McLaughlin R M, Tillson D M
Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan 66506.
Vet Surg. 1994 Jan-Feb;23(1):21-30. doi: 10.1111/j.1532-950x.1994.tb00438.x.
An external fixator consisting of two Ellis pins connected by a flexible band was developed and evaluated as a treatment for craniodorsal coxofemoral luxations in dogs. The technique for closed application of the fixator without injury to the coxofemoral joint or sciatic nerve was developed in six dog cadavers. The coxofemoral joints were then surgically destabilized and the limbs were manipulated through a full range of motion to assess the efficacy of the fixator in maintaining joint reduction. The fixator maintained joint reduction and stability after a surgically created craniodorsal luxation except when the femur was externally rotated 90 degrees. A flexible external fixator was then applied unilaterally in four healthy dogs. The dogs tolerated the fixator well and were bearing weight on the limb within 2 days after surgery; the range of motion was not limited by the fixator. The efficacy of a flexible external fixator in maintaining joint reduction after craniodorsal coxofemoral luxation was then evaluated in eight large dogs. The right coxofemoral joint in each dog was luxated surgically by removal of the dorsal joint capsule and transection of the ligament of the head of the femur and deep gluteal muscle. The joint was reduced and the fixator pins were applied in a closed fashion. In four dogs, a flexible external band was applied to the pins. Luxation did not reccur in these four dogs. The bands were not applied initially in four control dogs. Luxation occurred in three of the four control dogs within 24 hours of surgery. The joints that luxated were reduced and the flexible bands applied. Luxation did not recur after the bands were in place. The dogs tolerated the external fixators well, were bearing weight within 2 days of surgery, and walking with only minimal lameness 5 days after surgery. Luxation of the coxofemoral joints did not occur during the 2-week period in which the fixators were in place. The joints remained stable 1 week after removal of the fixators, at which time the dogs were euthanatized. Necropsy evaluation identified inflammation surrounding the pins and fibrous thickening of the dorsal joint capsule. The flexible external fixators were applied closed, maintained reduction of the coxofemoral joint after replacement of a craniodorsal luxation, and allowed weight bearing and limb usage soon after surgery. The flexible external fixator has several advantages over other methods of treating craniodorsal coxofemoral luxations. Complications noted in this study included pin tract drainage, pin loosening, and disruption of the flexible bands.
开发了一种由两个埃利斯针通过柔性带连接而成的外固定器，并对其作为犬颅背侧髋关节脱位的治疗方法进行了评估。在六只犬尸体上开发了在不损伤髋关节或坐骨神经的情况下闭合应用固定器的技术。然后通过手术使髋关节不稳定，并对肢体进行全范围活动操作，以评估固定器在维持关节复位方面的效果。除了股骨向外旋转90度时，该固定器在手术造成颅背侧脱位后能维持关节复位和稳定性。然后在四只健康犬身上单侧应用柔性外固定器。犬对固定器耐受性良好，术后2天内患肢即可负重；活动范围不受固定器限制。然后在八只大型犬身上评估了柔性外固定器在维持颅背侧髋关节脱位后关节复位方面的效果。通过切除背侧关节囊、切断股骨头韧带和臀深肌，对每只犬的右侧髋关节进行手术脱位。关节复位后，以闭合方式应用固定器针。在四只犬中，在针上应用了柔性外带。这四只犬未再发生脱位。最初在四只对照犬中未应用外带。四只对照犬中有三只在术后24小时内发生脱位。对脱位的关节进行复位，并应用柔性外带。外带就位后未再发生脱位。犬对外部固定器耐受性良好，术后2天内开始负重，术后5天仅略有跛行。在固定器放置的2周内未发生髋关节脱位。取出固定器1周后关节仍保持稳定，此时对犬实施安乐死。尸检评估发现针周围有炎症，背侧关节囊有纤维增厚。柔性外固定器以闭合方式应用，在替换颅背侧脱位后能维持髋关节复位，并允许术后不久即负重和使用肢体。与治疗颅背侧髋关节脱位的其他方法相比，柔性外固定器有几个优点。本研究中 noted 的并发症包括针道引流、针松动和柔性带断裂。
