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采用改良双切口胫骨平台平整截骨术及内侧新月形闭合楔形截骨术治疗患有前交叉韧带断裂和膝外翻畸形的犬类。

Use of a Modified Tibial Plateau Levelling Osteotomy with Double Cut and Medial Crescentic Closing Wedge Osteotomy to Treat Dogs with Cranial Cruciate Ligament Rupture and Tibial Valgus Deformity.

作者信息

Vezzoni Luca, Bazzo Sara, Boiocchi Silvia, Vezzoni Aldo

机构信息

Surgical Department, Clinica Veterinaria Vezzoni, Cremona, Italy.

Surgical Department, Clinica Veterinaria Malpensa, Samarate, Italy.

出版信息

Vet Comp Orthop Traumatol. 2020 Jan;33(1):59-65. doi: 10.1055/s-0039-1700565. Epub 2019 Nov 22.

Abstract

OBJECTIVE

The aim of this study was to report efficacy of a modified tibial plateau levelling osteotomy (TPLO) with double cut and medial crescentic closing wedge osteotomy (TPLO/MCCWO) to treat dogs with cranial cruciate ligament rupture and concurrent tibial valgus.

STUDY DESIGN

This study was a cases series.

MATERIALS AND METHODS

Medical records of dogs that had TPLO with medial crescentic closing wedge osteotomy were reviewed. Data collected included signalment, body weight, pre- and postoperative tibial valgus angle, tibial plateau angle (TPA), surgical planning, corrective osteotomy technique, method of fixation, complications, and length of time to radiographic healing.

RESULTS

Fifty-two surgical procedures performed in 45 dogs (7 bilateral) were included in the study. Mean age at surgery was 54 months, and body weight ranged from 5 to 63 kg (mean: 36.5 kg). Mean pre- and postoperative mechanical medial proximal tibial angle were 101° (98°-107°) and 92.80° (88°-97°) respectively. The mean pre- and postoperative TPA were 27.80° (16-35°) and 6.50° (3-11°) respectively. Intraoperative complications occurred in two stifles: in one stifle over-rotation of the proximal tibial segment resulted in a TPA of -8°, with immediate revision to a 5° TPA; in the second stifle a fissure of the lateral tibial cortex developed during insertion of a screw and required adjunctive fixation. No postoperative complications were recorded and all osteotomies healed uneventfully.

CONCLUSIONS

Tibial plateau levelling osteotomy/medial crescentic closing wedge osteotomy is an effective treatment for dogs with cranial cruciate ligament rupture and tibial valgus allowing accurate correction of the tibial deformity with a low complication rate.

摘要

目的

本研究旨在报告改良双切口胫骨平台水平截骨术(TPLO)联合内侧新月形闭合楔形截骨术(TPLO/MCCWO)治疗颅交叉韧带断裂并发胫骨外翻犬的疗效。

研究设计

本研究为病例系列研究。

材料与方法

回顾接受TPLO联合内侧新月形闭合楔形截骨术犬的病历。收集的数据包括特征、体重、术前和术后胫骨外翻角度、胫骨平台角(TPA)、手术规划、截骨矫正技术、固定方法、并发症以及影像学愈合时间。

结果

本研究纳入了45只犬(7只双侧手术)的52例手术。手术时的平均年龄为54个月,体重范围为5至63千克(平均:36.5千克)。术前和术后胫骨近端内侧机械角度的平均值分别为101°(98° - 107°)和92.80°(88° - 97°)。术前和术后TPA的平均值分别为27.80°(16 - 35°)和6.50°(3 - 11°)。术中并发症发生在两个膝关节:一个膝关节中胫骨近端节段过度旋转导致TPA为 - 8°,立即修正为5°的TPA;另一个膝关节在拧入螺钉时出现外侧胫骨皮质裂缝,需要辅助固定。未记录到术后并发症,所有截骨均顺利愈合。

结论

胫骨平台水平截骨术/内侧新月形闭合楔形截骨术是治疗颅交叉韧带断裂并发胫骨外翻犬的有效方法,能够准确矫正胫骨畸形,并发症发生率低。

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