Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis
An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Case Reports in Veterinary Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/1439237 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562885655527424 |
|---|---|
| author | Daniel D. Lewis Stanley E. Kim Justin Shmalberg Sandra L. MacArthur |
| author_facet | Daniel D. Lewis Stanley E. Kim Justin Shmalberg Sandra L. MacArthur |
| author_sort | Daniel D. Lewis |
| collection | DOAJ |
| description | An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of the caudal aspect of the proximal tibial physis, secondary to the proximal physeal fracture, resulted in an excessively high tibial plateau angle (TPA) of 50° with a limb length discrepancy of 13% by 24 weeks of age. The deformity was addressed by performing a proximal tibial osteotomy and subsequent distraction osteogenesis to reduce the TPA while concurrently lengthening the crus. A radial osteotomy was performed in the proximal metaphyseal region and the hinged fixator was applied. Distraction was initiated the day following surgery at a rate of 1 mm per day as measured along the caudal cortex of the tibia with a rhythm of three distractions daily. Distraction was terminated 19 days postoperatively. Sequential distraction of the osteotomy resulted in 17 mm of tibial lengthening and a final TPA of 3°. The fixator was removed 52 days after application. Complications included wire tract inflammation involving the wires securing the proximal segment and a calcaneal fracture which required bone plate stabilization. The left pelvic limb was only 8% shorter than the right pelvic limb and the dog had only a subtle lameness 12 months after surgery. The hinged circular fixator construct allowed for both the reduction of the TPA and limb segment lengthening in this dog. |
| format | Article |
| id | doaj-art-81559dfa8f284852a65dde6c99b3b13e |
| institution | Kabale University |
| issn | 2090-7001 2090-701X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Veterinary Medicine |
| spelling | doaj-art-81559dfa8f284852a65dde6c99b3b13e2025-02-03T01:21:33ZengWileyCase Reports in Veterinary Medicine2090-70012090-701X2019-01-01201910.1155/2019/14392371439237Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction OsteogenesisDaniel D. Lewis0Stanley E. Kim1Justin Shmalberg2Sandra L. MacArthur3Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USADepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USADepartment of Comparative Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USADepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USAAn 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of the caudal aspect of the proximal tibial physis, secondary to the proximal physeal fracture, resulted in an excessively high tibial plateau angle (TPA) of 50° with a limb length discrepancy of 13% by 24 weeks of age. The deformity was addressed by performing a proximal tibial osteotomy and subsequent distraction osteogenesis to reduce the TPA while concurrently lengthening the crus. A radial osteotomy was performed in the proximal metaphyseal region and the hinged fixator was applied. Distraction was initiated the day following surgery at a rate of 1 mm per day as measured along the caudal cortex of the tibia with a rhythm of three distractions daily. Distraction was terminated 19 days postoperatively. Sequential distraction of the osteotomy resulted in 17 mm of tibial lengthening and a final TPA of 3°. The fixator was removed 52 days after application. Complications included wire tract inflammation involving the wires securing the proximal segment and a calcaneal fracture which required bone plate stabilization. The left pelvic limb was only 8% shorter than the right pelvic limb and the dog had only a subtle lameness 12 months after surgery. The hinged circular fixator construct allowed for both the reduction of the TPA and limb segment lengthening in this dog.http://dx.doi.org/10.1155/2019/1439237 |
| spellingShingle | Daniel D. Lewis Stanley E. Kim Justin Shmalberg Sandra L. MacArthur Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis Case Reports in Veterinary Medicine |
| title | Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis |
| title_full | Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis |
| title_fullStr | Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis |
| title_full_unstemmed | Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis |
| title_short | Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis |
| title_sort | correction of excessive tibial plateau angle and limb shortening in a juvenile dog using a hinged circular fixator construct and distraction osteogenesis |
| url | http://dx.doi.org/10.1155/2019/1439237 |
| work_keys_str_mv | AT danieldlewis correctionofexcessivetibialplateauangleandlimbshorteninginajuveniledogusingahingedcircularfixatorconstructanddistractionosteogenesis AT stanleyekim correctionofexcessivetibialplateauangleandlimbshorteninginajuveniledogusingahingedcircularfixatorconstructanddistractionosteogenesis AT justinshmalberg correctionofexcessivetibialplateauangleandlimbshorteninginajuveniledogusingahingedcircularfixatorconstructanddistractionosteogenesis AT sandralmacarthur correctionofexcessivetibialplateauangleandlimbshorteninginajuveniledogusingahingedcircularfixatorconstructanddistractionosteogenesis |