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Menghini TL, Shriwise G, Muir P. Fracture Healing in 37 Dogs and Cats with Implant Failure after Surgery (2013-2018). Animals (Basel) 2023; 13:ani13091549. [PMID: 37174586 PMCID: PMC10177280 DOI: 10.3390/ani13091549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Implant failure is common in small animal orthopedics, but risk factors are rarely reported. Our objective was to determine whether abnormal fracture healing was associated with implant failure after fracture fixation in dogs and cats in a consecutive series of cases. Thirty-seven client-owned animals (thirty-two dogs, five cats) diagnosed with implant failure after fracture treatment from January 2013-September 2018 were studied. Medical and radiographic records were retrospectively reviewed to identify patients that underwent fracture fixation using open reduction and internal fixation with subsequent radiographic evidence of implant failure. Area moment of inertia (AMI), plate working length, and bone screw density were determined. Implant failure was found in 39 fractures in 37 animals, representing 23% of fracture cases during the study period. Cases of implant failure were at increased risk of delayed union, malunion, or non-union (p < 0.0001). The most common cause of implant failure was loosening (54%); the second most common was plate failure that included low AMI locking plates (28%). Major complications found in 22/39 fractures (56%) were associated with delayed union (p < 0.01). Surgical revision was performed in 49% of implant failure cases. Complications were most frequently identified after treatment of humeral fractures (26%). We conclude mechanical failure of implants increases the risk for delayed or abnormal fracture healing and often requires revision surgery. Implant AMI should be considered during preoperative planning. Locking plates are associated with implant failure if plate bending stiffness is not sufficient, based on findings from this case series.
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Affiliation(s)
- Timothy L Menghini
- Comparative Orthopaedic Research Laboratory, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Georgia Shriwise
- Comparative Orthopaedic Research Laboratory, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Peter Muir
- Comparative Orthopaedic Research Laboratory, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706, USA
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Mascellino H, Maritato K, Barnhart M, Kass P. A Retrospective Short-Term Evaluation Using a Polyaxial Plating System in 60 Small Animal Fractures. Vet Comp Orthop Traumatol 2023; 36:104-110. [PMID: 36577444 DOI: 10.1055/s-0042-1756520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this study was to retrospectively evaluate the use, complications and outcomes of the Liberty Lock System (LLS) used to repair fractures in dogs and cats. STUDY DESIGN Medical records (October 2016-June 2019) of dog and cat fractures repaired with the LLS were reviewed. Data reviewed included signalment, fracture classification, complications and radiographic outcome. RESULTS The LLS was used to repair 60 fractures (57 appendicular and 3 axial) in 54 dogs and 6 cats. Mean time to radiographic union was 6 weeks (range: 4-16). Radiographic union was achieved in all 60 fractures with 55/60 healing without recorded complications. Major complications 4/60 and minor complication 1/60 rates were low and no catastrophic complications occurred. The most common major complication was surgical site infection. CONCLUSION The LLS allowed for successful repair in all 60 cases with a wide variety of fractures. The LLS had a similar complication rate and time to radiographic union to that reported in other veterinary locking plate systems. The LLS is a reliable locking plate system which offers some advantages such as a low-profile plate with the ability to place non-polyaxial to angled polyaxial screws, to treat fractures in dogs and cats.
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Affiliation(s)
- Haley Mascellino
- MedVet Medical Center for Pets, Worthington, Ohio, United States
| | - Karl Maritato
- MedVet Medical and Cancer Center for Pets, Cincinnati, Ohio, United States
| | - Matthew Barnhart
- MedVet Medical Center for Pets, Worthington, Ohio, United States
| | - Philip Kass
- UC Davis School of Veterinary Medicine, Davis, California, United States
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Kaczmarek J, Bartkowiak T, Paczos P, Zawadzki P, Łączna D, Gapiński B. What Is the Cost of Off-Axis Insertion of Locking Screws? A Biomechanical Comparison of a 3.5 mm Fixed-Angle and 3.5 mm Variable-Angle Stainless Steel Locking Plate Systems. Vet Comp Orthop Traumatol 2022; 35:339-346. [PMID: 35839838 DOI: 10.1055/s-0042-1750431] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of screw insertion angle and insertion torque on the mechanical properties of a 3.5 fixed-angle locking plate locking compression plate (LCP) and 3.5 variable-angle locking plate polyaxial locking system (PLS). METHODS In the LCP group, screws were placed abaxially at 0, 5 and 10 degrees. In the PLS group, screws were placed at 0, 5, 10, 15 and 20 degrees abaxially. The insertion torque was set to 1.5 and 2.5 Nm in the LCP and PLS groups respectively. A load was applied parallel to the screw axis, and the screw push-out force was measured until the locking mechanism was loosened. RESULTS The 3.5 LCP showed higher push-out strength than the 3.5 PLS when the screws were placed at 0 degree regardless of the insertion torque. The off-axis insertion of 3.5 LCP locking screws resulted in a significant decrease in push-out strength (p < 0.05). A higher insertion torque value significantly increased the screw holding strength for the 3.5 LCP (p < 0.05). The 3.5 PLS system had a significantly higher push-out force when the screws are at 0 degree than at 5, 10 and 15 degrees, and 20 degrees (p < 0.05) at any given insertion torque. An increase in the insertion torque did not have a significant effect on the push-out strength of the 3.5 PLS locking system. CONCLUSION The 3.5 PLS is more sensitive to the screw insertion angle than to the insertion torque, whereas the 3.5 LCP is affected by both factors. Placing 3.5 LCP locking screws off-axis significantly reduces the screw holding strength; therefore, this approach has to be avoided. The findings of our research indicate that a 1.5 Nm torque can be used for a 3.5 PLS.
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Affiliation(s)
| | - Tomasz Bartkowiak
- Poznan University of Technology, Faculty of Mechanical Engineering, Poznan , Poland
| | - Piotr Paczos
- Poznan University of Technology, Faculty of Mechanical Engineering, Poznan , Poland
| | - Paweł Zawadzki
- Poznan University of Technology, Faculty of Mechanical Engineering, Poznan , Poland
| | - Daria Łączna
- Poznan University of Technology, Faculty of Mechanical Engineering, Poznan , Poland
| | - Bartosz Gapiński
- Poznan University of Technology, Faculty of Mechanical Engineering, Poznan , Poland
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Treatment of Y-T Humeral Fractures with Polyaxial Locking Plate System (PAX) in 14 Dogs. Vet Sci 2022; 9:vetsci9070310. [PMID: 35878327 PMCID: PMC9320906 DOI: 10.3390/vetsci9070310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/17/2022] [Accepted: 06/16/2022] [Indexed: 11/27/2022] Open
Abstract
The aim of this study is to report the results and to review the outcome of 14 cases of Y-T humeral fractures repair using paired polyaxial locking system (PAX) plates through a combined medial and lateral approach. Fourteen consecutive dogs, with traumatic humeral Y-T fractures, met the inclusion criteria. This study includes signalment, preoperative radiographs, type of implants, radiographic bone healing assessment, complications, range of motion (ROM) of the elbow and limb function evaluated at 120 days after surgery. Postoperative radiographs revealed adequate anatomic reconstruction, and in all cases, bone healing has been achieved. No implant failure was observed. Functional outcome was excellent in 7 dogs (no lameness and preserved ROM), good in 4 (slight lameness and moderate ROM reduction) and discrete in 2 (mild lameness and severe ROM reduction). Complications were encountered in 2/14 patients with implant-associated infection resolved after long-term antibiotic treatment and implant removal. The PAX system is shown to be a valid alternative for the treatment of Y-T humeral fractures, offering the benefit of polyaxial insertion of locking screws. The possibility of angle locking screws is helpful in the distal humeral bicondylar fractures, providing additional options for screw placement in juxtarticular fractures, avoiding fracture lines or other implants.
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Abstract
PRACTICAL RELEVANCE The femur is the most commonly fractured bone in cats. Femoral fractures usually result from high-velocity trauma such as a road traffic accident or fall from a height and, as such, are associated with a wide variety of concurrent injuries. The initial focus of treatment should always be on assessment and stabilisation of the major body systems. Once any concurrent injuries have been addressed, all femoral fractures need surgical stabilisation, with the notable exception of greenstick fractures in very young cats, which can heal with cage rest alone. A number of different surgical options are available depending on the fracture type, location, equipment, surgeon experience and owner finances. CLINICAL CHALLENGES Femoral fractures can vary hugely in complexity and the small size of feline bones can limit the choice of implants. Furthermore, cats can present unique challenges in the postoperative period due to their active nature and the limited means to control their exercise level. AUDIENCE This review is aimed at general and feline-specific practitioners who have some experience of feline orthopaedics, as well as those simply wishing to expand their knowledge. AIMS The aim of this review is to help clinicians assess, plan and manage feline femoral fractures. It provides an overview of diagnostic imaging and a discussion of a range of suitable surgical options, including the principles of different types of fixation. It also highlights cat-specific issues, approaches and implants pertinent to the management of these cases. EVIDENCE BASE A number of original articles and textbook chapters covering many aspects of femoral fractures in cats and dogs have been published. Where possible, this review draws on information from key feline research and, where necessary, extrapolates from relevant canine literature. The authors also offer practical guidance based on their own clinical experience.
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Affiliation(s)
| | - Richard L Meeson
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK
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Fischer RD, Klasen J, Shmatok A, Prorok BC. An additively manufactured locking fixation system for potential application in patient-specific implants. J Mech Behav Biomed Mater 2021; 124:104867. [PMID: 34601432 DOI: 10.1016/j.jmbbm.2021.104867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022]
Abstract
This study introduces a novel technique to implement a locking hole system into AM patient-specific implants without the need of additional post-processing steps such as mechanical machining. This has the potential to decrease the time and cost of manufacturing these implants, providing surgeons with an additional option, that is better suited in cases where the underlying bone is already weakened or bone porosis is an inherent risk. A commercially available locking system was chosen and replicated using high-resolution X-ray CT. A biocompatible material, 316L stainless steel was used to print specimen on a L-PBF machine in different orientations. The specimen were heat treated to tune the mechanical properties to enable the locking system to work. The accuracy of the printed holes was confirmed using a nominal/actual comparison between the original and printed holes. The strength of the system was evaluated by measuring the force needed to push the screw out of the locking plate. The 316L stainless steel samples, when annealed to tailor hardness, performed similarly to the commercial system. This included different build orientations that suggest the locking system can be included in AM implants without the need for additional post-processing steps.
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Affiliation(s)
- Ralf D Fischer
- Materials Research and Education Center, Auburn University, Auburn, AL, 36849, USA
| | | | - Andrii Shmatok
- Materials Research and Education Center, Auburn University, Auburn, AL, 36849, USA
| | - Barton C Prorok
- Materials Research and Education Center, Auburn University, Auburn, AL, 36849, USA.
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Pozzi A, Lewis DD, Scheuermann LM, Castelli E, Longo F. A review of minimally invasive fracture stabilization in dogs and cats. Vet Surg 2021; 50 Suppl 1:O5-O16. [PMID: 34309048 PMCID: PMC9292778 DOI: 10.1111/vsu.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/20/2021] [Accepted: 07/06/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To summarize and discuss peer-reviewed studies on minimally invasive osteosynthesis (MIO) of long bone, physeal, and articular fractures in dogs and cats. STUDY DESIGN Invited review. METHODS A critique of literature was performed to assess MIO feasibility, outcomes, and complications through PubMed, Scopus, and CAB abstracts research databases (2000-2020). RESULTS More than 40 MIO articles have been published in the last 15 years, but most studies had small numbers, lacked control groups, and used limited outcome measures. Studies generally showed that MIO was feasible in dogs and cats with low complication rates. The current evidence does not demonstrate superior bone healing or functional outcomes with MIO when compared to standard methods. Although treatment principles, case selection, and techniques varied depending on the anatomical location, there were no salient differences in complication rates among long bones, physeal, and articular fractures treated by MIO. CONCLUSION The current available evidence and the personal experience of the authors support MIO as a promising fracture management modality. MIO can yield excellent outcomes when applied in carefully selected cases, performed by surgeons experienced in the technique. We cannot, however, conclude that MIO is superior to open fracture stabilization based on the available evidence in veterinary literature. Randomized controlled studies are warranted to prospectively compare MIO with other osteosynthesis techniques and thereby validate its role in fracture management for dogs and cats.
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Affiliation(s)
- Antonio Pozzi
- Department of Small Animal SurgeryVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Daniel D. Lewis
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Logan M. Scheuermann
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Emanuele Castelli
- Department of Small Animal SurgeryVetsuisse Faculty, University of ZurichZurichSwitzerland
| | - Federico Longo
- Department of Small Animal SurgeryVetsuisse Faculty, University of ZurichZurichSwitzerland
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Bassanino J, Kaczmarek J, Boursier JF, Mindner J, Paton R, Bedu AS, Unger M, Scharvogel S, Meiler D, Leperlier D. Radiographically confirmed outcomes after fracture repair with a PLS polyaxial locking system in 40 dogs and cats. Vet Surg 2021; 50:571-578. [PMID: 33480076 DOI: 10.1111/vsu.13578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 12/04/2020] [Accepted: 12/13/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report radiographic findings and complications after fracture repair with a new polyaxial locking plate system (PLS polyaxial locking system; Aesculap/B Braun, Tuttlingen, Germany) in dogs and cats. STUDY DESIGN Retrospective case review from four veterinary practices. SAMPLE POPULATION Twenty-six dogs and 14 cats (40 long bone fractures). METHODS Medical and radiographic records of dogs and cats with long bone fractures treated with the PLS were reviewed. Cases were included when operative records were complete and included documentation of radiographic union or complications. Phone interviews of owners were performed for long-term follow-up. Ancillary methods of fracture fixation and associated complications were recorded. RESULTS Only two complications were recorded, one of which required a revision surgery. Radiographic follow-up was performed for all fractures. Radiographic union without complications was achieved in 38 of 40 (95%) fractures. Radiographic union was documented before 60 days in 19 of 40 (47.5%) fractures, between 61 and 90 days in 15 of 40 (37.5%) fractures, and after 90 days in six of 40 (15%) fractures. A functional union was observed at a mean time ± SD of 70.8 ± 38.9 days (range, 32-182). One or more ancillary fixation methods were used in 27 of 40 (67.5%) fractures. CONCLUSION The PLS polyaxial locking system was often used with adjunct fixation in this series, and radiographically confirmed healing without complications was documented in most cases. CLINICAL SIGNIFICANCE Use of the PLS can result in high success rates for fracture repair in dogs and cats, but ancillary fixation should be strongly considered.
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Affiliation(s)
| | | | | | | | | | | | - Martin Unger
- AniCura Kleintierspezialisten, Augsburg, Germany
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Ferrero FC, Baroncelli AB, Hudson CC, Peirone B, Reif U, Piras LA. Fracture Repair in Cats Using a Conical Coupling Mini 1.9 to 2.5 mm Locking Plate System. Vet Comp Orthop Traumatol 2020; 33:443-450. [PMID: 32951192 DOI: 10.1055/s-0040-1713005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to retrospectively evaluate the clinical application of the Fixin mini 1.9 to 2.5 system for the treatment of long bone fractures in cats. We proposed that the Fixin mini system would successfully stabilize long bone fractures in cats with a healing time and complication rate similar to those previously reported for feline fractures using other locking bone plate systems. MATERIALS AND METHODS Medical records and radiographs of cats with long bone fractures stabilized with the Fixin mini 1.9 to 2.5 system were retrospectively reviewed. Signalment, body weight, bone(s) fractured, region of bone fractured, fracture classification, concurrent orthopaedic injuries, complications, time to functional union, if minimally invasive plate osteosynthesis techniques were used, plate size, number of plates, bone graft use and ancillary methods of fixation were recorded. RESULTS Fifty-six fractures in 54 cats were included. Mean time to radiographic union was 8.8 weeks. Complications were recorded in 8 out of 56 fractures. Major complications occurred in 4 of 56 fractures and minor complications occurred in 4 of 56 fractures. CONCLUSION The Fixin mini 1.9 to 2.5 system had an overall complication rate and time to functional union similar to that of other implant systems used to treat feline long bone fractures and it appears suitable for repair of a wide variety of long bone fracture configurations in cats.
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Affiliation(s)
| | | | - Caleb C Hudson
- Department of Surgery, Gulf Coast Veterinary Specialists, Houston, Texas, United States
| | - Bruno Peirone
- Department of Animal Pathology, University of Turin, Grugliasco, Turin, Italy
| | - Ullrich Reif
- Tierklinik Dr. Reif, Schönhardterstr, Böbingen, Germany
| | - Lisa A Piras
- Department of Animal Pathology, University of Turin, Grugliasco, Turin, Italy
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Tremolada G, Taggart R, Lewis DD, Palmer RH, Lambrechts NE. An assessment of mechanical properties and screw push-out for two 3.5-mm pearl-type locking plate systems. Am J Vet Res 2019; 80:533-538. [DOI: 10.2460/ajvr.80.6.533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schmierer PA, Smolders LA, Zderic I, Gueorguiev B, Pozzi A, Knell SC. Biomechanical properties of plate constructs for feline ilial fracture gap stabilization. Vet Surg 2018; 48:88-95. [DOI: 10.1111/vsu.13124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 07/03/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Philipp A. Schmierer
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Lucas A. Smolders
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Ivan Zderic
- AO Research Institute Davos; Davos Switzerland
| | | | - Antonio Pozzi
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Sebastian C. Knell
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
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Single cycle to failure in bending of three titanium polyaxial locking plates. Vet Comp Orthop Traumatol 2017; 30:172-177. [DOI: 10.3415/vcot-16-07-0111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 02/07/2017] [Indexed: 11/17/2022]
Abstract
SummaryObjective: Evaluation of the bending properties in one direction of three titanium polyaxial locking plate systems.Materials and methods: The Polyaxial Advanced Locking System (PAX®) straight plate (PAX SP), the PAX® reconstruction plate (PAX RP), and the VetLOX reconstruction plates (VetLOX) were evaluated individually and as constructs applied to a bone model simulating a fracture gap and compared using a two-way analysis of variance and Tukey posthoc analysis.Results: The PAX SP had the highest values of bending stiffness, bending structural stiffness and bending strength. When tested as plates alone, the PAX RP and VetLOX showed no differences with regard to bending stiffness and bending structural stiffness, whilst the PAX RP had significantly higher strength. The PAX RP construct had significantly higher bending stiffness, bending structural stiffness and bending strength than the VetLOX construct.Clinical relevance: The PAX RP and VetLOX reconstruction plates are much more likely to fail when used as bridging implants, thus adjunct support is needed. The lower bending strength of the VetLOX reconstruction plates suggests it should not be used in fractures under high loads.
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Complications of appendicular fracture repair in cats and small dogs using locking compression plates. Vet Comp Orthop Traumatol 2017; 29:46-52. [DOI: 10.3415/vcot-14-09-0146] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 08/06/2015] [Indexed: 11/17/2022]
Abstract
SummaryObjective: Our objectives were: 1) to review the complications associated with stabilization of appendicular fractures in cats and small dogs using locking compression plates (LCP), and 2) to identify factors that could influence fixation construct stability.Study design: Retrospective clinical study.Materials and methods: Medical and radiographic records of cats and small dogs with appendicular fractures treated with LCP were reviewed. Only cases with adequate follow-up to document clinical union and cases for which complications appeared before the clinical union were included. Complications were classified as implant-related complications or other complications. Cases with implant-related complications were compared to cases with non-implant-related complications for differences in signalment (species, age, body weight, multiple fractures), fracture location and type (fractured bone, fracture localization, closed or open fracture), reduction method (open reduction and internal fixation [ORIF] or minimally invasive plate osteosynthesis [MIPO]) and fixation evaluations (implant size, platebridging ratio, plate span ratio, working length, plate screw density, number of screws and cortices engaged per plate and per main fragment, ratio between screw and bone diameter at the narrowest aspect of the bone, and presence of ancillary fixation).Results: Seventy-five fractures from 63 cats (64 fractures) and 10 dogs (11 fractures) met the inclusion criteria. Eight humeral, 13 radio-ulnar, 26 femoral, and 28 tibio-fibular fractures were treated. Primary repair of the fracture was performed using 2.0 mm and 2.4 mm LCP in 22 and 53 fractures, respectively. Overall and implant-related complications were encountered in 13 and seven of 75 fractures, respectively. Fixation failure was not significantly associated with any aforementioned factor considered in this study, and in particular, there was no significant difference in the occurrence of fixation failure between fractures stabilized with two, or more than two, bicortical locking screws per main fragment.Clinical significance: 2.0 mm and 2.4 mm LCP were used to manage appendicular fractures in cats and small dogs. The overall complication and fixation failure rate were comparable to those reported in previous studies in which various locking plate systems were used.Online Supplementary Material for this article is available at: http://dx.doi.org/10.3415/VCOT-14-09-0146
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Clinical evaluation of a mini locking plate system for fracture repair of the radius and ulna in miniature breed dogs. Vet Comp Orthop Traumatol 2017; 29:522-527. [DOI: 10.3415/vcot-16-01-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/22/2016] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To retrospectively evaluate the effectiveness of a novel 1.2 mm mini locking plate system in treating fractures of the radius and ulna in miniature breed dogs.Methods: Medical records and radiographs of miniature breed dogs with fractures treated with a 1.2 mm mini locking plate system were reviewed. The inclusion criteria were: body weight of 2.5 kg or less, trans-verse or short oblique fracture of the radius and ulna, and treatment with a mini locking plate system as the sole method of fixation. For each patient, data including signalment, time to radiographic union, use of bone graft or other agents, and previous repair attempts were recorded. The outcome and complications were determined from clinical and radiographic follow-up examinations.Results: Fourteen cases with a mean radial width of 4.5 mm (± 0.8 mm) were included into this study. The fractures healed without failure of fixation in all cases. Mean time to adequate radiographic union was 8.4 weeks (± 2.6 weeks). Major complications were not seen in any of the cases, and minor complications occurred in three of the cases. Limb function was graded as ‘normal’ in 10 cases and ‘occasional lameness’ in four cases.Clinical significance: The mini locking system evaluated in this study was an effective treatment method for radial and ulnar fractures in miniature breed dogs with a radial width smaller than 5.5 mm.Supplementary Material to this article is available online at http://dx.doi.org/10.3415/VCOT-16-01-0014.
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Effect of monocortical and bicortical screw numbers on the properties of a locking plate-intramedullary rod configuration. Vet Comp Orthop Traumatol 2017; 29:459-465. [DOI: 10.3415/vcot-16-03-0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/12/2016] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To evaluate the effect of varying the number and configuration of locking bicortical and monocortical screws on a plate-rod construct using a mid-diaphyseal femoral ostectomy model.Methods: Thirty Greyhound femurs were assigned to six groups (A-F). An intramedullary pin was placed in each bone following which a 3.5 mm locking plate was applied with six differing locking screw configurations. Groups A to C had one bicortical screw in the most proximal and distal plate holes and one to three monocortical locking screws in the proximal and distal fragments. Groups D to F had no bicortical screws placed and two to four monocortical locking screws in proximal and distal fragments. Each construct was axially loaded at 4 Hz from a preload of 10 Newtons (N) to 72 N, increasing to 144 N and 216 N, each of 6000 cycles with a further 45,000 cycles at 216 N to simulate a three to six week postoperative convalescence period. Constructs were then loaded to failure.Results: No construct suffered screw loosening or a significant change in construct stiffness during cyclic loading. There was no significant difference in load to failure of any construct (p = 0.34), however, less variation was seen with monocortical constructs. All constructs failed at greater than 2.5 times physiological load, and failure was by bending of the intramedullary pin and plate rather than screw loosening or pull-out.Clinical significance: Axially loaded locking monocortical plate-rod constructs applied to the canine femur may confer no difference biomechanically to those employing locking bicortical screws.
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Guthrie JW, Kalff S. Tibial plateau levelling osteotomy locking-compression plates for stabilisation of canine and feline ilial body fractures. J Small Anim Pract 2017; 59:232-237. [DOI: 10.1111/jsap.12803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/10/2017] [Accepted: 11/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - S. Kalff
- Fitzpatrick Referrals; Eashing Surrey, GU7 2QQ UK
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Tan CJ, Johnson KA. Stabilisation of periarticular fractures and osteotomies with a notched head locking T-plate. Aust Vet J 2016; 94:377-83. [PMID: 27671082 DOI: 10.1111/avj.12487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 01/27/2016] [Accepted: 02/16/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report the clinical outcomes and complications of small animals that had articular or periarticular fractures or osteotomies stabilised with a notched head locking T-plate. METHODS Medical records were searched retrospectively to identify animals that had a notched head locking T-plate used to stabilise a small articular or periarticular bone fragment. RESULTS Nine dogs and two cats had an articular or periarticular bone fragment stabilised with a 2.0- or 2.4-mm notched head locking T-plate (12 procedures). The median body weight was 4.7 kg. The plate was modified by removing holes in 10/12 procedures and a combination of locking and non-locking screws were used in 7/12 procedures. All fractures or osteotomies progressed to clinical union. There were two intraoperative complications (intra-articular screw placement and overlong screw) and two postoperative complications (skin necrosis and stress protection) CONCLUSIONS This study reports the successful use of a 2.0- or 2.4-mm notched head locking T-plate for articular or periarticular fractures or osteotomies in a variety of small-breed dogs and cats. Care must be taken to prevent inadvertent penetration of the articular surface, particularly in regions such as the proximal tibia. The ability to modify the plate dimensions intraoperatively proved beneficial in most cases.
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Affiliation(s)
- C J Tan
- Faculty of Veterinary Science, University of Sydney, New South Wales 2006, Australia.
| | - K A Johnson
- Faculty of Veterinary Science, University of Sydney, New South Wales 2006, Australia
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Schmierer PA, Kircher PR, Hartnack S, Knell SC. Screw Loosening and Pelvic Canal Narrowing After Lateral Plating of Feline Ilial Fractures With Locking and Nonlocking Plates. Vet Surg 2015; 44:900-4. [DOI: 10.1111/vsu.12367] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Philipp A. Schmierer
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Patrick R. Kircher
- Division of Diagnostic Imaging; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Sonja Hartnack
- Division of Epidemiology; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Sebastian C. Knell
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
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Mechanical performance in axial compression of a titanium polyaxial locking plate system in a fracture gap model. Vet Comp Orthop Traumatol 2015; 28:88-94. [PMID: 25703709 DOI: 10.3415/vcot-14-03-0046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 12/11/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the bending strength of the VetLOX® polyaxial locking plate system. MATERIALS AND METHODS Thirty-five 3.5 mm 12-hole titanium VetLOX® plates were used to stabilize seven different construct designs in a 1 cm fracture gap simulation model. Each construct was subjected to axial compression. Mean bending stiffness (BS) and yield load (YL) of each construct design were analysed using a one-way ANOVA and Tukey post-hoc analysis. Screw angulation was measured on reconstructed computed tomography (CT) images. RESULTS Reducing plate working length for fixed-angle constructs significantly increased BS (p <0.01) and YL (p <0.01). For a constant plate working length, increasing screw number did not significantly affect BS (p = 1.0) or YL (p = 0.86). Screw angulation measurement technique was validated by intra-class correlation coefficients (ICC) (ICC >0.9 for inter- and intra-observer measurements). An average screw angle of 13.2° did not significantly affect mechanical performance although incomplete screw head-plate engagement was noted on some reconstructed CT images when angulation exceeded 10°. Prefabricated screw-head inserts did not significantly increase mechanical performance. A 4 mm bone-plate stand-off distance significantly reduced BS and YL by 63% and 69% respectively. CLINICAL RELEVANCE The VetLOX® system allows the benefits of polyaxial screw insertion whilst maintaining comparable bending properties to fixed angle insertion. The authors recommend accurate plate contouring to reduce the risk of plate bending.
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Boudreau B, Benamou J, von Pfeil DJF, Guillou RP, Beckett C, Déjardin LM. Effect of Screw Insertion Torque on Mechanical Properties of Four Locking Systems. Vet Surg 2013; 42:535-43. [DOI: 10.1111/j.1532-950x.2013.12023.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 04/01/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Bianca Boudreau
- Collaborative Orthopaedic Investigations Laboratory, Department of Small Animal Clinical Sciences; College of Veterinary Medicine, Michigan State University; East Lansing; Michigan
| | - Jérôme Benamou
- Collaborative Orthopaedic Investigations Laboratory, Department of Small Animal Clinical Sciences; College of Veterinary Medicine, Michigan State University; East Lansing; Michigan
| | - Dirsko J. F. von Pfeil
- Collaborative Orthopaedic Investigations Laboratory, Department of Small Animal Clinical Sciences; College of Veterinary Medicine, Michigan State University; East Lansing; Michigan
| | - Reunan P. Guillou
- Collaborative Orthopaedic Investigations Laboratory, Department of Small Animal Clinical Sciences; College of Veterinary Medicine, Michigan State University; East Lansing; Michigan
| | - Clifford Beckett
- The Orthopaedic Biomechanics Laboratories; College of Osteopathic Medicine, Michigan State University; East Lansing; Michigan
| | - Loïc M. Déjardin
- Collaborative Orthopaedic Investigations Laboratory, Department of Small Animal Clinical Sciences; College of Veterinary Medicine, Michigan State University; East Lansing; Michigan
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