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在不使用术中透视的情况下,采用钢板下骨折复位的微创钢板接骨术来稳定犬猫胫骨干和股骨干骨折。

Minimally Invasive Plate Osteosynthesis Using Fracture Reduction Under the Plate without Intraoperative Fluoroscopy to Stabilize Diaphyseal Fractures of the Tibia and Femur in Dogs and Cats.

作者信息

Cabassu Julien

机构信息

Clinique Vétérinaire Cabassu, Marseille, France.

出版信息

Vet Comp Orthop Traumatol. 2019 Nov;32(6):475-482. doi: 10.1055/s-0039-1693413. Epub 2019 Jul 29.

Abstract

OBJECTIVE

The aim of this study was to prospectively evaluate postoperative alignment when using fracture reduction under the plate (FRUP) during a minimally invasive plate osteosynthesis in tibial and femoral fractures, without intraoperative imaging, and report immediate postoperative complications.

MATERIALS AND METHODS

After precise plate contouring and preoperative planning, FRUP was obtained with one cortical screw per fragment. Fractures were stabilized with a plate or plate rod. Tibial/femoral lengths, tibial plateau angles, mechanical medial proximal and distal tibial angles, anatomical lateral distal femoral angles, femoral curvatum and neck anteversion were evaluated on postoperative radiographs and contralateral bone. Tibial torsion was evaluated visually. Paired -test were used to compare data. Immediate postoperative complications were recorded.

RESULTS

Twenty-one tibial and 20 femoral fractures were stabilized (14 plate rod cases). Mean postoperative operated tibial length was 1.4% shorter ( = 0.001). Mean postoperative operated femoral length was 2% shorter ( = 0.04). Mean operated tibial plateau angle was 1.1° lower ( = 0.02). No difference in tibial torsion was noticed. No significant difference in mechanical medial proximal tibial angle, mechanical medial distal tibial angle, anatomical lateral distal femoral angle and femoral neck anteversion was observed. Mean operated femoral curvatum angle was 5.6° less ( = 0.01). Five cases (3 plate rod cases) required an immediate revision.

CLINICAL SIGNIFICANCE

Minimally invasive plate osteosynthesis with FRUP leads to acceptable postoperative alignment. Correct pin placement should be evaluated.

摘要

目的

本研究旨在前瞻性评估在胫骨和股骨骨折的微创钢板接骨术中采用钢板下骨折复位(FRUP)且无术中影像时的术后对线情况,并报告术后即刻并发症。

材料与方法

在精确塑形钢板和术前规划后,每个骨折块用一枚皮质骨螺钉实现FRUP。骨折用钢板或钢板棒固定。在术后X线片和对侧骨上评估胫骨/股骨长度、胫骨平台角、胫骨近端和远端内侧机械角、股骨远端外侧解剖角、股骨弯曲度和颈前倾角。通过视觉评估胫骨扭转。采用配对检验比较数据。记录术后即刻并发症。

结果

21例胫骨骨折和20例股骨骨折得到固定(14例为钢板棒固定)。术后患侧胫骨平均长度缩短1.4%(P = 0.001)。术后患侧股骨平均长度缩短2%(P = 0.04)。患侧胫骨平台平均角度降低1.1°(P = 0.02)。未发现胫骨扭转有差异。胫骨近端内侧机械角、胫骨远端内侧机械角、股骨远端外侧解剖角和股骨颈前倾角未观察到显著差异。患侧股骨平均弯曲角度减少5.6°(P = 0.01)。5例(3例为钢板棒固定)需要即刻翻修。

临床意义

采用FRUP的微创钢板接骨术可获得可接受的术后对线。应评估克氏针的正确置入情况。

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