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305 例犬应用特制钢板行双盆截骨术后并发症。

Postoperative Complications of Double Pelvic Osteotomy Using Specific Plates in 305 Dogs.

机构信息

AniCura Djursjukhuset Albano, Danderyd, Sweden.

Clinica Veterinaria Vezzoni, Cremona, Italy.

出版信息

Vet Comp Orthop Traumatol. 2022 Jan;35(1):47-56. doi: 10.1055/s-0041-1735288. Epub 2021 Sep 29.

Abstract

OBJECTIVE

The aim of this clinical retrospective study was to describe the postoperative complications and associated factors of double pelvic osteotomy (DPO) using DPO plates.

MATERIALS AND METHODS

Medical records were searched for dogs that underwent unilateral or bilateral DPO using DPO plates from February 2009 to October 2018 and were re-evaluated for a minimum of 1 to 2 months postoperatively. A variety of commercially available, specific DPO plates were used. Complications were determined during the immediate postoperative period and at the time of the clinical and radiographic re-evaluations done 1 and/or 2 months postoperatively.

RESULTS

A total of 458 DPO (226 right, 232 left) performed in 305 dogs satisfied the inclusion criteria. Double pelvic osteotomy plates from eight different manufacturers were used: Fixin ( = 160), Kyon ( = 154), New Generation Device ( = 63), Hofmann ( = 61), Veterinary Instrumentation ( = 12), DePuy Synthes ( = 4), Porte ( = 3) and Koenigsee ( = 1). Mean age of the dogs was 6.2 months (range: 5-8 months), and the body weight ranged from 10 to 47 kg. Overall, a total of 42 complications occurred in 38 DPO (8.2%). Complications included greenstick fracture of the ischium in 14 DPO (3%), isolated screw loosening in 13 DPO involving 16 of a total of 2,947 screws (0.5%), isolated screw breakage in 4 DPO involving 5 of 2,947 screws (0.1%), incomplete ilium fracture in 3 DPO (0.6%), partial caudal plate avulsion in 3 DPO (0.6%), iatrogenic sciatic neuropraxia in two DPO (0.4%), suspected surgical site infection (SSI) in 1 DPO (0.2%) and persistent pain and lameness caused by the implant in 2 DPO (0.4%). The case of suspected SSI and the two cases of persistent pain were classified as major complications (3 DPO, 0.6%), requiring medical and surgical intervention, respectively, whereas other 39 complications in 35 DPO were classified as minor, not requiring treatment (7.6%).

CONCLUSION

Double pelvic osteotomy using DPO plates appears to be a safe surgical option for the treatment of hip dysplasia in growing dogs; no catastrophic complications were reported and the incidence of complications (0.6% major complications and 7.6% minor complications) was low. This study showed that DPO using DPO plates and proper technique was safe in 92% of cases. The only two factors found to be significantly associated with the development of complications after DPO were the laterality (left-sided or right-sided) and body weight.

摘要

目的

本临床回顾性研究的目的是描述使用双骨盆截骨术(DPO)钢板进行单侧或双侧 DPO 的术后并发症及其相关因素。

材料和方法

从 2009 年 2 月至 2018 年 10 月,检索了接受过 DPO 钢板治疗的犬的病历,并对至少 1 至 2 个月后进行了再次评估。使用了各种市售的特定 DPO 钢板。在术后即刻和术后 1 个月和/或 2 个月进行临床和放射学再评估时确定并发症。

结果

305 只犬中共有 458 只 DPO(226 只右侧,232 只左侧)符合纳入标准。使用了来自 8 个不同制造商的双骨盆截骨术钢板:Fixin(n=160)、Kyon(n=154)、New Generation Device(n=63)、Hofmann(n=61)、Veterinary Instrumentation(n=12)、Depuy Synthes(n=4)、Porte(n=3)和 Koenigsee(n=1)。犬的平均年龄为 6.2 个月(范围:5-8 个月),体重范围为 10-47kg。总体而言,38 只 DPO(8.2%)发生了 42 种并发症。并发症包括 14 只 DPO(3%)坐骨青枝骨折、13 只 DPO 中单独的螺钉松动(16 个总共有 2947 个螺钉,0.5%)、4 只 DPO 中单独的螺钉断裂(5 个总共有 2947 个螺钉,0.1%)、3 只 DPO 不完全的髂骨骨折(0.6%)、3 只 DPO 部分尾侧钢板撕脱(0.6%)、2 只 DPO 医源性坐骨神经麻痹(0.4%)、1 只 DPO 疑似手术部位感染(0.2%)和 2 只 DPO 持续的植入物引起的疼痛和跛行(0.4%)。疑似 SSI 的病例和 2 例持续疼痛的病例被归类为主要并发症(3 只 DPO,0.6%),分别需要医疗和手术干预,而 35 只 DPO 中的其他 39 例并发症则被归类为次要并发症,无需治疗(7.6%)。

结论

使用 DPO 钢板进行双骨盆截骨术似乎是治疗生长犬髋关节发育不良的一种安全的手术选择;没有报告灾难性的并发症,并发症的发生率(0.6%的主要并发症和 7.6%的次要并发症)较低。本研究表明,在 92%的病例中,使用 DPO 钢板和正确的技术进行 DPO 是安全的。仅发现两个因素与 DPO 后并发症的发生显著相关,即侧别(左侧或右侧)和体重。

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