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Bennett MP, Silver G, Tromblee T, Kohler R, Frem D, Glass EN, Kent M. Case report: Nonsimultaneous bilateral triceps tendon rupture and surgical repair in a healthy dog. Front Vet Sci 2024; 10:1294395. [PMID: 38333033 PMCID: PMC10851743 DOI: 10.3389/fvets.2023.1294395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/05/2023] [Indexed: 02/10/2024] Open
Abstract
A 7-year-old female spayed Australian shepherd dog was presented for an acute onset of inability to stand. On physical examination, the dog was unable to support weight on the thoracic limbs. On neurological examination, the thoracic limbs had absent hopping and paw placement and reduced withdrawal reflexes bilaterally. The remainder of the neurological examination was normal. The anatomic lesion localized to the C6-T2 spinal nerve roots, spinal nerves, or the named nerves of the thoracic limb, bilaterally. A lesion affecting the ventral gray column of the C6 through T2 spinal cord segments was considered less likely. In an effort to exclude an orthopedic disorder from consideration, radiographs of the shoulders, elbows, and manus were normal. Magnetic resonance imaging of the cervical and cranial thoracic vertebral column was normal. Analysis of synovial fluid from the carpi, elbows, and shoulders were normal. Ultrasonography of the triceps muscle and tendon of insertion revealed bilateral, acute-subacute tears of the tendon at insertion of the triceps muscles, bilaterally. Magnetic resonance imaging of both elbows revealed complete avulsion of the triceps tendons bilaterally. Surgical repair of both tendons was performed using the Arthrex FiberLoop system combined with autologous conditioned plasma soaked in a collagen sponge. Postoperatively, external coaptation was provided using Spica splints for 6 weeks followed by the use of soft padded orthotic braces for an additional 6 weeks. Concurrently, a front support wheelchair was used for 10 weeks postoperative. By 10 weeks postoperative, the dog was able to ambulate without support. To the authors' knowledge, this is the first report of bilateral triceps tendon avulsion in a dog. Tendon avulsion occurred without a known history of trauma or predisposing metabolic abnormalities. Magnetic resonance imaging provided excellent anatomical detail that aided in surgical repair.
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Affiliation(s)
- Maureen P. Bennett
- Section of Neurology and Neurosurgery, Massachusetts Veterinary Referral Hospital, Woburn, MA, United States
| | - Gena Silver
- Section of Neurology and Neurosurgery, Massachusetts Veterinary Referral Hospital, Woburn, MA, United States
| | - Tonya Tromblee
- Section of Diagnostic Imaging, Massachusetts Veterinary Referral Hospital, Woburn, MA, United States
| | - Rickard Kohler
- Section of Orthopedic and Soft Tissue Surgery, Massachusetts Veterinary Referral Hospital, Woburn, MA, United States
| | - Daniel Frem
- Section of Orthopedic and Soft Tissue Surgery, Massachusetts Veterinary Referral Hospital, Woburn, MA, United States
| | - Eric N. Glass
- Section of Neurology and Neurosurgery, Red Bank Veterinary Hospital, Tinton Falls, NJ, United States
| | - Marc Kent
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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Ortiz V, Arthurs G, Kulendra N. Distal plate fracture as a novel complication following TTA surgery in two dogs. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Victor Ortiz
- Queen Mother Hospital for AnimalsRoyal Veterinary CollegeHatfieldUK
- University of Liverpool School of Veterinary ScienceLiverpoolUK
| | - Gareth Arthurs
- Veterinary HospitalUniversity College Dublin College of Agriculture Food Science and Veterinary MedicineDublinIreland
| | - Nicola Kulendra
- Queen Mother Hospital for AnimalsRoyal Veterinary CollegeHatfieldUK
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Echigo R, Fujita A, Nishimura R, Mochizuki M. Triceps brachii tendon injury in four Pomeranians. J Vet Med Sci 2018; 80:772-777. [PMID: 29563390 PMCID: PMC5989021 DOI: 10.1292/jvms.17-0318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The cases of 4 Pomeranians with injury of the triceps brachii tendon that underwent surgical treatment were retrospectively reviewed to evaluate some clinical findings including signalment, cause of injury, clinical signs, pattern of injury, surgical technique, external coaptation after operation, complications, and outcomes. While all of the dogs showed non-weight bearing posture of the affected limbs and severe pain shortly after injury onset, the pain level decreased over time. A characteristic finding of the 4 cases was an absence of tension in the triceps brachii tendon when the elbow joint was flexed. The pattern of triceps brachii tendon injury was either laceration of the central part of the tendon (n=1) or tendon rupture at its insertion to the olecranon (n=3). Although there were no major complications after surgery in 3 cases, the remaining case required a revision surgery. Long lateral splint was effective method for external coaptation after operation. Diagnosis of triceps brachii tendon injury was not difficult if we even recognize this trauma. This form of injury can have a good prognosis with adequate surgery and postoperative coaptation.
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Affiliation(s)
- Ryosuke Echigo
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Kita 19 jo Nishi 10 chome, Kita-ku, Sapporo-shi, Hokkaido 060-0818, Japan
| | - Atsushi Fujita
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Ryohei Nishimura
- Laboratory of Veterinary Surgery, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Manabu Mochizuki
- Laboratory of Veterinary Emergency Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Reconstruction of chronic triceps tendon avulsion using synthetic mesh graft in a dog. Vet Comp Orthop Traumatol 2017; 28:220-4. [DOI: 10.3415/vcot-14-11-0168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/10/2015] [Indexed: 11/17/2022]
Abstract
SummaryAvulsion of the triceps tendon insertion was diagnosed in a two-year-old Poodle mixed breed dog 10 weeks after traumatic injury. Diagnosis was confirmed with clinical examination and magnetic resonance imaging (MRI). The tendon was reconstructed using tension-relieving sutures augmented with a synthetic degradable porous polyurethane urea onlay mesh graft. The repair was immobilized using a transarticular external skeletal fixator with staged increases in elbow flexion. Treatment was successful, with signs of healing confirmed by MRI and normal clinical function one year after surgery. The successful outcome in this case suggests that surgical repair of a chronic triceps tendon injury using a synthetic mesh augmentation may be successful in similar cases.
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Surgical management and follow-up of triceps tendon avulsion after repeated local infiltration of steroids: two cases. Vet Comp Orthop Traumatol 2017; 27:405-10. [DOI: 10.3415/vcot-14-01-0004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 07/10/2014] [Indexed: 11/17/2022]
Abstract
SummaryDisruption of the triceps tendon insertion is an uncommon injury, with only a few reports of traumatic triceps tendon avulsion in dogs or cats present in the veterinary literature. Although this injury has been previously described in two dogs that had received a local injection of corticosteroids for the treatment of soft tissue injuries, reports with long term clinical follow-up and outcome in working dogs are lacking.This report describes two surgically treated cases of complete triceps tendon avulsion rupture in Malinois police dogs. These two dogs had a history of repeated local infiltration of a corticosteroid preparation used to treat adventitial bursitis. The clinical features, surgical treatment, long-term management and outcome are reported. A modified triple locking loop pattern was used to suture the tendons. The long-term outcome was considered excellent with both dogs resuming work. Although it is an uncommon condition in small animals, avulsion of the triceps tendon should remain on the differential diagnosis list for acute onset forelimb lameness, particularly if there is a history of local infiltration with corticosteroids. The diagnosis should be based on clinical, radiographic and ultrasonographic examination.
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Earley NF, Ellse G, Wallace AM, Parsons KJ, Voss K, Pugliese LC, Moores AP, Whitelock R, Stork C, Langley-Hobbs SJ, Radke H. Complications and outcomes associated with 13 cases of triceps tendon disruption in dogs and cats (2003-2014). Vet Rec 2017; 182:108. [PMID: 29097604 DOI: 10.1136/vr.104280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 08/24/2017] [Accepted: 10/04/2017] [Indexed: 11/03/2022]
Abstract
This study reports data from a larger number of cases of triceps tendon disruption. Records from 10 veterinary referral hospitals between 2003 and 2014 were searched for canine and feline cases diagnosed with triceps tendon disruption, based on orthopaedic examination confirmed during surgery. Long-term follow-up and owner satisfaction were assessed using a questionnaire. There were 13 cases of triceps tendon disruption diagnosed across seven hospitals (nine dogs, four cats). Trauma, history or presence of a wound, surgery in the region of tendon attachment or corticosteroid treatment preceded triceps tendon disruption. Radiographic signs or histopathology suggestive of a chronic tendinopathy was common. All cases underwent surgical repair involving a tendon suture pattern, 12 of which were secured through bone tunnels. Immobilisation was used in all cases in the form of transarticular external skeletal fixation (TAESF) (8/9 dogs) or spica splint (four cats, two dogs; in one dog a TAESF was applied after complications associated with the spica splint). Complications occurred in 11 cases (17 total complications), frequently associated with the immobilisation method. One case had traumatic tendon rerupture two years following surgery. A wound at presentation was associated with the development of multiple complications. Nine cases had long-term follow-up; five achieved normal function, four achieved acceptable function. Despite the complications, overall return to subjective normal or acceptable function, as assessed by the owners, was achieved in the majority of cases.
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Affiliation(s)
- Naomi Frances Earley
- Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.,Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Gemma Ellse
- Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK
| | - Adrian M Wallace
- Bundoora Veterinary Hospital and Clinic, Small Animal Veterinary Referral Hospital, Melbourne, AU
| | - Kevin J Parsons
- Langford Veterinary Services, University of Bristol, Bristol, UK
| | - Katja Voss
- University Veterinary Teaching Hospital, University of Sydney, Sydney, AU
| | | | - Andy P Moores
- Anderson Moores Veterinary Specialists, Small Animal Veterinary Referral Hospital, Hursley, Hampshire, UK
| | - Richard Whitelock
- Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.,Davies Veterinary Specialists, Small Animal Veterinary Referral Hospital, Higham Gobion, Hertfordshire, UK
| | - Christoph Stork
- Orthovet, Veterinary Orthopaedic Specialist Referral Service, Kings Hill, Kent, UK
| | - Sorrel J Langley-Hobbs
- Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.,Langford Veterinary Services, University of Bristol, Bristol, UK
| | - Heidi Radke
- Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK
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Yoon HY, Jeong SW. Traumatic triceps tendon avulsion in a dog: magnetic resonance imaging and surgical management evaluation. J Vet Med Sci 2013; 75:1375-7. [PMID: 23708931 PMCID: PMC3942941 DOI: 10.1292/jvms.12-0464] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We report here the clinical presentation, magnetic resonance imaging (MRI) findings and
successful surgical management associated with triceps tendon avulsion in a dog. A
definitive diagnosis of triceps tendon avulsion was made based on MRI with evidence of
displacement of the triceps tendon. Surgical correction of triceps tendon avulsion was
performed with two horizontal mattress sutures using polyester and two tunnels drilled in
the olecranon to reattach the tendon to the proximal olecranon. At 9 months, there was no
evidence of lameness on the left thoracic limb. This is the first case report to describe
MRI evaluation for the diagnosis of the triceps tendon avulsion.
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Affiliation(s)
- Hun-Young Yoon
- Department of Veterinary Surgery, College of Veterinary Medicine, and the Veterinary Science Research Institute, Konkuk University, Seoul 143-701, Korea
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Abstract
Traumatic avulsion of the triceps tendon was diagnosed in a 15-month-old, male, neutered European shorthair cat. Diagnosis was established clinically by palpation of a transverse groove proximal to the olecranon and by radiography. The avulsed end of the tendon was surgically reapposed using a modified three-loop pulley suture and horizontal mattress sutures. Postoperatively, elbow flexion was limited for three weeks with the aid of a spica splint and by exercise restriction for six weeks. The cat showed no lameness after bandage removal up to the time of writing (seven months). Although rare, triceps tendon injuries can occur after a blunt trauma and should be included in the differential diagnosis of foreleg lameness in the cat. The modified three-loop pulley suture in combination with subsequent immobilisation of the limb with a splinted bandage resulted in a successful outcome in this cat with a triceps tendon avulsion.
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Affiliation(s)
- L Liehmann
- Department for Small Animals and Horses, Clinic for Surgery and Ophthalmology, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria
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