Evers P, Johnston G R, Wallace L J, Lipowitz A J, King V L
Department of Small Animal Clinical Sciences, Veterinary Teaching Hospital, University of Minnesota, St. Paul 55108, USA.
J Am Vet Med Assoc. 1997 Jan 1;210(1):59-64.
To determine long-term results of various treatments for traumatic coxofemoral joint dislocation in dogs.
Retrospective case series.
64 dogs that underwent closed reduction and bandage stabilization, extracapsular suture stabilization, transacetabular pinning, toggle pinning, DeVita pinning, or femoral head and neck excision.
Follow-up evaluations included owner evaluation (64 dogs), physical evaluation (23), and radiography (19). Follow-up time ranged from 8 to 156 months.
Owner evaluation scores after closed reduction were significantly better than scores after DeVita pinning, extracapsular suture stabilization, and femoral head and neck excision. On physical examination, 6 of 23 dogs were lame on the side of the previous dislocation. Signs of pain and crepitation were evident during palpation of 12 and 8 of 25 joints, respectively. Thirteen of 21 joints had radiographic evidence of degenerative joint disease. There was a greater progression of degenerative joint disease in previously dislocated joints than in unaffected joints. There were not any significant differences between treatments in regard to results of physical and radiographic evaluation. Time between trauma and treatment and existence of concomitant injuries did not influence follow-up results, but there was a significant association between body weight and radiographic evaluation score.
Concomitant injuries do not appear to justify a worse prognosis in dogs with traumatic coxofemoral joint dislocation, nor does a delay in treatment of > 3 days. Gait abnormalities and degenerative joint disease might develop in the long term. Proper body weight should be maintained regardless of treatment.
确定犬创伤性髋关节脱位各种治疗方法的长期效果。
回顾性病例系列。
64只接受了闭合复位和绷带固定、关节囊外缝合固定、经髋臼穿针固定、肘节穿针固定、德维塔穿针固定或股骨头颈切除术的犬。
随访评估包括主人评估(64只犬)、体格检查(23只)和X线摄影(19只)。随访时间为8至156个月。
闭合复位后的主人评估得分显著优于德维塔穿针固定、关节囊外缝合固定和股骨头颈切除术后的得分。体格检查时,23只犬中有6只在先前脱位侧出现跛行。分别在25个关节中的12个和8个关节触诊时可明显感觉到疼痛和摩擦音。21个关节中有13个有关节退行性疾病的X线证据。先前脱位的关节比未受影响的关节有更严重的关节退行性疾病进展。在体格检查和X线评估结果方面,各治疗方法之间没有显著差异。创伤与治疗之间的时间以及是否存在合并伤并不影响随访结果,但体重与X线评估得分之间存在显著关联。
合并伤似乎并不能说明创伤性髋关节脱位犬的预后更差,治疗延迟超过3天也不会。长期可能会出现步态异常和关节退行性疾病。无论采用何种治疗方法,都应保持适当体重。