Surgical repair of a coxofemoral luxation in an alpaca

Modified toggle pin technique combined with prosthetic capsular reconstruction for surgical stabilization of coxofemoral luxation in a Shetland pony

OBJECTIVE

To describe open reduction and surgical stabilization of a coxofemoral luxation in a pony using a modified toggle pin technique and prosthetic joint capsule reconstruction without osteotomy of the greater trochanter.

ANIMAL

A 2-year-old Shetland pony with a bodyweight of 167 kg.

STUDY DESIGN

Case report.

METHODS

Radiographic examination confirmed craniodorsal luxation of the left coxofemoral joint. An open reduction with the aid of a pulley system was performed. A toggle pin was inserted through a bone tunnel extending from the level of the femoral shaft through the femoral head and the center of the acetabulum for the pin to be positioned on the medial wall of the acetabulum. FiberWire was subsequently passed through the cranial and caudal aspects of the acetabulum as well as a transverse tunnel in the femoral neck in a figure of 8 to facilitate capsular reconstruction. The pony was placed in a sling for 8 weeks and gradually returned to normal activity over 2 months.

RESULTS

Postoperative radiographic examination confirmed the position of the femoral head in the acetabulum with the implants in place. On 2-year follow-up the pony was sound at walk and trot.

CONCLUSION

A combined intra- and extra-articular stabilization technique for coxofemoral luxation in a pony resulted in successful long-term reduction and excellent outcome.

Successful Treatment of Acute Craniodorsal Coxofemoral Luxation in a Scarlet Ibis (Eudocimus ruber) Using Closed Reduction and a Modified Ehmer Sling

Whereas craniodorsal displacement of the coxofemoral joint is the most common luxation reported in small and large mammals, it occurs less often in avian species. Closed reduction and external coaptation with a modified Ehmer sling is the initial treatment, in most cases, for small animals (eg, dogs, cats) that present with a coxofemoral luxation. However, the Ehmer sling is reported to have a low success rate in treating coxofemoral luxations in these animals. Intractable coxofemoral luxations require an open surgical reduction. A few successful closed reductions of coxofemoral luxations have been reported in avian patients, as well as open reduction surgical techniques to repair avian coxofemoral luxations. The successful treatment of an acute craniodorsal coxofemoral luxation in a scarlet ibis (Eudocimus ruber) with a closed reduction and a modified Ehmer sling is described in this clinical report. The specific characteristics of both the patient and the injury are thought to have contributed to the success in this case.

Treatment of a coxofemoral luxation in a pony using a prosthetic capsule technique

OBJECTIVE

To report open reduction and joint stabilization using a prosthetic capsule technique for treatment of a craniodorsal coxofemoral luxation in a lightweight pony.

STUDY DESIGN

Clinical report.

ANIMALS

Pony stallion (8 years old, 113 kg).

METHODS

A craniodorsal approach to the coxofemoral joint was performed under general anesthesia. After open reduction, a prosthetic capsule technique was used. Four 3.5 mm self-tapping cortical anchor screws were implanted: 2 screws were inserted above the cranial aspect of the dorsal acetabular rim, and 2 screws were inserted into the femoral neck. Subsequently, a #5 USP ultra-high molecular weight polyethylene suture was placed through these anchor screws in figure-8 fashion to serve as a prosthetic capsule. Routine closure and a medial patellar desmotomy completed the surgical procedure. Postoperatively, the pony was cross tied for 4 weeks to prevent it from lying down.

RESULTS

Neither short-term nor long-term complications occurred and the pony was sound at the follow-up examination performed 15 months postoperatively.

CONCLUSIONS

A prosthetic capsule technique can be used successfully to stabilize the coxofemoral joint after open reduction of a craniodorsal luxation in a lightweight pony.

Cementless total hip replacement in an alpaca

OBJECTIVE

To report management of a chronic slipped capital femoral epiphysis (SCFE) in an alpaca using cementless total hip replacement (THR).

STUDY DESIGN

Case report.

ANIMAL

An 18-month-old, 47 kg alpaca male.

METHODS

Cementless THR was performed in an alpaca with a chronic, right SCFE, and secondary osteoarthritis. Force plate gait analysis was performed before and 8 weeks after surgery. Outcome was determined through clinical evaluation, radiography, and force plate gait analysis.

RESULTS

Cementless THR resulted in marked improvement in the alpaca's comfort level, degree of lameness, and range of motion. On preoperative force plate gait analysis there was decreased contact time (P=.01) and vertical impulse (P<.01) of the affected limb, whereas at 8 weeks postoperatively significant differences in gait analysis between pelvic limbs were not apparent.

CONCLUSION

THR using a BioMedtrix canine cementless modular prosthesis restored hip function in an alpaca with coxofemoral osteoarthritis from chronic SCFE.

CLINICAL RELEVANCE

THR may be an appropriate treatment for selected traumatic and degenerative conditions of the coxofemoral joint in alpacas.

Closed reduction of coxofemoral luxation in a goat: case report

Hip luxations have been reported in many ruminants, and several treatments have been described for them. However, successful closed reduction of hip joint luxation has not been reported in goats to date. This case report describes the closed reduction of coxofemoral luxation in a three-month-old male Saanen dairy goat. The goat showed non-weightbearing lameness and abnormal mobility of the proximal right hindlimb. Luxation of the right coxofemoral joint in craniodorsal direction was diagnosed by radiography. The femoral head was repositioned under sedation, and physiotherapy including non-weightbearing hindlimb movement and supported walking exercise was performed. Fifteen days after closed reduction the animal was discharged from the clinic. At that time the animal was sound at a slow walk but lameness was still present at faster gaits. Follow-up examinations revealed normal development of the animal, which subsequently showed no lameness and served successfully as a breeding goat.

Diagnostic procedures and surgical treatment of craniodorsal coxofemoral luxation in calves

OBJECTIVE

To report use of ultrasonographic examination of the coxofemoral joint, a surgical technique for repair of craniodorsal coxofemoral dislocation, and outcome.

STUDY DESIGN

Clinical case reports.

ANIMALS

Calves (n=4) with coxofemoral luxation.

METHODS

Craniodorsal coxofemoral luxation was diagnosed by physical examination, radiographic, and ultrasonographic findings. Open surgical reduction of the femoral head was performed using a modified caudal approach.

RESULTS

Craniodorsal luxation of the femoral head and the presence of an intact femoral neck were confirmed by ultrasonography. All luxations were successfully reduced and reluxation did not occur. At follow-up, 1 heifer had calved and 1 was 5 months pregnant. One calf died of bronchopneumonia 6 days after surgery. One calf had severe coxofemoral degenerative joint disease diagnosed (ultrasonography, radiography, and arthrocentesis) 3 months after surgery and confirmed by necropsy.

CONCLUSION

Ultrasonography proved to be a simple and effective non-invasive technique for diagnosis of coxofemoral luxation. Immediate surgical intervention in hip dislocation in calves is necessary to avoid unnecessary trauma to subchondral structures. In calves, open instead of closed surgical reduction appears preferable because it allows access to the acetabular cavity for removal of debris.

CLINICAL RELEVANCE

Ultrasonography should be considered a supplementary but not an alternative to radiographic examination for diagnosis of coxofemoral luxation and for follow-up examinations after reduction.

Humerus Fractures in Llamas and Alpacas: Seven Cases (1998?2004)

OBJECTIVE

To describe treatment and outcome of humerus fractures in llamas and alpacas.

STUDY DESIGN

Retrospective study.

ANIMALS

Llamas (n=4) and alpacas (3) with humerus fracture.

METHODS

Medical records (January 1, 1998-August 1, 2004) were reviewed for small camelids with a humeral fracture. Retrieved data were signalment, history, physical examination and radiographic findings, surgical and medical treatment, and outcome.

RESULTS

Humeral fracture occurred in 7 of 38 (18%) camelids admitted with fractures. Affected animals were aged from 1 month to 3 years old. Fracture configuration included long-oblique (n=4), short-oblique (2), and Salter-Harris Type II fracture of the proximal physis (1). One adult llama was managed by stall confinement and surgical repair was attempted in the other camelids: fixation by screws inserted in lag fashion (n=3), intramedullary pinning and fixation by screws inserted in lag fashion (1), rush pinning (1), and bone plating (1). A Velpeau sling was used for additional support in 3 animals. All fractures healed but temporary radial nerve paresis occurred in 3 animals. Limb shortening and permanent lameness occurred in the llama managed conservatively.

CONCLUSIONS

Humerus fractures in small camelids are amenable to surgical repair which may offer better long-term outcome than medical treatment alone.

CLINICAL RELEVANCE

Surgical treatment of humerus fractures should have a good prognosis in llamas and alpacas. In select cases, minimally invasive techniques, such as rush pinning or fixation by screws inserted in lag fashion are sufficient for fracture healing.