常见的诊断为V型Tc骨折。影响其他跗骨的骨折很常见,且与重度并发症的较高风险相关,尤其是那些影响跟骨的骨折。
孤立性Tc骨折的非赛犬短期预后似乎良好,但伴有跗骨骨折的犬易发生重度并发症。