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使用环扎缆线钢板系统稳定犬全髋关节置换术后的人工关节周围股骨骨折。

Use of a cerclage cable-plate system to stabilize a periprosthetic femoral fracture after total hip replacement in a dog.

作者信息

Carvajal Jose L, Kim Stanley E, Pozzi Antonio

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.

Clinic for Small Animal Surgery, Small Animal Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

出版信息

Vet Surg. 2019 Apr;48(3):437-443. doi: 10.1111/vsu.13185. Epub 2019 Feb 28.

Abstract

OBJECTIVE

To report the successful use of cerclage cables around the periprosthetic region of a femoral fracture after total hip replacement (THR) in a dog with bone stock too limited for other methods of fixation.

STUDY DESIGN

Case report.

ANIMAL

6-year-old male neutered, golden retriever.

METHODS

Locking plate fixation of a type-B1 diaphyseal periprosthetic femoral fracture (PFF) failed 14 days after cementless THR and 6 days after initial femoral fracture repair. Total hip replacement implants seemed unchanged on radiographs, but lateral retraction of the screw-plate construct from the proximal segment was evident. Bone stock was assessed as insufficient for adequate screw purchase, prompting revision of the fixation with cerclage cable fixation of the proximal segment; the cables were anchored to the original locking plate construct with threaded positioning pins that screwed into the locking holes.

RESULTS

Acceptable union was documented on radiographs by 3 months after revision. No lameness and good range of motion of the hip were observed on clinical examination 13 months after surgery. Radiographs at 13 months documented static implant positioning and remodeling at the fracture site.

CONCLUSION

Use of a cable-plate construct to stabilize a type-B1 PFF led to successful long-term outcome in this dog.

CLINICAL SIGNIFICANCE

Use of a cable-plate construct may be considered to treat type-B1 PFF with limited bone stock.

摘要

目的

报告在一只骨量有限、无法采用其他固定方法的犬全髋关节置换(THR)术后,使用环扎钢缆固定股骨假体周围骨折的成功案例。

研究设计

病例报告。

动物

一只6岁已绝育的雄性金毛寻回犬。

方法

在非骨水泥型THR术后14天以及初次股骨骨折修复术后6天,B1型骨干假体周围股骨骨折(PFF)的锁定钢板固定失败。X线片显示全髋关节置换植入物似乎未发生改变,但螺钉钢板结构向近端节段外侧移位明显。评估骨量不足以提供足够的螺钉把持力,因此采用近端节段环扎钢缆固定对固定方式进行翻修;钢缆通过拧入锁定孔的螺纹定位销固定在原锁定钢板结构上。

结果

翻修术后3个月的X线片显示骨折达到可接受的愈合。术后13个月的临床检查未发现跛行,髋关节活动范围良好。术后13个月的X线片显示植入物位置固定,骨折部位有重塑。

结论

在这只犬中,使用钢缆钢板结构稳定B1型PFF取得了成功的长期效果。

临床意义

对于骨量有限的B1型PFF,可考虑使用钢缆钢板结构进行治疗。

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