Department of Small Animal Surgery, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
Department of Small Animal Surgery, VetRef, Beaucouzé, France.
N Z Vet J. 2023 Nov;71(6):337-343. doi: 10.1080/00480169.2023.2246424. Epub 2023 Sep 4.
Three dogs and one cat sustained forelimb trauma and were presented to a university veterinary clinic (Liège, Belgium) and a private veterinary hospital (Beacouzé, France). All four animals were referred for surgery.
Two dogs and the cat were ambulatory on admission but unable to bear weight on the affected limb. One dog was non-ambulatory and lacked voluntary movement and sensation in one forelimb. Salter-Harris type II fractures of the distal humerus were diagnosed by radiography in all cases; avulsion of the brachial plexus and pelvic fractures were also present in the non-ambulatory dog.
All Salter-Harris type II fractures were stabilised by open reduction and internal fixation with cross pins. One minor complication (seroma) and three major complications (implant migration) developed after surgery. The pins were completely removed in one case and partially removed in two cases to resolve these complications. At the final follow-up examination (12-31 months after surgery), owners reported no lameness in three of the four cases and grade 2/5 left forelimb lameness in one case.
This type of fracture is rarely described in the literature; however, it should be included in the differential diagnoses of traumatic humeral fractures in growing dogs and cats. In this case series, we achieved fair-to-excellent short-term and long-term outcomes after osteosynthesis of Salter-Harris type II fractures by cross pinning.
三只狗和一只猫的前肢受伤,被送到一所大学兽医诊所(比利时列日)和一家私人兽医医院(法国博库兹)。四只动物均被转诊接受手术治疗。
两只狗和猫入院时可活动,但不能负重于患侧肢体。一只狗不能活动,且一只前肢失去了自主运动和感觉。所有病例的 X 射线检查均诊断为肱骨远端Ⅱ型 Salter-Harris 骨折;不能活动的狗还存在臂丛神经撕脱和骨盆骨折。
所有Ⅱ型 Salter-Harris 骨折均通过交叉克氏针开放复位内固定进行稳定。手术后出现 1 例轻微并发症(血清肿)和 3 例严重并发症(植入物迁移)。为解决这些并发症,1 例完全取出,2 例部分取出了克氏针。在最终随访检查(手术后 12-31 个月)时,4 例中有 3 例的主人报告没有跛行,1 例的左前肢跛行评分为 2/5。
这种类型的骨折在文献中很少被描述;然而,在生长中的犬猫外伤性肱骨骨折的鉴别诊断中应包括这种骨折。在本病例系列中,我们通过交叉克氏针固定Ⅱ型 Salter-Harris 骨折,获得了良好至优秀的短期和长期结果。