Steuri Stephanie K, Ferrigno Cassio, Hespel Adrien, Zhu Xiaojuan
Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, United States of America.
Perth Veterinary Specialists, Osborne Park, WA, Australia.
PLoS One. 2024 Sep 16;19(9):e0308764. doi: 10.1371/journal.pone.0308764. eCollection 2024.
Previous studies have compared the use of the Slocum- jig to the deformity reduction device (DRD) jig for the correction of distal femoral deformities of varying degrees in the frontal plane. The objective of the current study is to further investigate the use of the mini DRD jig in comparison to the Slocum jig for correction of varying degrees of torsional deformities of the distal femur. Femoral models (n = 60) were developed based on a CT scan of an approximately 16.5 kg normal canine femur. Models were created with a standard varus deformity of 15 degrees, and external torsional deformities of 15, 20, or 30 degrees. Using center of rotation of angulation (CORA) methodology, corrective osteotomies were planned and performed on each of the 3D printed models based on the group assigned. Modeling clay was applied the proximal femur to mimic visualization of a routine lateral surgical approach, while retaining the ability to palpate surgical landmarks. Post-correction anatomic lateral distal femoral angle (aLDFA) and femoral torsion angle (FTA) were measured and recorded. The mean post-correction FTA of groups using the DRD jig for correction were consistently closer to the ideal value compared to those using the Slocum jig, although these differences were not always statistically significant. Correction of external torsion between the DRD jig and the Slocum jig was significantly different in groups 1 and 2 (P = 0.026 and P = 0.046), but not in group 3. For the correction of varus deformity, no significant difference was found between the two jig types in any group. Results of this study suggest jig selection during distal femoral osteotomy for correction of torsional deformity may result in varying precision of post-correction alignment. Clinical significance of this variance remains unclear, and intra-operative visual assessment of alignment should be implemented to guide corrections.
以往的研究比较了使用斯洛库姆夹具和畸形矫正装置(DRD)夹具来矫正不同程度的股骨远端额面畸形。本研究的目的是进一步探讨与斯洛库姆夹具相比,微型DRD夹具在矫正不同程度股骨远端扭转畸形中的应用。基于对一只约16.5千克正常犬股骨的CT扫描,制作了60个股骨模型。创建的模型具有15度的标准内翻畸形以及15度、20度或30度的外扭转畸形。采用成角旋转中心(CORA)方法,根据分配的组别,对每个3D打印模型进行矫正截骨术规划并实施。在股骨近端涂抹塑形黏土,以模拟常规外侧手术入路的视野,同时保留触诊手术标志的能力。矫正后测量并记录股骨远端解剖外侧角(aLDFA)和股骨扭转角(FTA)。与使用斯洛库姆夹具的组相比,使用DRD夹具进行矫正的组的平均矫正后FTA始终更接近理想值,尽管这些差异并非总是具有统计学意义。在第1组和第2组中,DRD夹具和斯洛库姆夹具在外扭转矫正方面存在显著差异(P = 0.026和P = 0.046),但在第3组中没有。对于内翻畸形的矫正,在任何组中两种夹具类型之间均未发现显著差异。本研究结果表明,在股骨远端截骨术矫正扭转畸形时选择夹具可能会导致矫正后对线的精度不同。这种差异的临床意义尚不清楚,应在术中进行对线的视觉评估以指导矫正。