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犬先天性肩关节脱位继发肘关节挛缩:采用肘关节肌肉松解和基于环形截骨术的肩关节融合术的手术治疗

Elbow Contracture Secondary to Congenital Shoulder Luxation in a Dog: Surgical Management with Elbow Muscle Release and Circular Osteotomy-Based Shoulder Arthrodesis.

作者信息

Ryu Changhun, Lee Haebeom, Jeon Youngjin, Jeong Jaemin, Yoon Jongpil

机构信息

Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99, Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea.

出版信息

Animals (Basel). 2025 Sep 16;15(18):2717. doi: 10.3390/ani15182717.

DOI:10.3390/ani15182717
PMID:41007962
Abstract

A 10-month-old Poodle was presented with intermittent non-weight-bearing lameness of the left thoracic limb. Orthopedic and radiographic examinations revealed medial shoulder luxation and markedly reduced elbow extension. A two-stage surgical approach was performed. In the first stage, selective myotomy of periarticular structures, including the biceps brachii-brachialis complex and the extensor carpi radialis muscle, was conducted via medial and lateral approaches. A trans-articular external skeletal fixator was applied to maintain elbow extension. Elbow extension improved from 105° preoperatively to 142°. After confirming functional recovery of the elbow joint, the second stage involved shoulder arthrodesis using a circular osteotomy technique with a radial saw, which enabled fine-tuned intraoperative adjustment of limb alignment based on the contralateral limb posture. At nine months postoperatively, the patient exhibited a symmetrical gait, full weight-bearing, and no evidence of discomfort on range of motion assessment. This case highlights the clinical relevance of secondary elbow contracture associated with congenital shoulder instability and suggests that a combination of targeted muscle release and adjustable arthrodesis may offer favorable outcomes in managing complex joint dysfunction.

摘要

一只10个月大的贵宾犬出现左前肢间歇性非负重跛行。骨科和影像学检查发现肩关节内侧脱位,肘关节伸展明显受限。采用两阶段手术方法。第一阶段,通过内侧和外侧入路对包括肱二头肌-肱肌复合体和桡侧腕伸肌在内的关节周围结构进行选择性肌切开术。应用跨关节外固定架以维持肘关节伸展。肘关节伸展角度从术前的105°改善至142°。在确认肘关节功能恢复后,第二阶段采用环形截骨技术,使用桡骨锯进行肩关节融合术,这使得术中能够根据对侧肢体姿势对肢体对线进行微调。术后9个月,患者步态对称,完全负重,在活动度评估中无不适迹象。该病例突出了与先天性肩关节不稳定相关的继发性肘关节挛缩的临床相关性,并表明针对性肌肉松解和可调节关节融合术相结合可能为处理复杂关节功能障碍提供良好结果。

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本文引用的文献

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Stifle arthrodesis in dogs using semi-circular saw: Cadaveric study.应用半圆形骨锯行犬腕跗关节融合术:尸体研究。
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Assessment of a continuous passive motion assistive device in dogs following stifle surgery.评估连续被动运动辅助装置在犬膝关节手术后的应用。
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The examination and treatment of soft tissue contracture of the elbow.肘部软组织挛缩的检查与治疗
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Rat Model of Quadriceps Contracture by Joint Immobilization.关节固定致股四头肌挛缩的大鼠模型
Biology (Basel). 2022 Dec 7;11(12):1781. doi: 10.3390/biology11121781.
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Postoperative Complications Associated with External Skeletal Fixators in Dogs.犬体外骨骼固定器相关的术后并发症
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Investigating canine elbow joint stabilisation through mechanical constraints of the deep fascia and other soft tissues.通过深筋膜和其他软组织的机械性约束来研究犬肘关节的稳定性。
J Anat. 2018 Mar;232(3):407-421. doi: 10.1111/joa.12763. Epub 2017 Dec 14.
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