Bae Minji, Kang Byung-Jae, Kim Junhyung
Department of Veterinary Medicine, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon 24341, Republic of Korea.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Republic of Korea.
Animals (Basel). 2024 Dec 2;14(23):3480. doi: 10.3390/ani14233480.
A seven-month-old male Pomeranian presented with left forelimb lameness after a fall. Radiographic assessment confirmed proximal radial head and ulnar comminuted fracture. The initial surgical intervention involved the use of hybrid external skeletal fixation (ESF) to stabilize the radial head, concomitant with the application of a composite of bone morphogenetic protein type 2 (BMP-2)-loaded hydroxyapatite and gelatin microparticles at the fracture site. Although successful radial head healing was achieved, the ESF pinholes caused a defect in the proximal ulnar diaphysis. Subsequently, the ESF was removed, and a locking plate was applied in conjunction with the BMP-2-loaded collagen membrane to correct the radius defect. Clinical follow-up at 4.8 years postoperatively revealed a mildly decreased range of motion of the affected elbow joint, but no clinical symptoms such as lameness. Radiography revealed minimal degenerative changes and a radioulnar synostosis. Computed tomography revealed differences in the leg length and bone density. Gait analysis revealed that the left forelimb had a significant improvement in weight-bearing capacity based on weight distribution-peak vertical force metrics, compared with the right forelimb. Based on clinical outcomes, the combined application of hybrid ESF and bone tissue engineering techniques can be considered a feasible alternative treatment for radial head fractures.
一只七个月大的雄性博美犬在摔倒后出现左前肢跛行。影像学评估证实桡骨头近端和尺骨粉碎性骨折。最初的手术干预包括使用混合式外固定架（ESF）来稳定桡骨头，同时在骨折部位应用负载骨形态发生蛋白2（BMP-2）的羟基磷灰石和明胶微粒复合物。尽管桡骨头成功愈合，但ESF针孔导致尺骨近端骨干出现缺损。随后，拆除了ESF，并应用锁定钢板结合负载BMP-2的胶原膜来纠正桡骨缺损。术后4.8年的临床随访显示，患侧肘关节活动范围略有减小，但无跛行等临床症状。X线检查显示退行性改变轻微，桡尺骨融合。计算机断层扫描显示肢体长度和骨密度存在差异。步态分析显示，基于体重分布-峰值垂直力指标，与右前肢相比，左前肢的负重能力有显著改善。基于临床结果，混合式ESF与骨组织工程技术的联合应用可被视为桡骨头骨折的一种可行替代治疗方法。
