RESUMO

Um filhote de porquinho-da-índia (Cavia porcellus) foi recebido para atendimento após histórico de ataque por cão. Na avaliação física, observou-se edema, dor e crepitação em membro pélvico direito, sugestivo de fratura. Na avaliação radiográfica, confirmou-se fratura Salter-Harris tipo I em epífise distal da tíbia. A resolução cirúrgica escolhida foi a associação de pino transarticular e coaptação externa com tala de Altman. O paciente teve acompanhamento radiográfico semanal e obteve alta médica no 35o dia de pós-cirúrgico, quando se observou consolidação com completo remodelamento ósseo.(AU)

A guinea pig (Cavia porcellus) cub presented edema, pain, and crepitus in the right pelvic limb after being attacked by a dog. Radiographic examination revealed Salter-Harris type 1 fracture on the distal region of the tibia. The surgery technique to correct the fracture involved an association of transarticular pinning and external coaptation with Altman splint. After surgery, radiographs of the patient were performed weekly and on the 35th post-surgery day, the bone was completely remodeled and healed, and the animal was dismissed.(AU)

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BACKGROUND: Lisfranc injuries represent a spectrum of trauma from high-energy lesions, with significant instability of the midfoot, to low-energy lesions, with subtle subluxations or instability without gross displacement. Recently, treatment options that allow for physiologic fixation of this multiplanar joint are being evaluated. The purpose of this study was to analyze the stability of a cadaveric Lisfranc injury model fixed with a novel suture-augmented neoligamentplasty in comparison with a traditional transarticular screw fixation construct. METHODS: Twenty-four fresh-frozen, matched cadaveric leg and foot specimens (12 individuals younger than 65 years of age) were used for this study. Two different types of Lisfranc ligament injuries were tested: partial and complete. Two different methods of fixation were compared: transarticular screws and augmented suture ligamentplasty with FiberTape. Specimens were fixed to a rotation platform in order to stress the joints while applying 400 N of axial load and internal and external rotation. Six distances were measured and compared between the intact, injured, and fixed states with a 3D Digitizer arm, in order to evaluate the stability between them. Analysis of variance was used with P < .05 considered significant. RESULTS: Using distribution graphs and analyzing the grouped data, it was observed that there was no difference between the 2 stabilization methods, but the augmented suture ligamentplasty presented lower variability and observed distance shortenings were more likely to be around the mean. The variability of the stabilization with screws was 2.9 times higher than that with tape (P < .001). CONCLUSION: We suggest that augmented suture ligamentplasty can achieve similar stability to classic transarticular screws, with less variability. CLINICAL RELEVANCE: This cadaveric study adds new information on the debate about Lisfranc lesions treatment. Flexible fixations, such as the synthethic ligamentplasty used, can restore good stability such as conventional transarticular screws.

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A miniature pig was examined because of left pelvic limb lameness after falling from a short height. Clinical examination and radiographs of the pelvic region revealed a left caudoventral hip luxation. Surgical reduction of luxation was performed on the patient under general anesthesia using a transarticular pinning technique. Postoperative radiographs confirmed that the luxation was reduced, the joint was aligned, and the transarticular pinning was correct. The transarticular pin was removed 21 days after it was surgically inserted. The limb was fully functional in the immediate postoperative period. Nine months after the surgery, the patient could use the limb properly, but mild degenerative joint disease was observed via radiographic follow-up. This technique may be a viable treatment option for the repair of caudoventral hip luxation in miniature pigs.

Um mini-pig foi atendido devido à claudicação do membro pélvico esquerdo após pequena queda. O exame clínico e radiografias da região pélvica revelaram uma luxação caudoventral de quadril no lado esquerdo. A redução cirúrgica da luxação foi realizada, com o paciente sob anestesia geral, usando um pino transarticular. As radiografias pós-operatórias confirmaram que a luxação foi reduzida, com alinhamento e fixação transarticular corretos. O pino transarticular foi removido cirurgicamente 21 dias após de ter sido inserido. O membro se tornou totalmente funcional já no período pós-operatório imediato. Nove meses após a cirurgia, o paciente utilizava o membro corretamente, porém foi detectada doença articular degenerativa leve através de acompanhamento radiográfico. A técnica empregada foi uma opção viável de tratamento para a reparação da luxação caudoventral de quadril em mini-pig.

Assuntos

RESUMO

A miniature pig was examined because of left pelvic limb lameness after falling from a short height. Clinical examination and radiographs of the pelvic region revealed a left caudoventral hip luxation. Surgical reduction of luxation was performed on the patient under general anesthesia using a transarticular pinning technique. Postoperative radiographs confirmed that the luxation was reduced, the joint was aligned, and the transarticular pinning was correct. The transarticular pin was removed 21 days after it was surgically inserted. The limb was fully functional in the immediate postoperative period. Nine months after the surgery, the patient could use the limb properly, but mild degenerative joint disease was observed via radiographic follow-up. This technique may be a viable treatment option for the repair of caudoventral hip luxation in miniature pigs.(AU)

Um mini-pig foi atendido devido à claudicação do membro pélvico esquerdo após pequena queda. O exame clínico e radiografias da região pélvica revelaram uma luxação caudoventral de quadril no lado esquerdo. A redução cirúrgica da luxação foi realizada, com o paciente sob anestesia geral, usando um pino transarticular. As radiografias pós-operatórias confirmaram que a luxação foi reduzida, com alinhamento e fixação transarticular corretos. O pino transarticular foi removido cirurgicamente 21 dias após de ter sido inserido. O membro se tornou totalmente funcional já no período pós-operatório imediato. Nove meses após a cirurgia, o paciente utilizava o membro corretamente, porém foi detectada doença articular degenerativa leve através de acompanhamento radiográfico. A técnica empregada foi uma opção viável de tratamento para a reparação da luxação caudoventral de quadril em mini-pig.(AU)

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In this article, we present the techniques of axis screw fixation (laminar, pars, pedicle and transarticular screws), discussing the indications and contraindications of each one, as well as surgical tips and anatomical landmarks.

No presente artigo, apresentamos as técnicas de fixação do áxis com parafusos (lamina, parafusos de pars, pedículo e transarticular), discutindos as indicações e contraindicações das mesmas, assim como dicas cirúrgicas e parâmetros anatômicos relevantes.

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ABSTRACT: A miniature pig was examined because of left pelvic limb lameness after falling from a short height. Clinical examination and radiographs of the pelvic region revealed a left caudoventral hip luxation. Surgical reduction of luxation was performed on the patient under general anesthesia using a transarticular pinning technique. Postoperative radiographs confirmed that the luxation was reduced, the joint was aligned, and the transarticular pinning was correct. The transarticular pin was removed 21 days after it was surgically inserted. The limb was fully functional in the immediate postoperative period. Nine months after the surgery, the patient could use the limb properly, but mild degenerative joint disease was observed via radiographic follow-up. This technique may be a viable treatment option for the repair of caudoventral hip luxation in miniature pigs.

RESUMO: Um mini-pig foi atendido devido à claudicação do membro pélvico esquerdo após pequena queda. O exame clínico e radiografias da região pélvica revelaram uma luxação caudoventral de quadril no lado esquerdo. A redução cirúrgica da luxação foi realizada, com o paciente sob anestesia geral, usando um pino transarticular. As radiografias pós-operatórias confirmaram que a luxação foi reduzida, com alinhamento e fixação transarticular corretos. O pino transarticular foi removido cirurgicamente 21 dias após de ter sido inserido. O membro se tornou totalmente funcional já no período pós-operatório imediato. Nove meses após a cirurgia, o paciente utilizava o membro corretamente, porém foi detectada doença articular degenerativa leve através de acompanhamento radiográfico. A técnica empregada foi uma opção viável de tratamento para a reparação da luxação caudoventral de quadril em mini-pig.

RESUMO

BACKGROUND: Hallux valgus (HV) treatment is continuously evolving, and no definitive treatment can be recommended. Osteotomies are the main surgical choice for these deformities, but no clear role for soft tissue procedures is available. OBJECTIVE: To perform a retrospective comparison of the radiographic and clinical outcomes of 2 groups of patients with severe HV operated with the same osteotomy technique but differing on the type of lateral release. METHODS: Two groups of patients with symptomatic moderate to severe HV deformities were operated with the same proximal metatarsal osteotomy, which differed on the type of lateral release: group 1 had limited transarticular lateral capsule release (n = 62), and group 2 complete lateral release, including capsule, adductor tendon, and intermetatarsal (IM) ligament (n = 57). We recorded the American Orthopaedic Foot & Ankle Society (AOFAS) score, HV and IM angles, first metatarsal shortening, concomitant metatarsal shortening osteotomies (Weil), Akin osteotomies, and complications. RESULTS: The postoperative AOFAS score in group 1 was similar to that of group 2. The HV and IM angles improved in both groups with no significant difference. The multivariate analysis showed no influence of any variable analyzed on HV or IM angle improvement. Regarding AOFAS score improvement, a limited lateral release was associated with a higher increase in AOFAS score (P = .019). CONCLUSION: No studies are available to identify which soft tissue structures are involved in HV deformities nor which have to be released, if any. A limited transarticular release can provide similar clinical and radiologic outcomes when compared with a classic open lateral release. LEVEL OF EVIDENCE: Level IV, case series.

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A five-month-old Amazon parrot (Amazona aestiva), weighting 320g, was referred to the Veterinary Teaching Hospital at the Universidade Federal de Santa Maria presenting rotational deformities of the right limb distal leg. A knee joint luxation was identified in the radiographic exam. Arthrodesis was performed using transarticular external skeletal fixation. Sixty days after the surgery, there was complete osseous union (arthrodesis) between femur and tibiotarsus, and the bird recovered the function of the limb.

Foi atendido no Hospital Veterinário da Universidade Federal de Santa Maria um psitacídeo da espécie Amazona aestiva, com cinco meses de idade, 320 gramas, que apresentava desvio rotacional do membro direito na sua porção distal ao joelho. Ao exame radiográfico identificou-se luxação do joelho. Como tratamento, foi realizada artrodese dessa articulação, utilizando-se um fixador esquelético externo transarticular. Após 60 dias do procedimento cirúrgico, houve completa união (artrodese) entre o fêmur e o tibiotarso, e a ave utilizava adequadamente o membro.

RESUMO

A five-month-old Amazon parrot (Amazona aestiva), weighting 320g, was referred to the Veterinary Teaching Hospital at the Universidade Federal de Santa Maria presenting rotational deformities of the right limb distal leg. A knee joint luxation was identified in the radiographic exam. Arthrodesis was performed using transarticular external skeletal fixation. Sixty days after the surgery, there was complete osseous union (arthrodesis) between femur and tibiotarsus, and the bird recovered the function of the limb.

Foi atendido no Hospital Veterinário da Universidade Federal de Santa Maria um psitacídeo da espécie Amazona aestiva, com cinco meses de idade, 320 gramas, que apresentava desvio rotacional do membro direito na sua porção distal ao joelho. Ao exame radiográfico identificou-se luxação do joelho. Como tratamento, foi realizada artrodese dessa articulação, utilizando-se um fixador esquelético externo transarticular. Após 60 dias do procedimento cirúrgico, houve completa união (artrodese) entre o fêmur e o tibiotarso, e a ave utilizava adequadamente o membro.