Lee Hee-Ryung, Adam Gareeballah Osman, Kim Shang-Jin
Hansarang Animal Hospital, Seoul 02880, Korea.
Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, Sudan University of Science and Technology, Khartoum P.O. Box 204, Sudan.
Vet Sci. 2022 Mar 25;9(4):157. doi: 10.3390/vetsci9040157.
One of the most frequent bone deformities in dogs is antebrachial growth deformity (AGD), which results from malunion of the distal growth plates. The objective of the present study was to re-align the limbs, which can correct the length mismatch and reset the coherence of the joint with the aid of a 3-D phantom model for surgical preplanning. A 14-month-old, intact female Golden Retriever with an angular deformity of the left radius and ulna was selected for the study. The diagnosis was confirmed by orthogonal radiographs. Moreover, computed tomography (CT) scans revealed a multiplane deformity with valgus, procurator, and external rotation of the left radius. The pre-surgical planning started with the quantification of the angular deformity, followed by a simulated virtual osteotomy, and concluded with an in vitro rehearsal surgery on 3-D printed phantom bone models. In the operating room, prefabricated patient-specific instrumentation (PSI) was attached at the planned site of the radial bone surface for a precise closing wedge osteotomy. Then two locking plates were fixed routinely. Post-operative radiographs showed accurate correction of the deformity as we had planned. At 12 weeks post-operatively, the follow-up surveys revealed improved gait, weight-bearing, and progression of bone healing. Our PSI design, based on novel surgical planning, was steady yet straightforward during the osteotomy. The osteotomy was performed without difficulty since the PSI that pre-determined the sites and angles let the surgeon perform the antebrachial malformation surgery. This method of operation reduces stress on the operator and helps to improve accuracy, repeatability, and surgery time.
犬类最常见的骨骼畸形之一是前臂生长畸形（AGD），它是由远端生长板的愈合不良引起的。本研究的目的是通过三维模型进行手术预规划，重新调整肢体，以纠正长度不匹配并恢复关节的连贯性。选择一只14个月大、未绝育的雌性金毛猎犬，其左桡骨和尺骨存在角畸形，用于本研究。通过正交X线片确诊。此外，计算机断层扫描（CT）显示左桡骨存在多平面畸形，伴有外翻、前凸和外旋。手术前规划从量化角畸形开始，接着进行模拟虚拟截骨术，最后在三维打印的模型骨上进行体外模拟手术。在手术室中，将预制的个体化手术器械（PSI）附着在桡骨表面的计划部位，进行精确的闭合楔形截骨术。然后常规固定两块锁定钢板。术后X线片显示畸形得到了如我们计划的精确矫正。术后12周的随访调查显示步态、负重和骨愈合进程均有改善。我们基于新颖手术规划的PSI设计在截骨术中稳定且操作简便。由于预先确定了部位和角度的PSI，截骨术顺利进行，使外科医生能够实施前臂畸形手术。这种手术方法减轻了术者的压力，有助于提高准确性、可重复性和缩短手术时间。
