Dixon B C, Tomlinson J L, Wagner-Mann C C
Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri-Columbia 65211.
Vet Surg. 1994 Nov-Dec;23(6):448-55. doi: 10.1111/j.1532-950x.1994.tb00506.x.
The effects of three different techniques of intramedullary (IM) pin placement on pin location and incidence of stifle joint injury were evaluated using 70 cadaver canine tibiae after mid-disphyseal osteotomy. In 50 tibiae, pins were placed retrograde in either a nondirected (group A) or a craniomedially directed fashion (group B) with 25 tibiae in each group. Pins were driven normograde (group N) in 20 tibiae. All the stifles were dissected to qualitatively evaluate pin interference with different joint structures. End-on radiographs of the tibial plateaus were used to quantitatively evaluate pin location. Interference with the caudal cruciate ligament, medial meniscus, lateral meniscus, or meniscal ligaments was not observed in any group. There was a significant association between pinning technique and incidence of involvement of the cranial cruciate ligament (P < .005), patella (P < .001), patellar ligament (P < .005), and femoral condyle (P < .01). Pin location for group A was significantly different from either other group in a cranial-caudal direction (P = .003), and was significantly different from group N in a medial-lateral direction (P = .005). No significant difference was observed between pin location for groups B and N in either plane. It was concluded that although nondirected retrograde pinning cannot be recommended, retrograde pins directed craniomedially may be an acceptable technique for the repair of proximal to mid-diaphyseal tibial fractures if care is taken to properly seat the pins.
在70具犬类尸体胫骨进行骨干中段截骨术后，评估了三种不同的髓内针置入技术对针位置及 stifle 关节损伤发生率的影响。在50根胫骨中，将针逆行置入，其中25根胫骨采用无定向方式（A组），另外25根胫骨采用向颅内侧定向方式（B组）。20根胫骨采用顺行置针（N组）。解剖所有的 stifle 关节以定性评估针与不同关节结构的干扰情况。使用胫骨平台的正位X线片定量评估针的位置。在任何组中均未观察到对后交叉韧带、内侧半月板、外侧半月板或半月板韧带的干扰。置针技术与颅交叉韧带受累发生率（P < 0.005）、髌骨（P < 0.001）、髌韧带（P < 0.005）和股骨髁（P < 0.01）之间存在显著关联。A组在颅尾方向的针位置与其他任何一组均有显著差异（P = 0.003），在内外侧方向与N组有显著差异（P = 0.005）。B组和N组在任一平面的针位置之间未观察到显著差异。得出的结论是，尽管不推荐无定向逆行置针，但如果小心地正确安置针，向颅内侧定向的逆行针可能是修复胫骨近端至骨干中段骨折的一种可接受技术。
