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骨膜横断与剥离治疗马驹四肢成角畸形:影像学观察

Periosteal transection and stripping for treatment of angular limb deformities in foals: radiographic observations.

作者信息

Bertone A L, Park R D, Turner A S

出版信息

J Am Vet Med Assoc. 1985 Jul 15;187(2):153-6.

PMID:4030449
Abstract

Radiographs of 23 foals (35 forelimbs) with carpal region angular limb deformities, which later were corrected by hemicircumferential transection of the periosteum and periosteal stripping, were evaluated as to geometric and morphologic abnormalities. Geometric evaluation included deviation angle and deviation pivot point. Morphologic abnormalities were categorized as: asymmetric width of the distal radial physis; asymmetric width of the distal radial epiphysis; carpal bone collapse or fracture; carpal bone hypoplasia; carpal bone displacement; and metacarpal bone displacement. Fifty-seven percent of limbs had radiographic lesions in the carpal joints and 20% had lesions in the metacarpus. Of all the limbs, 48% had carpal or metacarpal bone hypoplasia, 26% had carpal or metacarpal bone displacement, and 12% had carpal bone collapse or fragmentation. On long-term followup (5 months to 2 years), 83% of the foals were sound and had straight limbs, regardless of the deviation angle, deviation pivot point, or morphologic carpal bone changes. Sixty percent of the foals were in performance training. About 50% of these foals in performance training had carpal bone hypoplasia before correction of the deviation. It was concluded that geometric and morphologic radiographic interpretation should be performed before surgical correction of carpal angular limb deformities with hemicircumferential transection of the periosteum and periosteal stripping, but that epiphyseal, carpal bone, or metacarpal bone changes, severe deviation angle (20 to 29 degrees) or distal location of the pivot point should not discourage attempted surgical correction.

摘要

对23匹患有腕关节区域角度肢畸形的马驹(35个前肢)的X线片进行了评估,这些畸形后来通过骨膜半周横断和骨膜剥离得到了纠正,评估内容包括几何和形态学异常。几何评估包括偏差角度和偏差枢轴点。形态学异常分为:桡骨远端骨骺宽度不对称;桡骨远端骨骺宽度不对称;腕骨塌陷或骨折;腕骨发育不全;腕骨移位;以及掌骨移位。57%的肢体在腕关节有X线病变,20%的肢体在掌骨有病变。在所有肢体中,48%有腕骨或掌骨发育不全,26%有腕骨或掌骨移位,12%有腕骨塌陷或碎裂。在长期随访(5个月至2年)中,83%的马驹健康,四肢笔直,无论偏差角度、偏差枢轴点或腕骨形态学变化如何。60%的马驹接受了性能训练。在这些接受性能训练的马驹中,约50%在纠正偏差前有腕骨发育不全。得出的结论是,在用骨膜半周横断和骨膜剥离手术纠正腕关节角度肢畸形之前,应进行几何和形态学X线解释,但骨骺、腕骨或掌骨变化、严重偏差角度(20至29度)或枢轴点的远端位置不应阻碍尝试进行手术纠正。

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