Treatment of calvarial defects by resorbable and non-resorbable sonic activated polymer pins and mouldable titanium mesh in two dogs: a case report

Application of a bilateral temporal fascia free graft in a dog with multifragmented frontal sinus and nasal bone fracture

OBJECTIVE

To describe the use of temporal fascia free grafts to treat dorsal open comminuted frontal sinus and nasal fractures.

ANIMAL

One Belgian shepherd dog.

STUDY DESIGN

Case report METHODS: A 5-year-old spayed female Belgian shepherd was admitted with severe facial deformation due to trauma. A deep, 3 cm wide wound was present between the nose and the frontal sinus. No abnormalities were detected on neurological examination. On computed tomographic examination, comminuted open fractures of the frontal and nasal bones were associated with a severe depression of the dorsal wall and presence of bone fragments in the sinus cavities. Bone fragments were apposed with polydioxanone monofilament suture. Bilateral temporal fascia grafts were placed over the bone fragments.

RESULTS

The integrity of the frontal and nasal cavities, and the facial profile of the dog were restored. No short-term or long-term complications were observed after 4 months follow up.

CONCLUSION

The innovative combination of suture apposition of bone fragments and a temporal fascia free graft resulted in very satisfying long-term outcomes in a dog with open sinus and nasal bone fractures.

Titanium mesh osteosynthesis for the treatment of severely comminuted maxillofacial fractures in four dogs

INTRODUCTION

Major goals in maxillofacial fracture treatment include to restore the dental occlusion, stabilise the major skeletal supports, restore the contour of the face and achieve proper function and appearance of the face. Titanium is considered an optimal material for maxillofacial reconstruction due to its biocompatibility, high strength, minimal inflammatory reaction and minimal imaging artefact.

OBJECTIVES

To describe the clinical details, surgical technique, pre- and postoperative imaging and short- and long-term follow-up of severely comminuted maxillofacial fractures treated with titanium mesh and titanium screws in dogs.

MATERIALS AND METHODS

Retrospective short case series included four client-owned dogs with maxillofacial fractures. After appropriate medical stabilisation, preoperative CT examination of the head was obtained in all patients for evaluation of fracture configuration and surgical planning. The maxillofacial fractures were stabilised by titanium mesh osteosynthesis. Short- and long-term clinical and radiographic follow-ups were available for all dogs.

RESULTS

Proper dental occlusion and reconstruction of the anatomic buttresses was achieved in all cases. All dogs recovered uneventfully from the surgery and no complications were recorded on the long-term follow-up up to 43 months. Occlusion was maintained in all dogs, as well as excellent cosmesis of the midface.

CLINICAL SIGNIFICANCE

Titanium mesh osteosynthesis can achieve sufficient rigidity and lead to uncomplicated healing of severely comminuted maxillofacial fractures. This internal fixation method can be considered a valuable option to treat maxillofacial fractures in particular in cases of large bone defect and midface reconstruction.

Polymeric-based drug delivery systems for veterinary use: State of the art

One of the challenges to the success of veterinary pharmacotherapy is the limited number of drugs and dosage forms available exclusively to this market, due to the interspecies variability of animals, such as anatomy, physiology, pharmacokinetics, and pharmacodynamics. For this reason, studies in this area have become a highlight, since they are still scarce in comparison with those on human drug use. To overcome many limitations related to the bioavailability, efficacy, and safety of pharmacotherapy in animals, especially livestock and domestic animals, polymers-based drug delivery systems are promising tools if they guarantee greater selectivity and less toxicity in dosage forms. In addition, these tools may be developed according to the great interspecies variability. To contribute to these discussions, this paper provides an updated review of the major polymer-based drug delivery systems projected for veterinary use. Traditional and innovative drug delivery systems based on polymers are presented, with an emphasis on films, microparticles, micelles, nanogels, nanoparticles, tablets, implants and hydrogel-based drug delivery systems. We discuss important concepts for the veterinarian about the mechanisms of drug release and, for the pharmacist, the advantages in the development of pharmaceutical forms for the animal population. Finally, challenges and opportunities are presented in the field of pharmaceutical dosage forms for veterinary use in response to the interests of the pharmaceutical industry.

Clinical results of the BoneWelding®Fiji® anchor for the treatment of Stener lesions of the thumb

INTRODUCTION

A new technology (Sportwelding®) was recently presented, which uses ultrasonic energy to meld a resorbable suture anchor at the interface with the host bone. A standardized clinical use was not investigated yet. This study prospectively evaluated the surgical and clinical outcomes of the Fiji Anchor® (Sportwelding®, Schlieren, Switzerland) in the repair of an ulnar collateral ligament lesion of the metacarpophalangeal joint of the thumb.

MATERIAL AND METHODS

The range of motion, grip and pinch strength, disability of arm, shoulder and the hand (DASH) and patient rated evaluation (PRWE) score, pain, satisfaction, complications and adverse events were assessed in 24 patients after surgical treatment for an acute displaced rupture or avulsion of the ulnar collateral metacarpophalangeal ligament of the thumb using the Fiji Anchor® after 6, 12 and 52 weeks.

RESULTS

At final follow up, the range of motion of the metacarpophalangeal joint reached almost the contralateral side (49.3° SD 11.7°). Thumb opposition showed a Kapandji score of 9.7 (SD 0.5; range 9-10). Grip strength, the lateral, tip and the three jaw pinch showed nearly similar values compared to the contralateral side (83-101%). Pain was low (0.2 SD 0.7 at rest and 0.6 SD 1.0 during load). The DASH score was 5.0 (SD 7.3) and the PRWE score was 4.1 (SD 9.0). 81% of patients were very satisfied at final follow-up. Two patients were rated unstable during the follow-up period due to a second traumatic event. Three cases experienced difficulties during anchor insertion, whereby incorrect anchor insertion resulted in damage to the suture material; however, this was resolved after additional training.

CONCLUSION

One advantage of this anchor appears to be its stable fixation in cancellous bone. The surgical treatment of an ulnar collateral ligament lesion of the thumb using the Fiji Anchor® can lead to an excellent clinical outcome with a minor complication rate; however, long-term dangers and the cost effectiveness of the procedure are not known yet.